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Sample records for cervix cancer low-dose

  1. Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Anne Sophie Weingertner

    2009-01-01

    Full Text Available The development of acute myeloid leukaemia after low-dose radioiodine therapy and its presentation as a myeloid sarcoma of the uterine cervix are both rare events. We report a case of acute myeloid leukaemia revealed by a myeloid sarcoma of the uterine cervix in a 48-year-old woman, 17 months after receiving a total dose of 100 mCi 131I for papillary thyroid cancer. A strict hematological follow-up of patients treated with any dose of 131I is recommended to accurately detect any hematological complications which might have been underestimated. Unusual presentations, such as chloroma of the uterine cervix, may reveal myeloid malignancy and should be kept in mind.

  2. Cervix cancer

    International Nuclear Information System (INIS)

    A retrospective and descriptive study was conducted to characterize the behavior of cervix cancer in a sample of 162 patients with this diagnosis during 2003-2009 in the Isla de la Juventud municipality. From the review of case reports from the National Unit of Cancer the individual medical records of Teaching General Hospital of this municipality and from the National Institute of Oncology and Radiology, as well as the deceased persons, it was possible to note that the 63% of cases were women aged 34-57 and that the 20% was in ages outside the screening program. The NIC and/or infection by HPV and smoking were the more frequent risk factors. There was predominance of large cells epidermoid non-keratinized carcinoma and the O stage or in situ. Most of patients were operated on is initial therapy. The great mortality was between fifth and sixth decades of life with a acceptable survival at 5 years

  3. Low dose irradiation reduces cancer mortality rates

    International Nuclear Information System (INIS)

    Low doses of ionizing radiation stimulate development, growth, memory, sensual acuity, fecundity, and immunity (Luckey, T.D., ''Radiation Hormesis'', CRC Press, 1991). Increased immune competence reduces cancer mortality rates and provides increased average lifespan in animals. Decreased cancer mortality rates in atom bomb victims who received low dose irradiation makes it desirable to examine populations exposed to low dose irradiation. Studies with over 300,000 workers and 7 million person-years provide a valid comparison of radiation exposed and control unclear workers (Luckey, T.D., Nurture with Ionizing Radiation, Nutrition and Cancer, 34:1-11, 1999). Careful selection of controls eliminated any ''healthy worker effect''. The person-year corrected average indicated the cancer mortality rate of exposed workers was only 51% that of control workers. Lung cancer mortality rates showed a highly significant negative correlation with radon concentrations in 272,000 U.S. homes (Cohen, B.L., Health Physics 68:157-174, 1995). In contrast, radon concentrations showed no effect on lung cancer rates in miners from different countries (Lubin, J.H. Am. J. Epidemiology 140:323-332, 1994). This provides evidence that excessive lung cancer in miners is caused by particulates (the major factor) or toxic gases. The relative risk for cancer mortality was 3.7% in 10,000 Taiwanese exposed to low level of radiation from 60Co in their steel supported homes (Luan, Y.C. et al., Am. Nuclear Soc. Trans. Boston, 1999). This remarkable finding needs further study. A major mechanism for reduced cancer mortality rates is increased immune competence; this includes both cell and humoral components. Low dose irradiation increases circulating lymphocytes. Macrophage and ''natural killer'' cells can destroy altered (cancer) cells before the mass becomes too large. Low dose irradiation also kills suppressor T-cells; this allows helper T-cells to activate killer cells and antibody producing cells

  4. Low dose irradiation reduces cancer mortality rates

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    Luckey, T.D.

    2000-05-01

    Low doses of ionizing radiation stimulate development, growth, memory, sensual acuity, fecundity, and immunity (Luckey, T.D., ''Radiation Hormesis'', CRC Press, 1991). Increased immune competence reduces cancer mortality rates and provides increased average lifespan in animals. Decreased cancer mortality rates in atom bomb victims who received low dose irradiation makes it desirable to examine populations exposed to low dose irradiation. Studies with over 300,000 workers and 7 million person-years provide a valid comparison of radiation exposed and control unclear workers (Luckey, T.D., Nurture with Ionizing Radiation, Nutrition and Cancer, 34:1-11, 1999). Careful selection of controls eliminated any ''healthy worker effect''. The person-year corrected average indicated the cancer mortality rate of exposed workers was only 51% that of control workers. Lung cancer mortality rates showed a highly significant negative correlation with radon concentrations in 272,000 U.S. homes (Cohen, B.L., Health Physics 68:157-174, 1995). In contrast, radon concentrations showed no effect on hlumg cancer rates in miners from different countries (Lubin, J.H. Am. J. Epidemiology 140:323-332, 1994). This provides evidence that excessive lung cancer in miners is caused by particulates (the major factor) or toxic gases. The relative risk for cancer mortality was 3.7% in 10,000 Taiwanese exposed to low level of radiation from {sup 60}Co in their steel supported homes (Luan, Y.C. et al., Am. Nuclear Soc. Trans. Boston, 1999). This remarkable finding needs further study. A major mechanism for reduced cancer mortality rates is increased immune competence; this includes both cell and humoral components. Low dose irradiation increases circulating lymphocytes. Macrophage and ''natural killer'' cells can destroy altered (cancer) cells before the mass becomes too large. Low dose irradiation also kills suppressor T-cells; this allows

  5. Cancer cervix?: a retrospective study

    International Nuclear Information System (INIS)

    Anemia is very commonly seen in most of the malignancies including cancer cervix. Anemia has long been reported to adversely affect the efficacy of radiation treatment in cervical cancer. At our center, carcinoma cervix accounts for approximately 8-10% of all malignancies. The objective of this study is to see the impact of anemia in the treatment of cancer cervix. In the present study, we collected data of treatment results of FIGO stage II and III cancer cervix patients retrospectively treated in years of 2009-10. We have tried to assess the outcome of results in patients whom haemoglobin (Hb) level < 10 gm/dl and e''10 gm/dl. Out of 200 patients of disease with baseline Hb less than 10 gm/dl, 80(40%) patients had residual disease after 4 weeks of completion of treatment. Out of 168 patients with baseline Hb more than 10 gm/dl, 42(25%) had residual disease (p-0.0012 i.e highly significant). Our study shows that there is a good disease control at local site in patients with higher pretreatment Hb level. Effect of pretreatment Hb on treatment outcome in terms of overall survival, disease free survival, and local relapse free survival along with effect on corrective measures should be studied in detail. (author)

  6. Low dose rate Ir-192 interstitial brachytherapy for prostate cancer

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    Oki, Yosuke; Dokiya, Takushi; Yorozu, Atsunori; Suzuki, Takayuki; Saito, Shiro; Monma, Tetsuo; Ohki, Takahiro [National Tokyo Medical Center (Japan); Murai, Masaru; Kubo, Atsushi

    2000-04-01

    From December 1997 through January 1999, fifteen prostatic cancer patients were treated with low dose rate Ir-192 interstitial brachytherapy using TRUS and perineal template guidance without external radiotherapy. Up to now, as no apparent side effects were found, the safety of this treatment is suggested. In the future, in order to treat prostatic cancer patients with interstitial brachytherapy using I-125 or Pd-103, more investigation for this low dose rate Ir-192 interstitial brachytherapy is needed. (author)

  7. The American Brachytherapy Society recommendations for low-dose-rate brachytherapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: This report presents guidelines for using low-dose-rate (LDR) brachytherapy in the management of patients with cervical cancer. Methods: Members of the American Brachytherapy Society (ABS) with expertise in LDR brachytherapy for cervical cancer performed a literature review, supplemented by their clinical experience, to formulate guidelines for LDR brachytherapy of cervical cancer. Results: The ABS strongly recommends that radiation treatment for cervical carcinoma (with or without chemotherapy) should include brachytherapy as a component. Precise applicator placement is essential for improved local control and reduced morbidity. The outcome of brachytherapy depends, in part, on the skill of the brachytherapist. Doses given by external beam radiotherapy and brachytherapy depend upon the initial volume of disease, the ability to displace the bladder and rectum, the degree of tumor regression during pelvic irradiation, and institutional practice. The ABS recognizes that intracavitary brachytherapy is the standard technique for brachytherapy for cervical carcinoma. Interstitial brachytherapy should be considered for patients with disease that cannot be optimally encompassed by intracavitary brachytherapy. The ABS recommends completion of treatment within 8 weeks, when possible. Prolonging total treatment duration can adversely affect local control and survival. Recommendations are made for definitive and postoperative therapy after hysterectomy. Although recognizing that many efficacious LDR dose schedules exist, the ABS presents suggested dose and fractionation schemes for combining external beam radiotherapy with LDR brachytherapy for each stage of disease. The dose prescription point (point A) is defined for intracavitary insertions. Dose rates of 0.50 to 0.65 Gy/h are suggested for intracavitary brachytherapy. Dose rates of 0.50 to 0.70 Gy/h to the periphery of the implant are suggested for interstitial implant. Use of differential source activity or

  8. Pain management in cancer cervix

    Directory of Open Access Journals (Sweden)

    Palat Gayatri

    2005-01-01

    Full Text Available Cancer of the cervix uteri is a common cause of pain among women. On the physical realm, the cancer may cause somatic [soft tissue and bone], visceral and neuropathic pain [lumbosacral plexopathy]. Radiotherapy and chemotherapy may cause neuropathy too. Psychological, social and cultural factors modify the pain. Evaluation of the individual type of pain and a patient-centred approach are fundamental requirements for rational management. Disease modifying treatment like radiotherapy and chemotherapy must be considered when applicable. Pain control is usually achieved by the use of WHO three-step ladder, remembering that possible association of renal dysfunction would necessitate caution in the use of NSAIDs and opioids. Side effects must be anticipated, prevented when possible, and aggressively treated; nausea and vomiting may already be present, and constipation can worsen pain when there is a pelvic mass. Pain emergencies can be treated by quick titration with intravenous morphine bolus doses. Neuropathic pain may warrant the use of usual adjuvants, with particular reference to cortico-steroids and the NMDA antagonist, ketamine. In intractable pain, many neurolytic procedures are tried, but a solid evidence base to justify their use is lacking. Continuous epidural analgesia with local anaesthetic and opioid may be needed when drug therapy fails, and desperate situations may warrant interventions such as neurolysis. Such physical measures for pain relief must be combined with psychosocial support and adequate explanations to the patient and the family.

  9. Low-dose radiation: a cause of breast cancer

    International Nuclear Information System (INIS)

    It is likely that the breast is the organ most sensitive to radiation carcinogenesis in postpubertal women. Studies of different exposed populations have yielded remarkably consistent results, in spite of wide differences in underlying breast cancer rates and conditions of exposure. Excess risk is approximately proportional to dose, and is relatively independent of ionization density and fractionization of dose. This implies that the risk associated with low-dose exposures to ionizing radiation can be estimated with some confidence from higher-dose data. Excess risk is heavily dependent on age at exposure but relatively independent of population differences in normal risk. The temporal patterns after exposure of both radiation-induced and naturally occurring breast cancer are similar, suggesting a strong influence of factors other than radiation on radiation-induced breast cancer. Uncertainties remain about risks from exposures before puberty and after menopause

  10. Screening for lung cancer with low-dose computed tomography

    International Nuclear Information System (INIS)

    Lung cancer is the most common cause of death from malignancy. It is characterized by a favourable prognosis when treated in early stages and a poor prognosis in advanced stages. Populations at risk are relatively well defined, i.e. heavy smokers and workers exposed to asbestos and radon. Therefore, early detection using diagnostic techniques promises reduction of mortality from this tumor. Previous studies using chest radiography and sputum cytology were, however, disappointing due to poor sensitivity of these tests for early tumor stages. The new technique of low-dose computed tomography provides both high sensitivity for small tumors and a comfortable examination. As small benign pulmonary nodules are common reliable non-invasive diagnostic algorithms are required for classification of nodules. Preliminary studies using low-dose CT screening in smokers have provided promising results. Prior to a wide application of the technique in clinical routine more data are required as to inclusion criteria, examination intervals and the effect of screening on mortality reduction. (orig.)

  11. Treatment Outcome of Medium-Dose-Rate Intracavitary Brachytherapy for Carcinoma of the Uterine Cervix: Comparison With Low-Dose-Rate Intracavitary Brachytherapy

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    Kaneyasu, Yuko, E-mail: kaneyasu@hiroshima-u.ac.jp [Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan); Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Kita, Midori [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Department of Clinical Radiology, Tokyo Metropolitan Tama Medical Center, Tokyo (Japan); Okawa, Tomohiko [Evaluation and Promotion Center, Utsunomiya Memorial Hospital, Tochigi (Japan); Maebayashi, Katsuya [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan); Kohno, Mari [Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women' s Medical University Hospital, Tokyo (Japan); Sonoda, Tatsuo; Hirabayashi, Hisae [Department of Radiology, Tokyo Women' s Medical University Hospital, Tokyo (Japan); Nagata, Yasushi [Department of Radiation Oncology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

    2012-09-01

    Purpose: To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer. Methods and Materials: We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women's Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA. Results: The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences. Conclusion: These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.

  12. Treatment Outcome of Medium-Dose-Rate Intracavitary Brachytherapy for Carcinoma of the Uterine Cervix: Comparison With Low-Dose-Rate Intracavitary Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To evaluate and compare the efficacy of medium-dose-rate (MDR) and low-dose-rate (LDR) intracavitary brachytherapy (ICBT) for uterine cervical cancer. Methods and Materials: We evaluated 419 patients with squamous cell carcinoma of the cervix who were treated by radical radiotherapy with curative intent at Tokyo Women’s Medical University from 1969 to 1999. LDR was used from 1969 to 1986, and MDR has been used since July 1987. When compared with LDR, fraction dose was decreased and fraction size was increased (1 or 2 fractions) for MDR to make the total dose of MDR equal to that of LDR. In general, the patients received a total dose of 60 to 70 Gy at Point A with external beam radiotherapy combined with brachytherapy according to the International Federation of Gynecology and Obstetrics stage. In the LDR group, 32 patients had Stage I disease, 81 had Stage II, 182 had Stage III, and 29 had Stage IVA; in the MDR group, 9 patients had Stage I disease, 19 had Stage II, 55 had Stage III, and 12 had Stage IVA. Results: The 5-year overall survival rates for Stages I, II, III, and IVA in the LDR group were 78%, 72%, 55%, and 34%, respectively. In the MDR group, the 5-year overall survival rates were 100%, 68%, 52%, and 42%, respectively. No significant statistical differences were seen between the two groups. The actuarial rates of late complications Grade 2 or greater at 5 years for the rectum, bladder, and small intestine in the LDR group were 11.1%, 5.8%, and 2.0%, respectively. The rates for the MDR group were 11.7%, 4.2%, and 2.6%, respectively, all of which were without statistical differences. Conclusion: These data suggest that MDR ICBT is effective, useful, and equally as good as LDR ICBT in daytime (about 5 hours) treatments of patients with cervical cancer.

  13. Law 16.097 Prevention program of uterine cervix cancer in Uruguay: Uterine cervix cancer

    International Nuclear Information System (INIS)

    Every year in Uruguay, is diagnosed around 600 new cases of cancer of uterine cervix. Next important information was related on this cancer and the evolution that will have the carrying of this illness, it was informed about the prevention, symptoms, I diagnose and treatment of the same one

  14. In vivo Raman spectroscopy of cervix cancers

    Science.gov (United States)

    Rubina, S.; Sathe, Priyanka; Dora, Tapas Kumar; Chopra, Supriya; Maheshwari, Amita; Krishna, C. Murali

    2014-03-01

    Cervix-cancer is the third most common female cancer worldwide. It is the leading cancer among Indian females with more than million new diagnosed cases and 50% mortality, annually. The high mortality rates can be attributed to late diagnosis. Efficacy of Raman spectroscopy in classification of normal and pathological conditions in cervix cancers on diverse populations has already been demonstrated. Our earlier ex vivo studies have shown the feasibility of classifying normal and cancer cervix tissues as well as responders/non-responders to Concurrent chemoradiotherapy (CCRT). The present study was carried out to explore feasibility of in vivo Raman spectroscopic methods in classifying normal and cancerous conditions in Indian population. A total of 182 normal and 132 tumor in vivo Raman spectra, from 63 subjects, were recorded using a fiberoptic probe coupled HE-785 spectrometer, under clinical supervision. Spectra were acquired for 5 s and averaged over 3 times at 80 mW laser power. Spectra of normal conditions suggest strong collagenous features and abundance of non-collagenous proteins and DNA in case of tumors. Preprocessed spectra were subjected to Principal Component-Linear Discrimination Analysis (PCLDA) followed by leave-one-out-cross-validation. Classification efficiency of ~96.7% and 100% for normal and cancerous conditions respectively, were observed. Findings of the study corroborates earlier studies and suggest applicability of Raman spectroscopic methods in combination with appropriate multivariate tool for objective, noninvasive and rapid diagnosis of cervical cancers in Indian population. In view of encouraging results, extensive validation studies will be undertaken to confirm the findings.

  15. Continuous Low-Dose Oral Chemotherapy in Recurrent and Persistent Carcinoma of Cervix Following Chemoradiation: A Comparative Study Between Prolonged Oral Cyclophosphamide and Oral Etoposide

    OpenAIRE

    Upasana Baruah; Debabrata Barmon; Munlima Hazarika; Pankaj Deka; Amal Chandra Kataki; Sushruta Shrivastava

    2014-01-01

    Aim: To compare the efficacy and toxicities of low-dose oral cyclophosphamide and oral etoposide in patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy. Materials and Methods: 30 patients with recurrent and persistent cervical cancer with gross pelvic disease were enrolled in this trial. The patients were randomly divided into two groups of 15 patients each with one group receiving low dose oral cyclophosphamide ...

  16. Arsenic, mode of action at biologically plausible low doses: What are the implications for low dose cancer risk?

    International Nuclear Information System (INIS)

    Arsenic is an established human carcinogen. However, there has been much controversy about the shape of the arsenic response curve, particularly at low doses. This controversy has been exacerbated by the fact that the mechanism(s) of arsenic carcinogenesis are still unclear and because there are few satisfactory animal models for arsenic-induced carcinogenesis. Recent epidemiological studies have shown that the relative risk for cancer among populations exposed to ≤60 ppb As in their drinking water is often lower than the risk for the unexposed control population. We have found that treatment of human keratinocyte and fibroblast cells with 0.1 to 1 μM arsenite (AsIII) also produces a low dose protective effect against oxidative stress and DNA damage. This response includes increased transcription, protein levels and enzyme activity of several base excision repair genes, including DNA polymerase β and DNA ligase I. At higher concentrations (> 10 μM), As induces down-regulation of DNA repair, oxidative DNA damage and apoptosis. This low dose adaptive (protective) response by a toxic agent is known as hormesis and is characteristic of many agents that induce oxidative stress. A mechanistic model for arsenic carcinogenesis based on these data would predict that the low dose risk for carcinogenesis should be sub-linear. The threshold dose where toxicity outweighs protection is hard to predict based on in vitro dose response data, but might be estimated if one could determine the form (metabolite) and concentration of arsenic responsible for changes in gene regulation in the target tissues

  17. Risk of cancer subsequent to low-dose radiation

    International Nuclear Information System (INIS)

    The author puts low dose irradiation risks in perspective using average background radiation doses for standards. He assailed irresponsible media coverage during the height of public interest in the Three-Mile Island Reactor incident

  18. Implications of effects ''adaptive response'', ''low-dose hypersensitivity'' und ''bystander effect'' for cancer risk at low doses and low dose rates

    International Nuclear Information System (INIS)

    A model for carcinogenesis (the TSCE model) was applied in order to examine the effects of ''Low-dose hypersensitivity (LDH)'' and the ''Bystander effect (BE)'' on the derivation of radiation related cancer mortality risks. LDH has been discovered to occur in the inactivation of cells after acute exposure to low LET radiation. A corresponding version of the TSCE model was applied to the mortality data on the Abomb survivors from Hiroshima and Nagasaki. The BE has been mainly observed in cells after exposure to high LET radiation. A Version of the TSCE model which included the BE was applied to the data on lung cancer mortality from the workers at the Mayak nuclear facilities who were exposed to Plutonium. In general an equally good description of the A-bomb survivor mortality data (for all solid, stomach and lung tumours) was found for the TSCE model and the (conventional) empirical models but fewer parameters were necessary for the TSCE model. The TSCE model which included the effects of radiation induced cell killing resulted in non-linear dose response curves with excess relative risks after exposure at young ages that were generally lower than in the models without cell killing. The main results from TSCE models which included cell killing described by either conventional survival curves or LDH were very similar. A sub multiplicative effect from the interaction of smoking and exposure to plutonium was found to result from the analysis of the Mayak lung cancer mortality data. All models examined resulted in the predominant number of Mayak lung cancer deaths being ascribed to smoking. The interaction between smoking and plutonium exposures was found to be the second largest effect. The TSCE model resulted in lower estimates for the lung cancer excess relative risk per unit plutonium dose than the empirical risk model, but this difference was not found to be statistically significant. The excess relative risk dose responses were linear in the empirical model and

  19. Low-dose CT scan screening for lung cancer: comparison of images and radiation doses between low-dose CT and follow-up standard diagnostic CT

    OpenAIRE

    ONO, KOJI; Hiraoka, Toru; Ono, Asami; Komatsu, Eiji; Shigenaga, Takehiko; Takaki, Hajime; Maeda, Toru; Ogusu, Hiroyuki; Yoshida, Shintaro; Fukushima, Kiyoyasu; Kai, Michiaki

    2013-01-01

    Objectives This study aim to compare image quality and radiation doses between low-dose CT and follow-up standard diagnostic CT for lung cancer screening. Methods In a single medical institution, 19 subjects who had been screened for lung cancer by low-dose CT before going through follow-up standard diagnostic CT were randomly selected. Both CT image sets for all subjects were independently evaluated by five specialized physicians. Results There were no significant differences between low-dos...

  20. 20 percent lower lung cancer mortality with low-dose CT vs chest X-ray

    Science.gov (United States)

    Scientists have found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray.

  1. Low-dose capecitabine (Xeloda) for treatment for gastrointestinal cancer

    OpenAIRE

    Miger, Jasmine; Holmqvist, Annica; Sun, Xiao-Feng; Albertsson, Maria

    2014-01-01

    The prodrug capecitabine (Xeloda) has been an important drug for treatment for gastrointestinal cancer (GI-cancer). This study explores the efficacy of continuous metronomic Xeloda, as well as tolerability and best response during treatment. Patients (n = 35) with stage IV GI-cancer were included in the study and were divided into two groups; upper (n = 13) and lower (n = 22) GI-cancer. All patients were given continuous metronomic Xeloda (500 mg × 2). Best response was measured by radiologic...

  2. Accelerated hyperfractionated radiotherapy for locally advanced cervix cancer

    International Nuclear Information System (INIS)

    Purpose: A phase II trial was designed to evaluate the toxicity and outcome of patients with locally advanced cervix cancer treated with accelerated hyperfractionated radiotherapy (AHFX). Methods and Materials: In this prospective trial, AHFX doses of 1.25 Gy were administered twice daily at least 6 hours apart to a total pelvic dose of 57.5 Gy. A booster dose was then administered via either low-dose rate brachytherapy or external beam therapy to a smaller volume. All patients were accrued and treated at Peter MacCallum Cancer Institute (PMCI) between 1986 until April 1991. Results: Sixty-one eligible patients were enrolled in this protocol; 2 (3.2%) had Stage IIB; 42 (68.9%) had Stage III; 8 (13.1%) had Stage IV and 9 (14.8%) had recurrent cervical cancer. Fifty-two patients (85%) completed the planned external beam without a treatment break. Thirty patients had acute toxicity that required regular medication. One patient died of acute treatment related toxicity. Fifty-five patients received booster therapy: 45 with intrauterine brachytherapy, 6 with interstitial brachytherapy, and 4 with external beam. The median follow-up of surviving patients was 6 years. Overall 5-year survival is 27% and 5-year relapse free survival is 36%. Nineteen patients died with pelvic disease and the actuarial local control rate was 66%. There were 8 severe late complications observed in 7 patients. Seven required surgical intervention (an actuarial rate of 27%). Five patients also required total hip replacement. Conclusions: The local control rate was favorable compared with other series that have used standard fractionation, although overall survival remained similar. The severe late complication rate was high for this protocol and higher than similar protocols reported in the literature

  3. Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: A comparative study between prolonged oral cyclophosphamide and oral etoposide

    Directory of Open Access Journals (Sweden)

    Upasana Baruah

    2014-01-01

    Full Text Available Aim: To compare the efficacy and toxicities of low-dose oral cyclophosphamide and oral etoposide in patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy. Materials and Methods: 30 patients with recurrent and persistent cervical cancer with gross pelvic disease were enrolled in this trial. The patients were randomly divided into two groups of 15 patients each with one group receiving low dose oral cyclophosphamide (100 mg/day and the other group receiving low-dose oral etoposide (50 mg/day. Results were statistically analysed by IBM SPSS Statistics 19. Results: Oral etoposide was not well tolerated with grade 2 neutropenia occurring in 33.3% and grade 3 neutropenia in 6.6% and thrombocytopenia occurring in 13.3%. Oral cyclophosphamide group on the other hand was better tolerated with none of the patients having thrombocytopenia and 6.6% patients having grade 2 neutropenia. There were two complete response (15.38% and one partial response at the end of study (7.6% in the cyclophosphamide group whereas there was no complete response and two partial response (16.6% in the oral etoposide group. Conclusion: Long-term, low-dose oral etoposide was found to be less tolerated without any significant effect with patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy in contrast to oral cyclophosphamide which was found to be effective and well-tolerated by the patients.

  4. Low Dose Radiation Cancer Risks: Epidemiological and Toxicological Models

    Energy Technology Data Exchange (ETDEWEB)

    David G. Hoel, PhD

    2012-04-19

    The basic purpose of this one year research grant was to extend the two stage clonal expansion model (TSCE) of carcinogenesis to exposures other than the usual single acute exposure. The two-stage clonal expansion model of carcinogenesis incorporates the biological process of carcinogenesis, which involves two mutations and the clonal proliferation of the intermediate cells, in a stochastic, mathematical way. The current TSCE model serves a general purpose of acute exposure models but requires numerical computation of both the survival and hazard functions. The primary objective of this research project was to develop the analytical expressions for the survival function and the hazard function of the occurrence of the first cancer cell for acute, continuous and multiple exposure cases within the framework of the piece-wise constant parameter two-stage clonal expansion model of carcinogenesis. For acute exposure and multiple exposures of acute series, it is either only allowed to have the first mutation rate vary with the dose, or to have all the parameters be dose dependent; for multiple exposures of continuous exposures, all the parameters are allowed to vary with the dose. With these analytical functions, it becomes easy to evaluate the risks of cancer and allows one to deal with the various exposure patterns in cancer risk assessment. A second objective was to apply the TSCE model with varing continuous exposures from the cancer studies of inhaled plutonium in beagle dogs. Using step functions to estimate the retention functions of the pulmonary exposure of plutonium the multiple exposure versions of the TSCE model was to be used to estimate the beagle dog lung cancer risks. The mathematical equations of the multiple exposure versions of the TSCE model were developed. A draft manuscript which is attached provides the results of this mathematical work. The application work using the beagle dog data from plutonium exposure has not been completed due to the fact

  5. Postirradiation sarcoma (malignant fibrous histiocytoma) following cervix cancer

    International Nuclear Information System (INIS)

    A case of postirradiation sarcoma is described. The tumor, a malignant fibrous histiocytoma, occurred in the radiation field 11 years following postoperative external beam radiation therapy (7,000 rad) for carcinoma of the cervix. Reports of postirradiation malignant fibrous histiocytoma are rare, and the occurrence of this neoplasm following treatment for cervix cancer has not previously been described. The literature concerning postirradiation bone and soft tissue sarcomas is briefly reviewed, with special attention to malignant fibrous histiocytomas. (author)

  6. Low-dose aspirin or other nonsteroidal anti-inflammatory drug use and prostate cancer risk

    DEFF Research Database (Denmark)

    Skriver, Charlotte; Dehlendorff, Christian; Borre, Michael;

    2016-01-01

    PURPOSE: Increasing evidence suggests that aspirin use may protect against prostate cancer. In a nationwide case-control study, using Danish high-quality registry data, we evaluated the association between the use of low-dose aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) and the...... risk of prostate cancer. METHODS: We identified 35,600 patients (cases) with histologically verified prostate cancer during 2000-2012. Cases were matched to 177,992 population controls on age and residence by risk-set sampling. Aspirin and nonaspirin NSAID exposure was defined by type, estimated dose......, duration, and consistency of use. We used conditional logistic regression to estimate odds ratios (ORs), with 95 % confidence intervals (CIs), for prostate cancer associated with low-dose aspirin (75-150 mg) or nonaspirin NSAID use, adjusted for potential confounders. RESULTS: Use of low-dose aspirin was...

  7. Low-dose paclitaxel modulates tumour fibrosis in gastric cancer

    OpenAIRE

    TSUKADA, TOMOYA; Fushida, Sachio; Harada, Shinichi; Terai, Shiroh; Yagi, Yasumichi; Kinoshita, Jun; OYAMA, KATSUNOBU; Tajima, Hidehiro; NINOMIYA, ITASU; FUJIMURA, TAKASHI; Ohta, Tetsuo

    2013-01-01

    Various treatments have been used for peritoneal dissemination, which is the most common mode of metastasis in gastric cancer, but sufficiently good clinical outcomes have not yet been obtained because of the presence of rich fibrous components and acquired drug resistance. Epithelialmesenchymal transition (EMT) is one of the major causes of tissue fibrosis and transforming growth factor-β (TGF-β) has a pivotal function in the progression of EMT. Smad proteins play an important role in the TG...

  8. Risk of breast cancer following low-dose radiation exposure

    International Nuclear Information System (INIS)

    Risk of breast cancer following radiation exposure was studied, based on surveys of tuberculosis patients who had multiple fluoroscopic examinations of the chest, mastitis patients given radiotherapy, and atomic bomb survivors. Analysis suggests that the risk is greatest for persons exposed as adolescents, although exposure at all ages carries some risk. The dose-response relationship was consistent with linearity in all studies. Direct evidence of radiation risk at doses under 0.5 Gy (50 rad) is apparent among A-bomb survivors. Fractionation does not appear to diminish risk, nor does time since exposure (even after 45 years of observation). The interval between exposure and the clinical appearance of radiogenic breast cancer may be mediated by hormonal or other age-related factors but is unrelated to dose. Age-specific absolute risk estimtes for all studies are remarkably similar. The best estimate of risk among American women exposed after age 20 is 6.6 excess cancers/104 WY-Gy

  9. Cancer risk from low doses of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Auvinen, A.

    1997-06-01

    The aim of the study was to estimate cancer risk from small doses of ionizing radiation from various sources, including both external and internal exposure. The types of radiation included alpha, gamma, and neutron radiation. A nationwide follow-up study covering the years up to 1992 revealed no significant association between fallout from the Chernobyl accident and incidence of childhood leukemia. An excess of eight cases or more per year could be excluded. However, some indication of an increase was evident in the most heavily affected areas. Furthermore, the risk estimates were in accordance with those reported from Hiroshima and Nagasaki, although the confidence intervals were wide. (282 refs.).

  10. Cancer risk from low doses of ionizing radiation

    International Nuclear Information System (INIS)

    The aim of the study was to estimate cancer risk from small doses of ionizing radiation from various sources, including both external and internal exposure. The types of radiation included alpha, gamma, and neutron radiation. A nationwide follow-up study covering the years up to 1992 revealed no significant association between fallout from the Chernobyl accident and incidence of childhood leukemia. An excess of eight cases or more per year could be excluded. However, some indication of an increase was evident in the most heavily affected areas. Furthermore, the risk estimates were in accordance with those reported from Hiroshima and Nagasaki, although the confidence intervals were wide. (282 refs.)

  11. Spectrum of early lung cancer presentation in low-dose screening CT: a pictorial review.

    Science.gov (United States)

    Rampinelli, Cristiano; Calloni, Sonia Francesca; Minotti, Marta; Bellomi, Massimo

    2016-06-01

    The typical presentation of early stage lung cancers on low-dose CT screening are non-calcified pulmonary nodules. However, there is a wide spectrum of unusual focal abnormalities that can be early presentations of lung cancer. These abnormalities include, for example, cancers associated with 'cystic airspaces' or scar-like cancers. The detection of lung cancer with low-dose CT can be affected by the absence of intravenous contrast medium. As a consequence, endobronchial and central lesions can be difficult to recognize, raising the potential for missed cancers. Focal lesions arising within pre-existing lung disease, such as lung fibrosis or apical scars, can also be early lung cancer manifestations and deserve particular consideration as recognition of these lesions may be hindered by the underlying disease. Furthermore, the unpredictable growth rate of lung cancer, which ranges from indolent to aggressive cancers, necessitates attention to the wide spectrum of progression in lung cancer appearance on serial low-dose CT scans. In this pictorial review we discuss the spectrum of early lung cancer presentation in low-dose CT screening, highlighting typical as well as unusual radiological features and the varied growth rates of early lung cancer. Teaching Points • There is a wide spectrum of early presentations of lung cancer on LDCT. • Low radiation dose and the absence of contrast medium injection can affect lung cancer detection. • Lung cancer growth shows various behaviours, ranging from indolent to aggressive cancers. • Familiarity with LDCT technique can improve CT screening effectiveness and avoid missed diagnosis. PMID:27188380

  12. Tumour size in cancer of the cervix

    International Nuclear Information System (INIS)

    In a randomized trial comprising 204 patients with operable cervical carcinomas stages I and II, two low-dose rates in gynaecological brachytherapy were compared. Treatment consisted of Cs-137 uterovaginal application followed by surgery (either immedidate or delayed). The results for the two dose rates have been published previously. The present paper concerns the correlation between outcome and tumour size. Tumour size was carefully estimated in two ways: by clinical examination under general anaesthesia and by measurements on the customized vaginal mould used for the brachytherapy. Ninety-one patients (45%) were classified as stage I, and 113 were classified as stage II proximal. The mean tumour size was 39 mm (range 15-64 mm). Cox's multivariate analysis indicated that the factors with a poor prognostic value were for survival: node involvement (N+) (p<0.001), large tumour size (T+) (p<0.001); for local control; N+ (p=0.0001); for metastasis and regional relapse: N+ (p<0.001) and T+ (p<0.001). Stage was not a prognostic factor over the present range in either univariate or multivariate analysis. In this series tumour size is a powerful independent prognostic factor. It is therefore suggested that for the classification of cervical cancer and the indications for surgical staging and adjuvant treatment, tumour size should be taken into account. (orig.)

  13. Low-dose aspirin use and the risk of ovarian cancer in Denmark

    DEFF Research Database (Denmark)

    Baandrup, Lone; Kjaer, S K; Olsen, J H;

    2015-01-01

    BACKGROUND: A comprehensive body of evidence has shown that aspirin has cancer-preventive effects, particularly against gastrointestinal cancer, but its effects on the risk of ovarian cancer are less well established. This nationwide case-control study examined the association between low...... were seen for mucinous and endometrioid tumours. CONCLUSION: This nationwide case-control study indicates that low-dose aspirin use may be associated with a reduced risk of epithelial ovarian cancer....... regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for the association between low-dose aspirin use and the risk of epithelial ovarian cancer, both overall and for specific histological types. RESULTS: For 4103 ovarian cancer cases and 58 706 population controls, the...

  14. Cancer risk at low doses of ionizing radiation: artificial neural networks inference from atomic bomb survivors.

    Science.gov (United States)

    Sasaki, Masao S; Tachibana, Akira; Takeda, Shunichi

    2014-05-01

    Cancer risk at low doses of ionizing radiation remains poorly defined because of ambiguity in the quantitative link to doses below 0.2 Sv in atomic bomb survivors in Hiroshima and Nagasaki arising from limitations in the statistical power and information available on overall radiation dose. To deal with these difficulties, a novel nonparametric statistics based on the 'integrate-and-fire' algorithm of artificial neural networks was developed and tested in cancer databases established by the Radiation Effects Research Foundation. The analysis revealed unique features at low doses that could not be accounted for by nominal exposure dose, including (i) the presence of a threshold that varied with organ, gender and age at exposure, and (ii) a small but significant bumping increase in cancer risk at low doses in Nagasaki that probably reflects internal exposure to (239)Pu. The threshold was distinct from the canonical definition of zero effect in that it was manifested as negative excess relative risk, or suppression of background cancer rates. Such a unique tissue response at low doses of radiation exposure has been implicated in the context of the molecular basis of radiation-environment interplay in favor of recently emerging experimental evidence on DNA double-strand break repair pathway choice and its epigenetic memory by histone marking. PMID:24366315

  15. Cancer risk at low doses of ionizing radiation. Artificial neural networks inference from atomic bomb survivors

    International Nuclear Information System (INIS)

    Cancer risk at low doses of ionizing radiation remains poorly defined because of ambiguity in the quantitative link to doses below 0.2 Sv in atomic bomb survivors in Hiroshima and Nagasaki arising from limitations in the statistical power and information available on overall radiation dose. To deal with these difficulties, a novel nonparametric statistics based on the ‘integrate-and-fire’ algorithm of artificial neural networks was developed and tested in cancer databases established by the Radiation Effects Research Foundation. The analysis revealed unique features at low doses that could not be accounted for by nominal exposure dose, including (1) the presence of a threshold that varied with organ, gender and age at exposure, and (2) a small but significant bumping increase in cancer risk at low doses in Nagasaki that probably reflects internal exposure to 239Pu. The threshold was distinct from the canonical definition of zero effect in that it was manifested as negative excess relative risk, or suppression of background cancer rates. Such a unique tissue response at low doses of radiation exposure has been implicated in the context of the molecular basis of radiation–environment interplay in favor of recently emerging experimental evidence on DNA double-strand break repair pathway choice and its epigenetic memory by histone marking. (author)

  16. Cancer risk at low doses of ionizing radiation: artificial neural networks inference from atomic bomb survivors

    OpenAIRE

    Sasaki, Masao S.; Tachibana, Akira; Takeda, Shunichi

    2013-01-01

    Cancer risk at low doses of ionizing radiation remains poorly defined because of ambiguity in the quantitative link to doses below 0.2 Sv in atomic bomb survivors in Hiroshima and Nagasaki arising from limitations in the statistical power and information available on overall radiation dose. To deal with these difficulties, a novel nonparametric statistics based on the ‘integrate-and-fire’ algorithm of artificial neural networks was developed and tested in cancer databases established by the R...

  17. Cancer risk at low doses of ionizing radiation: artificial neural networks inference from atomic bomb survivors.

    OpenAIRE

    Sasaki, Masao S.; Tachibana, Akira; Takeda, Shunichi

    2014-01-01

    Cancer risk at low doses of ionizing radiation remains poorly defined because of ambiguity in the quantitative link to doses below 0.2 Sv in atomic bomb survivors in Hiroshima and Nagasaki arising from limitations in the statistical power and information available on overall radiation dose. To deal with these difficulties, a novel nonparametric statistics based on the 'integrate-and-fire' algorithm of artificial neural networks was developed and tested in cancer databases established by the R...

  18. Hypoxia and metastasis in an orthotopic cervix cancer xenograft model

    International Nuclear Information System (INIS)

    Background: Hypoxia can promote tumor metastasis by mechanisms that are believed to result from changes in gene expression. The current study examined the role of putative metastatic genes regulated by cyclic hypoxia in relation to metastasis formation in orthotopic models of cervix cancer. Methods: Orthotopic tumors derived from ME180 human cervix cancer cells or from early generation human cervix cancer xenografts were exposed to cyclic hypoxic conditions during growth in vivo and tumor growth and lymphnode metastases were monitored. Expression of the chemokine receptor CXCR4 and various genes in the Hedgehog (Hh) pathway were inhibited using genetic (inducible shRNA vs CXCR4) small molecule (AMD3100) or antibody (5E1) treatment (CXCR4 and Hh genes, respectively) during tumor growth. Results: As reported previously, exposure of tumor bearing mice to cyclic hypoxia caused a reduction of tumor growth but a large increase in metastasis. Inhibition of CXCR4 or Hh gene activity during tumor growth further reduced primary tumor size and reduced lymphatic metastasis to levels below those seen in control mice exposed to normoxic conditions. Conclusion: Blocking CXCR4 or Hh gene expression are potential therapeutic pathways for improving cervix cancer treatment

  19. Early detection of lung cancer using low-dose CT: an update

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of death from malignancy. Due to a lack of early symptoms patients usually undergo therapy at advanced tumor stages when prognosis is poor. Feasibility studies of low-dose spiral CT screening of heavy smokers have shown that many small, resectable lung cancers can be diagnosed at early stages using simple diagnostic algorithms based on size and attenuation of detected pulmonary nodules with a small proportion of invasive procedures for benign lesions. Preliminary results of repeat screening confirms small size and favourable stage distribution of detected cancers, using even simpler diagnostic algorithms: additional diagnostic procedures are only required in new or growing nodules whereas follow-up with low-dose CT is sufficient in nodules that appear unchanged to exclude slow growth. However, mortality reduction by lung cancer screening with low-dose CT has yet to be demonstrated. Several randomised controlled trials are under way to assess possible mortality reduction by comparison of mortalities in a screening group and a control group. It is hoped that through international cooperation data from these trials can be pooled to allow for statistically significant conclusions as early as possible. (orig.)

  20. Cancer and non-cancer risk at low doses of radiation: biological basis of radiation-environment interplay

    International Nuclear Information System (INIS)

    Cancer and non-cancer risk at low doses of ionizing radiation remains poorly defined due to ambiguity at low doses caused by limitations in statistical power and information available on interplay with environment. To deal with these problems, a novel non-parametric statistics was developed based on artificial neural networks theorem and applied to cancer and non-cancer risk in A-bomb survivors. The analysis revealed several unique features at low doses that could not be accounted for by nominal radiation dose alone. They include (1) threshold that varies with organ, gender and age, including cardiovascular diseases, (2) prevalence of infectious diseases, and (3) suppression of pathogenesis of HTLV1. The threshold is unique as it is manifested as negative excess relative risk, a reduction of spontaneous rate at low doses. The response is consistent with currently emerging laboratory data on DNA double-strand break (DSB) repair pathway choice and its sustainability as epigenetic memory in accordance with histone code theory. In response to DSB, of radiation or DNA replication arrest origin, distinct and competitively operating repair pathways are instigated. Activation by low doses of restitution-directed canonical non-homologous end-joining (C-NHEJ) suppresses both error-prone alternative end-joining (Alt-NHEJ) and homologous recombination (HR). The latter two present major pathways to mutagenesis at stalled replication folk associated with endogenous and exogenous genotoxin such as tobacco smoke metabolites and AID-associated somatic hypermutation and class switch recombination in Ig gene. Suppression of these error-prone pathways by low doses of low LET radiation is consistent with the reduction of cancer occurrence by environmental genotoxin, immunodiversity and stable integration of retrovirus DNA, providing a significant modulator of dose linearity at low doses. Whole picture may bring about a new landscape of cancer and non-cancer molecular epidemiology which

  1. More than lung cancer: Automated analysis of low-dose screening CT scans

    OpenAIRE

    Mets, O.M.

    2012-01-01

    Smoking is a major health care problem and is projected to cause over 8 million deaths per year worldwide in the coming decades. To reduce lung cancer mortality in heavy smokers, several randomized screening trials were initiated in the past years using screening with low-dose Computed Tomography (CT). Recently, the National Lung Screening Trial (NLST), which was performed in the United States of America and compared about 25,000 participants screened with CT against 25,000 participants scree...

  2. Whole-body low dose radiation promotes the efficiency of conventional radiotherapy of cancer

    International Nuclear Information System (INIS)

    Full text: Radiotherapy is the most commonly used local treatment of cancer. However, the large dose needed for local control often limits its successful use. In view of the stimulatory effect of low dose radiation (LDR) on anticancer immunity an experimental study of the effect of whole-body LDR on the outcome of conventional local radiotherapy of cancer was designed with an aim at reducing the total dose and promoting treatment efficiency. With a Lewis lung cancer model in mice it was observed that a regimen of 2 Gy x 3 per week for 2 weeks with a total local dose of 12 Gy resulted in only 23% reduction of tumor volume in 1 month as| compared with untreated control, while substitution of the second, third, fifth and sixth doses of 2 Gy with whole-body irradiation (WBI) of 0.075 Gy with a total local dose of 4 Gy plus 0.3 Gy WBI caused a 69% reduction of tumor volume in the same period. Since gene therapy with Egr-IL-18-B7.1 in combination with local X-rays showed better control of mouse I melanoma than local radiotherapy alone, a trial was made with this plasmid in the above Lewis lung cancer model. The results showed that in the 12 Gy protocol the tumor volume) reduction was 42% and in the 4 Gy local plus 0.3 Gy WBI protocol the tumor volume reduction was 77% in one month. This better control of cancer growth was apparently related to the stimulation of anticancer immunity by WBI with low doses and facilitation of IL-18) and B7.1 expression from the cancer cells in the gene therapy group resulting in up-regulation of immunity. It is concluded that WBI with low doses in combination with conventional radiotherapy exerts a significant promoting effect manifested in reduction in local radiation dose and improvement in tumor control

  3. Outcomes of low-dose-rate brachytherapy for treatment of tongue cancer

    International Nuclear Information System (INIS)

    Between 1997 and 2006, 324 patients with T1-2 tongue cancer were treated with low-dose-rate brachytherapy at Tokyo Medical and Dental University Hospital. Their 5- and 10-year local control rates were 83% and 80%, respectively, and the occurrence rates of ≥ grade 3 mucositis and osteonecrosis were both 0.3%. During the study period, 9 other patients with tongue cancer underwent surgery and brachytherapy for positive surgical margins at our institution. Their 5- and 10-year local control rates were 76% and 64%. Moreover, 24 patients with tongue cancer received chemotherapy followed by brachytherapy, and their 5- and 10-year local control rates were both 100%. These outcomes are comparable to those of the patients who underwent low-dose-rate brachytherapy for T1-2 tongue cancer. In this study, 80% of patients treated by brachytherapy for T1-2 tongue cancer were cured with preserved function. However, for some patients with tumors unsuitable for treatment by brachytherapy alone, a combination of brachytherapy and surgery or chemotherapy may be a suitable treatment option. (author)

  4. Screening of cancer cervix: Pap smear in rural India

    OpenAIRE

    Parimala A; Nidhi Sharma; Jayashree K. Srinivasan

    2016-01-01

    Background: The incidence of cervical premalignant lesions in rural India is likely to be high due to presence of several risk factors like early marriage, early coitarche and multiparity. Hence prospective cross sectional study was conducted to find the incidence of pre-invasive state and cancer of cervix in women between the age group 30 and 60 years, visiting Thirumazhisai health centre by Pap's smear method. Methods: Cervical mucosa is scraped, using Ayre spatula a 360 and deg; tu...

  5. Reviewing risks and benefits of low-dose computed tomography screening for lung cancer.

    Science.gov (United States)

    Chopra, Ishveen; Chopra, Avijeet; Bias, Thomas K

    2016-01-01

    Lung cancer is the third most common cancer among men and women and is one of the leading causes of cancer-related mortality. Diagnosis at an early stage has been suggested crucial for improving survival in individuals at high-risk of lung cancer. One potential facilitator to early diagnosis is low-dose computed tomography (LDCT). The United States Preventive Services Task Force guidelines call for annual LDCT screening for individuals at high-risk of lung cancer. This recommendation was based on the effectiveness of LDCT in early diagnosis of lung cancer, as indicated by the findings from the National Lung Screening Trial conducted in 2011. Although lung cancer accounts for more than a quarter of all cancer deaths in the United States and LDCT screening shows promising results regarding early lung cancer diagnosis, screening for lung cancer remains controversial. There is uncertainty about risks, cost-effectiveness, adequacy of evidence, and application of screening in a clinical setting. This narrative review provides an overview of risks and benefits of LDCT screening for lung cancer. Further, this review discusses the potential for implementation of LDCT in clinical setting. PMID:26680693

  6. Mortality from diseases other than cancer following low doses of ionizing radiation

    DEFF Research Database (Denmark)

    Vrijheid, M; Cardis, E; Ashmore, P;

    2007-01-01

    BACKGROUND: Ionizing radiation at very high (radio-therapeutic) dose levels can cause diseases other than cancer, particularly heart diseases. There is increasing evidence that doses of the order of a few sievert (Sv) may also increase the risk of non-cancer diseases. It is not known, however......, whether such effects also occur following the lower doses and dose rates of public health concern. METHODS: We used data from an international (15-country) nuclear workers cohort study to evaluate whether mortality from diseases other than cancer is related to low doses of external ionizing radiation....... Analyses included 275 312 workers with adequate information on socioeconomic status, over 4 million person-years of follow-up and an average cumulative radiation dose of 20.7 mSv; 11 255 workers had died of non-cancer diseases. RESULTS: The excess relative risk (ERR) per Sv was 0.24 [95% CI (confidence...

  7. Effect of low-dose X-ray radiation on adaptive response in gastric cancer cell

    Institute of Scientific and Technical Information of China (English)

    Shukai Wang; Gang Jiang; Hongsheng Yu; Xiangping Liu; Chang Xu

    2013-01-01

    Objective: We aimed to study the effect and mechanism of low-dose radiation (LDR) on adaptive response of gastric cancer cell. Methods: SGC7901 cells were cultured in vitro, and divided into 4 groups: control group (D0 group), low-dose radiation group (D1 group, 75 mGy), high-dose radiation group (D2 group, 2 Gy), low-dose plus high-dose radiation group (D1 + D2 group, 75 mGy + 2 Gy, the interval of low and high-dose radiation being 8 h). Cell inhibition rate was detected by cytometry and CCK8 method; the proportion of cell cycle at different times after irradiation was determined by using a flow cytometry. The ATM mRNA levels were detected by using quantitative real-time reverse transcription polymerase chain reaction (RT-PCR). Results: There was no significant different between groups D0 and D1, groups D2 and D1 + D2 cell inhibition rate (P > 0.05). There was a significant increase G2/M arrest in groups D2 and D1 + D2 than groups D0 and D1 after 6 h of radiation and did not recover at 48 h (P 0.05). Conclusion: LDR cannot induce adaptive response in SGC7901 cells in vitro, which may be associated the regulation of cell cycle, and its ATM mRNA expression cannot be affected by 75 mGy X-ray radiation.

  8. LOW-DOSE RATE BRACHYTHERAPY FOR PROSTATE CANCER: DIFFERENT INDICATIONS – DIFFERENT RESULTS

    Directory of Open Access Journals (Sweden)

    V. A. Biryukov

    2014-07-01

    Full Text Available In Russia, there is presently a growing interest in low-dose intratissue radiotherapy (brachytherapy for locally advanced prostate cancer (PC. Since its inception, current brachytherapy has undergone a number of significant changes in terms of improved visualization and better treatment planning and monitoring, which is sure to have affected the higher quality of their performance and better long-term results. The main purpose of the given paper is to generalize the data of foreign investigators who have the greatest experience with brachytherapy for its further use in the treatment of patients with locally advanced PC under the conditions of Russian clinics.

  9. A COMPARATIVE STUDY OF CAREGIVER BURDEN IN CANCER CERVIX AND CANCER BREAST ILLNESSES

    Directory of Open Access Journals (Sweden)

    Srinivasagopalan, Nappinnai, Solayappan

    2015-07-01

    Full Text Available Background: Caregivers of individuals suffering from cancer illnesses are at risk of having subjected to mental health consequences. There is a paucity of data comparing the caregiver burden of cancer breast and cancer cervix patients. Aim: The aim of the present study is to compare the caregiver burden of cancer breast and cancer cervix patients. To study the association of caregiver burden with demographic factors like age, gender, duration of caregiving etc. Materials & Methods: This Cross sectional study is performed on the key relatives of patients of 31 cancer cervix and 31 cancer breast patients. Burden assessment schedule was used. Results: Our findings suggest burden is more in male caregivers of breast cancer patients. It is not so in caregivers of cancer cervix patients. Whenever the caregiver is closely related to the patients the burden is high in both groups. Whenever the burden scores were high the depression scores were also high. Treatment modalities as a whole correlates with burden scores in caregivers of breast cancer patients but not in cancer cervix patients. Conclusion: Caregivers with breast and cervical cancer patients are vulnerable if the caregiver is male, from low socioeconomical background, more closely related and when the patients received poor treatment modalities.

  10. Sexual dysfunction after radiotherapy for cancer of the cervix uteri

    International Nuclear Information System (INIS)

    Investigations of sexual consciousness and sexual dysfunction after radiotherapy for cancer of the cervix uteri were performed on patients of middle and old ages by questionnaires and questionning by doctors, and the following results were obtained. 1. Before radiotherapy, sexual activity was most prominent in their twenties and thirties. However, patients who were in fifties when this study was performed had most active sexual lives during the ages from 35 to 50 years. 2. Frequencies of sexual intercourse decreased markedly just before radiotherapy, and many patients received radiotherapy when sexual activity fell. 3. 32% of the patients have not experienced sexual intercourse after radiotherapy. 4. Decreases in the sex urge, sexuality, vaginal dicharge, and frequency of sexual intercourse after radiotherapy were recognized in 77%, 77%, 70%, and 93% respectively. 5. Patients who became unwilling to maintain sexual lives after radiotherapy because of fear about recurrence or aggravation of cancer were 38% by questionnaires and 49% by questionning by doctors. 6. Pains on sexual intercourse were found in 69% by questionnaires and 49% by questionning by doctors. Most pains occurred at pennis insertion and was thought to be due to atrophy and inflammation of vagina and external genitalia in most cases. 7. Both vaginal damages and sexual dysfunction in patients with radiotherapy following surgery for cancer of the cervix uteri, in patients with radiotherapy alone for cancer of the cervix uteri, and in patients with radiotherapy following surgery for cancer of the ovary and corpus uteri were marked, modest and mild, respectively. 8. Vaginal damage score was higher in patients treated more than 5 years before than those less than 2 years ago, but there were no differences in sexual dysfunction score between both groups. (Tsunoda, M.)

  11. Sexual dysfunction after radiotherapy for cancer of the cervix uteri

    Energy Technology Data Exchange (ETDEWEB)

    Ohkawa, R.; Takamizawa, H. (Chiba Univ. (Japan). School of Medicine); Arai, T.; Morita, S.

    1981-03-01

    Investigations of sexual consciousness and sexual dysfunction after radiotherapy for cancer of the cervix uteri were performed on patients of middle and old ages by questionnaires and questioning by doctors, and the following results were obtained. 1. Before radiotherapy, sexual activity was most prominent in their twenties and thirties. However, patients who were in fifties when this study was performed had most active sexual lives during the ages from 35 to 50 years. 2. Frequencies of sexual intercourse decreased markedly just before radiotherapy, and many patients received radiotherapy when sexual activity fell. 3. 32% of the patients have not experienced sexual intercourse after radiotherapy. 4. Decreases in the sex urge, sexuality, vaginal discharge, and frequency of sexual intercourse after radiotherapy were recognized in 77%, 77%, 70%, and 93% respectively. 5. Patients who became unwilling to maintain sexual lives after radiotherapy because of fear about recurrence or aggravation of cancer were 38% by questionaires and 49% by questioning by doctors. 6. Pains on sexual intercourse were found in 69% by questionaires and 49% by questionning by doctors. Most pains occurred at penis insertion and was thought to be due to atrophy and inflammation of vagina and external genitalia in most cases. 7. Both vaginal damage and sexual dysfunction in patients with radiotherapy following surgery for cancer of the cervix uteri, in patients with radiotherapy alone for cancer of the cervix uteri, and in patients with radiotherapy following surgery for cancer of the ovary and corpus uteri were marked, modest and mild, respectively. 8. Vaginal damage score was higher in patients treated more than 5 years before than those less than 2 years ago, but there were no differences in sexual dysfunction score between both groups.

  12. Effect of low doses of estradiol and tamoxifen on breast cancer cell karyotypes.

    Science.gov (United States)

    Rondón-Lagos, Milena; Rangel, Nelson; Di Cantogno, Ludovica Verdun; Annaratone, Laura; Castellano, Isabella; Russo, Rosalia; Manetta, Tilde; Marchiò, Caterina; Sapino, Anna

    2016-08-01

    Evidence supports a role of 17&-estradiol (E2) in carcinogenesis and the large majority of breast carcinomas are dependent on estrogen. The anti-estrogen tamoxifen (TAM) is widely used for both treatment and prevention of breast cancer; however, it is also carcinogenic in human uterus and rat liver, highlighting the profound complexity of its actions. The nature of E2- or TAM-induced chromosomal damage has been explored using relatively high concentrations of these agents, and only some numerical aberrations and chromosomal breaks have been analyzed. This study aimed to determine the effects of low doses of E2 and TAM (10(&8 )mol L(&1) and 10(&6 )mol L(&1) respectively) on karyotypes of MCF7, T47D, BT474, and SKBR3 breast cancer cells by comparing the results of conventional karyotyping and multi-FISH painting with cell proliferation. Estrogen receptor (ER)-positive (+) cells showed an increase in cell proliferation after E2 treatment (MCF7, T47D, and BT474) and a decrease after TAM treatment (MCF7 and T47D), whereas in ER& cells (SKBR3), no alterations in cell proliferation were observed, except for a small increase at 96 h. Karyotypes of both ER+ and ER& breast cancer cells increased in complexity after treatments with E2 and TAM leading to specific chromosomal abnormalities, some of which were consistent throughout the treatment duration. This genotoxic effect was higher in HER2+ cells. The ER&/HER2+ SKBR3 cells were found to be sensitive to TAM, exhibiting an increase in chromosomal aberrations. These in vitro results provide insights into the potential role of low doses of E2 and TAM in inducing chromosomal rearrangements in breast cancer cells. PMID:27357940

  13. Response to the argument on the risk of cancer with chest CT screening. Is low-dose chest CT safe?

    International Nuclear Information System (INIS)

    The steady increase in the annual number of chest CT screening has become a worldwide concern because of its associated risk of lung cancer. Epidemiological studies, however, have shown that repeated exposure to low-dose radiation does not increase the risk of lung cancer. In addition, a recent randomized controlled study on chest CT screening has shown its usefulness for reducing lung cancer mortality. We reviewed the risk of lung cancer after repeated exposure to low-dose radiation, the efficacy of chest CT screening, and device technology for reducing the irradiation dose. (author)

  14. Cohort studies on cancer mortality among nuclear workers exposed to low-dose ionizing radiation: a meta-analysis

    International Nuclear Information System (INIS)

    To provide direct estimates of risk of cancer after protracted low doses of ionising radiation and to strengthen the scientific basis of radiation protection standards for low-dose ionising radiation exposure. Published papers referring to 20 low-dose ionising radiation-exposed cohorts among nuclear industry workers with Standardized Mortality Ratios (SMR) were recta-analyzed in fixed and random effect models. The significantly deficient Meta-SMRs for all deaths (0.73; 95% CI: 0.66-0.80), all cancers (0.83; 95% CI: 0.77- 0.91), lung cancer (0.93; 95% CI: 0.90-0.95), non-Hodgkin lymphoma (0.88; 95% CI: 0.78- 0.99), esophagus cancer (0.83; 95% CI:0.76-0.91), colorectal cancer (0.88; 95% CI: 0.83-0.94), stomach cancer (0.81; 95% CI: 0.76-0.86) were observed. The Meta-SMRs for leukemia, multiple myeloma, Hodgkin's disease were found to be no significant difference with normal populations. There was no excessive risk of cancers among nuclear workers exposed to low-doses and low-dose rates ionizing radiation. (authors)

  15. Low-dose-rate interstitial brachytherapy preserves good quality of life in buccal mucosa cancer patients

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the results and long-term changes in radiation toxicity of stage I-II buccal mucosa cancer patients treated by low-dose-rate (LDR) brachytherapy with 198Au grains. A total of 133 stage I-II buccal mucosa carcinomas patients received 198Au grain implantation brachytherapy between January 1982 and July 2005: 75 of them were treated by 198Au grain implantation alone and 58 were treated by 198Au implantation in combination with external irradiation. The average 198Au-grain dose was 70 Gy in 7 days. Gross tumor areas ranged from 2.4 cm2 to 9 cm2, and the clinical target areas ranged from 6 cm2 to 15 cm2. The follow-up periods ranged from 3 months to 20 years (mean: 5 years 11 months and median: 5 years 1 months). Failure at the site of the primary lesion occurred in 17 patients. Post-treatment mucosal ulceration developed in 15 patients, and all were cured within 25 months by conservative treatment. Osteoradionecrosis was diagnosed in 8 patients, but only one patient required surgical treatment. No severe complications or aggravation of complications developed more than 10 years after treatment. The results of low-dose-rate (LDR)-brachytherapy (BT) alone and LDR-BT in combination with external irradiation at a total dose of 25 Gy were acceptable from the standpoint of cure rate and quality of life (QOL). (author)

  16. Molecular alterations in childhood thyroid cancer after Chernobyl accident and low-dose radiation risk

    International Nuclear Information System (INIS)

    The linear no-threshold (LNT) model of radiation carcinogenesis has been used for evaluating the risk from radiation exposure. While the epidemiological studies have supported the LNT model at doses above 100 mGy, more uncertainties are still existed in the LNT model at low doses below 100 mGy. Thus, it is urged to clarify the molecular mechanisms underlying radiation carcinogenesis. After the Chernobyl accident in 1986, significant amount of childhood thyroid cancer has emerged in the children living in the contaminated area. As the incidence of sporadic childhood thyroid cancer is very low, it is quite evident that those cancer cases have been induced by radiation exposure caused mainly by the intake of contaminated foods, such as milk. Because genetic alterations in childhood thyroid cancers have extensively been studied, it should provide a unique chance to understand the molecular mechanisms of radiation carcinogenesis. In a current review, molecular signatures obtained from the molecular studies of childhood thyroid cancer after Chernobyl accident have been overviewed, and new roles of radiation exposure in thyroid carcinogenesis will be discussed. (author)

  17. Long-term results of breast cancer irradiation treatment with low-dose-rate external irradiation

    International Nuclear Information System (INIS)

    Purpose: The aim of this study was to assess beam therapy with low-dose-rate (LDR) external irradiation in a group of patients with breast cancer. Methods and Materials: This trial compared, from 1986 to 1989, patients with advanced breast cancer treated either by conventional fractionation or low-dose-rate (LDR) external radiotherapy (dose-rate 15 mGy/min, 5 sessions of 9 Gy delivered on 5 consecutive days). Results: A total of 21 patients were included in the fractionated therapy arm. At follow-up 15 years after treatment, 7 local recurrences had occurred, 3 patients had died of cancer, 18 patients were alive, 10 were without evidence of disease, and 6 had evidence of disease. A total of 22 patients had been included in the LDR arm of the study. Of these, 11 had received a dose of 45 Gy; thereafter, in view of severe local reactions, the dose was reduced to 35 Gy. There was no local recurrence in patients who had received 45 Gy, although there were 2 local recurrences among the 11 patients after 35 Gy. The sequelae were severe in patients who received 45 Gy but were comparable to those observed in patients treated by fractionated radiotherapy who received 35 Gy. The higher efficacy of tumor control in patients treated by LDR irradiation as well as the lower tolerance of normal tissue are probably related to the lack of repopulation. Conclusion: Although the patient numbers in this study are limited, based on our study results we conclude that the data for LDR irradiation are encouraging and that further investigation is warranted

  18. Aggressive approach in a case of cancer cervix with uremia

    Directory of Open Access Journals (Sweden)

    M G Janaki

    2010-01-01

    Full Text Available Carcinoma of cervix is the most common cancer in developing countries. Majority of them present in locally advanced stages. A 36-year-old lady presented with bleeding and white discharge per vagina since four months, vomiting and reduced urine output since two weeks. Patient had an exophytic cervical growth. Investigation revealed elevated serum creatinine. Patient received single fraction radiation and underwent percutaneous nephrostomy. At one month follow-up, serum creatinine returned to almost normal level. Patient underwent bilateral ante grade stenting and completed concurrent chemoradiotherapy. In selected subsets of patients, aggressive management offered longer palliation and good quality of life.

  19. Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure

    Directory of Open Access Journals (Sweden)

    Picano Eugenio

    2012-04-01

    Full Text Available Abstract Background According to a fundamental law of radiobiology (“Law of Bergonié and Tribondeau”, 1906, the brain is a paradigm of a highly differentiated organ with low mitotic activity, and is thus radio-resistant. This assumption has been challenged by recent evidence discussed in the present review. Results Ionizing radiation is an established environmental cause of brain cancer. Although direct evidence is lacking in contemporary fluoroscopy due to obvious sample size limitation, limited follow-up time and lack of focused research, anecdotal reports of clusters have appeared in the literature, raising the suspicion that brain cancer may be a professional disease of interventional cardiologists. In addition, although terminally differentiated neurons have reduced or mild proliferative capacity, and are therefore not regarded as critical radiation targets, adult neurogenesis occurs in the dentate gyrus of the hippocampus and the olfactory bulb, and is important for mood, learning/memory and normal olfactory function, whose impairment is a recognized early biomarker of neurodegenerative diseases. The head doses involved in radiotherapy are high, usually above 2 Sv, whereas the low-dose range of professional exposure typically involves lifetime cumulative whole-body exposure in the low-dose range of Conclusions At this point, a systematic assessment of brain (cancer and non-cancer effects of chronic low-dose radiation exposure in interventional cardiologists and staff is needed.

  20. Histopathologic Changes in the Uterus, Cervix and Vagina of Immature CD-1 Mice Exposed to Low Doses of Perfluorooctanoic Acid (PFOA) in a Uterotrophic Assay

    OpenAIRE

    Dixon, Darlene; Reed, Casey E.; Moore, Alicia B.; Gibbs-Flournoy, Eugene A; Hines, Erin P.; Wallace, Elizabeth A.; Stanko, Jason P.; Lu, Yi; Jefferson, Wendy N.; Newbold, Retha R.; Fenton, Suzanne E.

    2011-01-01

    The estrogenic and antiestrogenic potential of perfluorooctanoic acid (PFOA) was assessed using an immature mouse uterotrophic assay and by histologic evaluation of the uterus, cervix and vagina following treatment. Female offspring of CD-1 dams were weaned at 18 days old and assigned to groups of equal weight, and received 0, 0.01, 0.1, or 1 mg PFOA/kg BW/d by gavage with or without 17-β estradiol (E2, 500 μg/kg/d) from PND18-20 (n=8/treatment/block). At 24 hr after the third dose (PND 21), ...

  1. Radiotherapy for cancer of the maxillary sinus, with boost therapy by low dose rate intracavitary irradiation

    International Nuclear Information System (INIS)

    Prognosis of cancer of the maxillary sinus markedly depends on its local control. In order to increase the local control rate for cancer of the maxillary sinus, low dose rate intracavitary irradiation of the maxillary sinus was performed as boost therapy of external irradiation. During the period from January 1975 through September 1982, 87 patients with cancer of the maxillary sinus were treated by radiotherapy at the Department of Radiology, The Jikei University School of Medicine, and 43 out of these 87 cases were treated with intracavitary irradiation as boost therapy of external irradiation. The 3-year and 5-year cumulative survival rates of the 43 cases treated with intracavitary irradiation were 44% and 39%, respectively. The same two rates of the 44 cases without intracavitary irradiation were both 47%. Considering that tumor foci still persisted in the maxillary sinus in almost all of the 43 intracavitary irradiation cases and that 34 of them were of the postero-superior type (according to Oehngren's classification), which generally results in poor prognosis, intracavitary irradiation as boost therapy can be assumed to be one of the effective therapeutic techniques for cancer of the maxillary sinus. (author)

  2. The effect for metastasis of urinary tract cancer by combination therapy with adriamycin and low dose radiation

    International Nuclear Information System (INIS)

    Thee were 12 cases (men 11 and 1 woman) with metastasis of urinary tract cancer. Average age was 65.3 years. Primary tumors were 7 bladder cancers, 3 pelvico-ureter cancers and 2 renal cell carcinomas. Treatment was mainly intravenous administration of 100 mg ADM and low dose of local radiation (2000 rad). Effective rate was 85.7% for metastasis of transitional cell carcinoma, but effective rate was 0% by treatment of administration of 30 mg ADM and local low dose radiation (2000 rad). No effect to metastasis of renal cell carcinoma was observed. (author)

  3. Concurrent chemoradiotherapy with daily low dose CDDP/5FU for locally unresectable head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kohno, Naoyuki; Kitahara, Satoshi; Tamura, Etsuyo; Tanabe, Tetsuya [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine; Murata, Yasuhiro [National Defence Medical Coll., Tokorozawa, Saitama (Japan)

    2002-07-01

    To improve the local control rate and the prognosis of locally unresectable head and neck cancer patients, we studied the concurrent chemoradiotherapy. Between September 1996 and September 2000, thirty-eight patients with locally unresectable head and neck cancer were administered concurrent chemoradiotherapy consisting of low-dose and long-term treatment with cisplatin (CDDP) plus 5-fluorouracil (5FU), or (L-CF); the L-CF regimen consisted of CDDP, 3 mg/m{sup 2} on 5 days of the week and 5FU, 150 mg/m{sup 2} as a 24-hour infusion on 5 days of the week. Concurrently, conventional radiotherapy was given up to total dose of around 60 Gy. In the 36 patients evaluable for response, 19 complete and 10 partial responses were noted, with an overall response rate of 81%. Oral mucositis and myelosuppression were the major side effects and dose limiting toxicity. This study demonstrates increase in survival among the responders (complete+partial) in the concurrent chemoradiotherapy setting. We concluded that this treatment strategy was beneficial. Further studies for patients with locally unresectable head and neck cancer are warranted. (author)

  4. Combined chemoradiotherapy with daily low-dose cisplatin in stage III non-small cell lung cancer. An interim report

    International Nuclear Information System (INIS)

    To improve the local control of stage III non-small cell lung cancer, we tried concurrent chemoradiotherapy with daily low-dose cisplatin during the first 5 weeks conventional radiotherapy. Ten consecutive patients with stage III non-small cell lung cancer were treated with chemoradiotherapy with 66 Gy in conventional fractionation and concurrent daily low-dose cisplatin (4 mg/m2), which was given 5 days per week (from Monday to Friday) for the first 5 weeks. There was no case with ≥grade 3 toxicity. The median survival was 14.6 months, and the 2-year local progression-free survival rate was 35%. Daily low-dose cisplatin combined with conventional radiotherapy was considered to be feasible and to have the possibility to offer better local control than radiotherapy alone in the treatment of stage III non-small cell lung cancer. (author)

  5. A brief measure of Smokers' knowledge of lung cancer screening with low-dose computed tomography.

    Science.gov (United States)

    Lowenstein, Lisa M; Richards, Vincent F; Leal, Viola B; Housten, Ashley J; Bevers, Therese B; Cantor, Scott B; Cinciripini, Paul M; Cofta-Woerpel, Ludmila M; Escoto, Kamisha H; Godoy, Myrna C B; Linder, Suzanne K; Munden, Reginald F; Volk, Robert J

    2016-12-01

    We describe the development and psychometric properties of a new, brief measure of smokers' knowledge of lung cancer screening with low-dose computed tomography (LDCT). Content experts identified key facts smokers should know in making an informed decision about lung cancer screening. Sample questions were drafted and iteratively refined based on feedback from content experts and cognitive testing with ten smokers. The resulting 16-item knowledge measure was completed by 108 heavy smokers in Houston, Texas, recruited from 12/2014 to 09/2015. Item difficulty, item discrimination, internal consistency and test-retest reliability were assessed. Group differences based upon education levels and smoking history were explored. Several items were dropped due to ceiling effects or overlapping constructs, resulting in a 12-item knowledge measure. Additional items with high item uncertainty were retained because of their importance in informed decision making about lung cancer screening. Internal consistency reliability of the final scale was acceptable (KR-20 = 0.66) and test-retest reliability of the overall scale was 0.84 (intraclass correlation). Knowledge scores differed across education levels (F = 3.36, p = 0.04), while no differences were observed between current and former smokers (F = 1.43, p = 0.24) or among participants who met or did not meet the 30-pack-year screening eligibility criterion (F = 0.57, p = 0.45). The new measure provides a brief, valid and reliable indicator of smokers' knowledge of key concepts central to making an informed decision about lung cancer screening with LDCT, and can be part of a broader assessment of the quality of smokers' decision making about lung cancer screening. PMID:27512650

  6. Quality of Life of Oral Cancer Patients After Low-Dose-Rate Interstitial Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the quality of life (QOL) of oral cancer patients treated with low-dose-rate interstitial brachytherapy (LDR-BT) alone. Methods and Materials: Between June 2005 and July 2006, a total of 56 patients with oral cancer were enrolled in this prospective study. QOL was assessed by means of the core questionnaire and head and neck questionnaire module of the European Organization for Research and Treatment of Cancer (EORTC Quality of Life Questionnaire-Core 30 [QLQ-C30] and QLQ Head and Neck 35 [H and N35]). The questionnaires were distributed to the patients before the start of treatment and 3 months, 6 months, and 12 months after the start of LDR-BT. Results: It was possible to analyze the results for 20 of the initial 56 patients because they did not experience metastasis or recurrence during this study. No functions or symptoms asked about in the QLQ-C30 deteriorated during the first year. The emotional function score steadily and significantly increased. No symptoms in the QLQ-H and N35 significantly deteriorated. The scores for pain, trouble with social eating, and weight loss on the QLQ-H and N35 steadily and significantly decreased. Age, gender, and LDR-BT source had no effect on the change in QOL during the first year, but T-stage significantly affected the change in global health status, tumor site affected the changes in swallowing, sensory problems, sticky saliva, and complications affected the changes in pain, swallowing, and mouth opening. Conclusions: QOL of oral cancer patients treated with LDR-BT is high. However, tumor stage, tumor site, and complications affected the changes in a few functions and symptoms during the first year

  7. Lung cancer screening with low-dose computed tomography: Canadian experience

    International Nuclear Information System (INIS)

    In 2003, the department of medical imaging at the University Health Network in Toronto, Ontario, became the first Canadian site of the International Early Lung Cancer Action Program (I-ELCAP). We report the results from the first 1000 baseline studies. Between June 2003 and December 2005, we enrolled 1000 high-risk smokers (that is, smokers with a history of a least 10 pack years, or the equivalent of one pack daily for 10 years), aged 55 years or older. A low-dose helical computed tomography (CT) (40 to 60 mA, 120 kV) was performed with 1.0mm to 1.25 collimation. Nodules found at baseline were followed according to the I-ELCAP protocol: 1) no noncalcified nodules (NCNs) or NCNs ≤ 4 mm or nonsolid nodules < 8 mm, annual repeat: 2) NCNs ≥ 5mm or nonsolid nodules ≥ 8 mm, 3-month follow up: or 3) nonsolid nodules ≥ 15 mm, antibiotics and 1-month follow-up. The first 100 study participants were aged 63 years, standard deviation (SD) 6 years, with a smoking history of 38 pack years, SD 22 pack years; 662 (66%) were former smokers, and 338 (34%) were current smokers; 453 (45%) were men, and 547 (55%) were women. Of the participants, 256 (26%) had a positive baseline low-dose computed tomography (LCDT) scan; 227 (23%) were followed after 3 months and 15 (1.6%) after 1 month; 7 (0.7%) received a contrast-enhanced CT and 6 (0.6%) an immediate CT-guided biopsy. Twenty-six invasive procedures were performed: 22 CT-guided biopsies, 1 ultrasound-guided lymph node metastasis biopsy, 1 bronchoscopic biopsy and 2 surgeries. The malignancy rate of the invasive procedures was 85%. Overall, the malignancy prevalence is 2.2%. Of the malignancies, 20 are lung carcinomas: 19 non-small-cell lung carcinomas (NSCLCs) (14 adenocarcinoma or bronchioalveolar carcinoma [BAC], 4 squamous carcinoma, and 1 large-cell carcinoma) and 1 small-cell carcinoma; 15 (78%) of the NSCLCs are Stage 1. Fourteen patients underwent surgery (1 pneumonectomy, 9 lobectomies, and 4 segmentectomies). Our

  8. Cancer and non-cancer brain and eye effects of chronic low-dose ionizing radiation exposure

    International Nuclear Information System (INIS)

    According to a fundamental law of radiobiology (“Law of Bergonié and Tribondeau”, 1906), the brain is a paradigm of a highly differentiated organ with low mitotic activity, and is thus radio-resistant. This assumption has been challenged by recent evidence discussed in the present review. Ionizing radiation is an established environmental cause of brain cancer. Although direct evidence is lacking in contemporary fluoroscopy due to obvious sample size limitation, limited follow-up time and lack of focused research, anecdotal reports of clusters have appeared in the literature, raising the suspicion that brain cancer may be a professional disease of interventional cardiologists. In addition, although terminally differentiated neurons have reduced or mild proliferative capacity, and are therefore not regarded as critical radiation targets, adult neurogenesis occurs in the dentate gyrus of the hippocampus and the olfactory bulb, and is important for mood, learning/memory and normal olfactory function, whose impairment is a recognized early biomarker of neurodegenerative diseases. The head doses involved in radiotherapy are high, usually above 2 Sv, whereas the low-dose range of professional exposure typically involves lifetime cumulative whole-body exposure in the low-dose range of < 200 mSv, but with head exposure which may (in absence of protection) arrive at a head equivalent dose of 1 to 3 Sv after a professional lifetime (corresponding to a brain equivalent dose around 500 mSv). At this point, a systematic assessment of brain (cancer and non-cancer) effects of chronic low-dose radiation exposure in interventional cardiologists and staff is needed

  9. Risk factors for cancer cervix among rural women of a hilly state: A case-control study

    OpenAIRE

    Anita Thakur; Bhupender Gupta; Anmol Gupta; Raman Chauhan

    2015-01-01

    In Himachal Pradesh, cancer cervix is a major public health problem since it ranks as the number one female cancer. A case-control study of 226 newly diagnosed, histopathologically confirmed cases of cancer cervix and equal number of matched controls was conducted at Regional Cancer Center, Himachal Pradesh during the period from July 2008 to October 2009 with the objective to study the common factors associated with cancer cervix. Univariate analysis identified 10 risk factors associated sig...

  10. Radiotherapy combined with daily administration of low dose cisplatin for head and neck cancer

    International Nuclear Information System (INIS)

    Radiotherapy combined with daily administration of low-dose cisplatin (CDDP) was applied to 12 cases of head and neck cancer. They consisted of 12 carcinomas, occurring in the epipharynx (3 cases), mesopharynx (3), oral cavity (1), larynx (3), and parasinuses (2). The total response rate (CR+PR) was 83.3%. There was a remarkable effect in reducing tumor size, particularly on patients with laryngeal or epipharyngeal carcinoma. Severe mucositis with ulcers as a side effect was seen in eight cases after the irradiation of 20 to 30 Gy. Six of them tolerated a full dose of irradiation, but CDDP administration was stopped except in one case. To continue the CDDP administration in cases having irradiation of over 40 Gy, it is necessary to reduce the frequency of CDDP administration and/or to give post-irradiative hydration with 500 ml saline. When this combination therapy is used as a preoperative treatment, daily administration should be continued. Incidence of nausea or vomiting was not so frequent and they could be easily controlled by a serotonin-antagonist. Leukopenia was not severe. (author)

  11. Contamination and cancers: low-dose risks and standards of radioprotection

    International Nuclear Information System (INIS)

    Irradiation of the population due to the running of nuclear power stations represents less than 1% of the natural radioactivity today, and should amount to 3% at most by the year 2 000. The main effects of ionizing radiations are reviewed and their undetectability below 100 rems is underlined. Thus the evaluation of low-dose risks can only be speculative and the cautions hypothesis adopted is that of a linear relationship between dose and effect, together with the absence of threshold. According to calculations the worker, supposedly exposed to 500 mrem a year between ages 18 and 65, would run a 22.2% instead of the normal 22% risk of dying of cancer. As for the population, the risk would increase by only 1 per 10 000 in the year 2 000. This means that no other mutagenic and carcinogenic agent is as well regulated as radioactive pollution and efforts directed at a better control of harmful chemicals, for instance, are only taking an example from the ruling on radioprotection

  12. Treatment outcome with low-dose-rate interstitial brachytherapy in early-stage oral tongue cancers

    Directory of Open Access Journals (Sweden)

    Bhalavat Rajendra

    2009-01-01

    Full Text Available Purpose : Although radical radiotherapy is known to be equally effective for early-stage oral tongue cancers (T1-2 N0 with the added advantage of organ and function preservation, surgery remains the preferred treatment. We present outcome of patients treated with brachytherapy (BT either radical or boost. Materials and Methods : Fifty-seven patients (T1/T2 31/26 were studied. Seventeen patients (30% were treated with radical BT (50-67 Gy while 40 (70% with external beam radiation therapy (EBRT + BT (36-56 Gy + 15-38 Gy]. Low-dose-rate (LDR BT was delivered with 192 Ir wires, using plastic bead technique with varied dose rates (< 60 cGy/h in 29 patients, 60-90 cGy/h in 17, and> 90 cGy/h in 11. Results : The overall local control (LCR was achieved in 59.7% (34/57 patients. LCR for T1 and T2 was 67.8% and 50%, respectively. A total of 23 patients had failures [local: 20 (T1: 8; T2: 12 patients, node: 5 (T1:2; T2: 3, and local + nodal: 3]. Overall 5-year disease-free survival and overall survival (OAS were 51% and 67%, respectively and those for T1 and T2 was 64.5/77.4% and 38.5/54% respectively (P = 0.002. All 16 patients were salvaged. Median survival after salvage treatment was 13.5 months (6-100 months. Soft tissue necrosis was observed in 12.3% (7/57 and osteoradionecrosis in two patients. Conclusion : BT, as an integral part of radical radiation therapy in early-stage tongue cancers, appears to be an effective alternative treatment modality with preservation of the organ and function without jeopardizing the outcome.

  13. Brachytherapy for early oral tongue cancer. Low dose rate to high dose rate

    International Nuclear Information System (INIS)

    To examine the compatibility of low dose rate (LDR) with high dose rate (HDR) brachytherapy, we reviewed 399 patients with early oral tongue cancer (T1-2N0M0) treated solely by brachytherapy at Osaka University Hospital between 1967 and 1999. For patients in the LDR group (n=341), the treatment sources consisted of Ir-192 pin for 227 patients (1973-1996; irradiated dose, 61-85 Gy; median, 70 Gy), Ra-226 needle for 113 patients (1967-1986; 55-93 Gy; median, 70 Gy). Ra-226 and Ir-192 were combined for one patient. Ir-192 HDR (microSelectron-HDR) was used for 58 patients in the HDR group (1991-present; 48-60 Gy; median, 60 Gy). LDR implantations were performed via oral and HDR via a submental/submandibular approach. The dose rates at the reference point for the LDR group were 0.30 to 0.8 Gy/h, and for the HDR group 1.0 to 3.4 Gy/min. The patients in the HDR group received a total dose of 48-60 Gy (8-10 fractions) during one week. Two fractions were administered per day (at least a 6-h interval). The 3- and 5-year local control rates for patients in the LDR group were 85% and 80%, respectively, and those in the HDR group were both 84%. HDR brachytherapy showed the same lymph-node control rate as did LDR brachytherapy (67% at 5 years). HDR brachytherapy achieved the same locoregional result as did LDR brachytherapy. A converting factor of 0.86 is applicable for HDR in the treatment of early oral tongue cancer. (author)

  14. Risk of prostate cancer in low-dose aspirin users: A retrospective cohort study.

    Science.gov (United States)

    Lapi, F; Levi, M; Simonetti, M; Cancian, M; Parretti, D; Cricelli, I; Sobrero, A; Cricelli, C

    2016-07-01

    A growing body of evidence indicates that use of low-dose aspirin (LDA) reduces the risk of certain adenocarcinomas. While there are several and consistent findings on the protective effect of LDA on colorectal and other cancers, few and conflicting evidence is available on prostate cancer (PCa). The aim of this study was to assess whether LDA reduces the incidence rate of PCa. We conducted a nationwide, population-based, retrospective cohort study by using Health Search IMS Health Longitudinal Patient Database (HSD). Patients with ischemic cardio- or cerebrovascular disease (index date) were identified. Time-dependent multivariable Cox proportional hazard models were adopted to estimate Hazard Ratios (HRs) and related 95% confidence intervals (95% CI) of PCa associated with use of LDA. The exposure was lagged by one year to consider the latency of drug effect on the outcome onset. Within a cohort 13,453 patients, the overall incidence rate of PCa was 2.5 per 1,000 person-years. Use of LDA was associated with a decreased incidence rate of PCa (HR = 0.64; 95% CI: 0.48-0.86), which was primarily driven by a frequency of LDA use equal to or higher than twice per week (HR = 0.60; 95% CI: 0.43-0.83). Such an association was more pronounced (HR = 0.43; 95% CI: 0.21-0.91) when LDA was used for five or more years. Our findings indicate that LDA use might be associated with a reduction of risk of PCa in patients with cardio- or cerebrovascular diseases. PMID:26915905

  15. Role of neoadjuvant chemotherapy in cancer cervix: A brief review

    Directory of Open Access Journals (Sweden)

    Aramita Saha

    2013-01-01

    Full Text Available Neoadjuvant chemotherapy (NACT represents a promising modality apart from or radiotherapy as initial treatment of locally advanced cervical cancer. The primary objectives of NACT in the treatment of cervical cancer include improvement in tumor characteristics, to allow avoidance of radiotherapy, to prolong disease-free and overall survival, and facilitation of fertility-sparing surgery. Though several studies have shown promising results of NACT on tumor response, downstaging, decrease in local recurrence, improved progression free survival, yet its role is controversial and plenty of study results are waiting to establish its efficacy. After reviewing the available literatures in the internet, and focusing the light of our continuous 3 years experience, we have made an effort to find out the relevance of NACT in cancer cervix. NACT is feasible and produces impressive responses in cervical carcinoma, as has been demonstrated by several phase II and phase III trials. Some meta-analysis suggested that NACT followed by surgery improves overall survival compared with nonstandard radiotherapy alone.

  16. Phase III trial of high and low dose rate interstitial radiotherapy for early oral tongue cancer

    International Nuclear Information System (INIS)

    Purpose: Oral tongue carcinomas are highly curable with radiotherapy. In the past, patients with tongue carcinoma have usually been treated with low dose rate (LDR) interstitial radiation. This Phase III study was designed to compare the treatment results obtained with LDR with those obtained with high dose rate (HDR) interstitial radiotherapy for tongue carcinoma. Methods and Materials: The criteria for patient selection for the Phase III study were: (a) presence of a T1T2N0 tumor that could be treated with single-plane implantation, (b) localization of tumor at the lateral tongue border, (c) tumor thickness of 10 mm or less, (d) performance status between O and 3, and (e) absence of any severe concurrent disease. From April 1992 through December 1993, 15 patients in the LDR group (70 Gy/4 to 9 days) and 14 patients in the HDR group (60 Gy/10 fractions/6 days) were accrued. The time interval between two fractions of the HDR brachytherapy was more than 6 h. Results: Local recurrence occurred in two patients treated with LDR brachytherapy but in none of the patients treated with HDR. One- and 2-year local control rates for patients in the LDR group were both 86%, compared with 100% in the HDR group (p = 0.157). There were four patients with nodal metastasis in the LDR group and three in the HDR group. Local recurrence occurred in two of the four patients with nodal metastases in the LDR group. One- and 2-year nodal control rates for patients in the LDR group are were 85%, compared with 79% in the HDR group. Conclusion: HDR fractionated interstitial brachytherapy can be an alternative to traditional LDR brachytherapy for early tongue cancer and eliminate the radiation exposure for medical staffs

  17. Cancer of the cervix: a training guide to promote awareness.

    Science.gov (United States)

    1997-01-01

    This 4-page training guide presents factual information and suggested community activities related to the prevention of cervical cancer in developing countries. After describing the risk factors for cervical carcinoma and possible signs of advanced disease, the guide presents the story of Maya--a woman in an arranged marriage whose husband would not permit her to seek medical care for abdominal pain and bleeding until her cervical cancer had advanced beyond treatment. Health educators are encouraged to use Maya's story as a learning tool to identify the chain of physical, social, economic, and political factors that contributed to her premature death. Audiences can be encouraged to identify links in Maya's story (e.g., not receiving a Pap test) that could have been changed to produce a different ending. It is recommended that, in low-resource communities, Pap smears be provided at least every 5 years to women over 35 years of age. Under development is a simple, inexpensive alternative to Pap tests that involves putting a vinegar solution on the cervix and examining it with the aid of a low-power magnifying tool; the vinegar causes abnormal cervical tissue to turn white. PMID:12292697

  18. Optimization of combined radiation therapy of the cervix cancer

    Directory of Open Access Journals (Sweden)

    Vladimir Philippenko

    2010-04-01

    Full Text Available Use of a new combination of known medical products - inhibitorsenzyme of cyclooxigenase-2 (diclofenac, ketoprofen with smalldoses cytostatics (methotrexate, 5-fluorouracil as“nonconventional” radiosensibilizators for optimization of combinedradial treatment of cervical cancer is offered. One hundred andtwenty patients with cervix cancer were involved into research(average age - 52.5±3.3, mainly II stage of process (50.8±4.6%,morphologically - nonkeratinizing squamous cell carcinoma(65.0±4.4%. Frequency of full regress of a tumor in the basicgroups has reached in 77.5±6.6% (1-basic group and 82.5±6.0% (2-basic group in comparison with a control group 70.0±7.2%(р<0.05. By results of the cytological research in cells thepathomorphosis of IV degree was recorded in 1-basic group - 60.0%(superficial smears and 57.5% (a puncture biopsy, in 2-basic group- 85.0% (superficial smears and 82.5% (a puncture biopsy incomparison with the control - 55.0% (superficial smears and apuncture biopsy, р<0.05.

  19. Palliative low dose fortnightly methotrexate in oral cancers: Experience at a rural cancer centre from India

    Directory of Open Access Journals (Sweden)

    Santam Chakraborty

    2014-01-01

    Full Text Available Context: Palliative fortnightly chemotherapy in oral cancers. Aims: We present our experience with a regimen employing fortnightly (once in 2 weeks injectable methotrexate (MTX (40 mg/m 2 in a predominantly elderly cohort of patients with carcinoma of oral cavity and oropharynx. Settings and Design: Retrospective chart review conducted at a rural cancer center in India. Materials and Methods: All patients with oral cavity and oropharyngeal cancers started on treatment with fortnightly injectable MTX (40 mg/m 2 between 01/01/2011 and 31/12/2011. Statistical Analysis Used: The factors analyzed included the duration of disease control, pain control, overall survival and progression free survival which were evaluated using the Kaplan Meier method. Results: A total of 60 patients with a median age of 66.5 years were analyzed. Majority of the patients had poor nutritional status, performance status or co-morbidities. MTX was given for recurrent disease in 19 patients and after initial palliative radiotherapy in 41 patients. The median number of cycles delivered was nine. Grade 3/4 toxicities were seen in 2 patients only. Disease control rate at the end of treatment was seen in 33 (55% patients. Median overall survival was 34 weeks (interquartile range: 17-50 weeks. Conclusions: The fortnightly regimen of MTX was well-tolerated and showed a good clinical activity in this elderly cohort of patients with advanced oral cavity and oropharyngeal cancers.

  20. What physicians think about the need for informed consent for communicating the risk of cancer from low-dose radiation

    International Nuclear Information System (INIS)

    The National Institute of Environmental Health Sciences, a subsidiary of the Food and Drug Administration, has declared that X-ray radiation at low doses is a human carcinogen. The purpose of our study was to determine if informed consent should be obtained for communicating the risk of radiation-induced cancer from radiation-based imaging. Institutional review board approval was obtained for the prospective survey of 456 physicians affiliated with three tertiary hospitals by means of a written questionnaire. Physicians were asked to state their subspecialty, number of years in practice, frequency of referral for CT scanning, level of awareness about the risk of radiation-induced cancer associated with CT, knowledge of whether such information is provided to patients undergoing CT, and opinions about the need for obtaining informed consent as well as who should provide information about the radiation-induced cancer risk to patients. Physicians were also asked to specify their preference among different formats of informed consent for communicating the potential risk of radiation-induced cancer. Statistical analyses were performed using the chi-squared test. Most physicians stated that informed consent should be obtained from patients undergoing radiation-based imaging (71.3%, 325/456) and the radiology department should provide information about the risk of radiation-induced cancer to these patients (54.6%, 249/456). The informed consent format that most physicians agreed with included modifications to the National Institute of Environmental Health Services report on cancer risk from low-dose radiation (20.2%, 92/456) or included information on the risk of cancer from background radiation compared to that from low-dose radiation (39.5%, 180/456). Most physicians do not know if patients are informed about cancer risk from radiation-based imaging in their institutions. However, they believe that informed consent for communicating the risk of radiation-induced cancer

  1. Effect of troglitazone on radiation sensitivity in cervix cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    An, Zheng Zhe; Liu, Xian Guang; Song, Hye Jin; Choi, Chi Hwan; Kim, Won Dong; Park, Woo Yoon [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of); Yu, Jae Ran [Konkuk University College of Medicine, Chungju (Korea, Republic of)

    2012-06-15

    Troglitazone (TRO) is a peroxisome proliferator-activated receptor {gamma} (PPAR{gamma} ) agonist. TRO has antiproliferative activity on many kinds of cancer cells via G1 arrest. TRO also increases Cu{sup 2+}/Zn{sup 2+} -superoxide dismutase (CuZnSOD) and catalase. Cell cycle, and SOD and catalase may affect on radiation sensitivity. We investigated the effect of TRO on radiation sensitivity in cancer cells in vitro. Three human cervix cancer cell lines (HeLa, Me180, and SiHa) were used. The protein expressions of SOD and catalase, and catalase activities were measured at 2-10 {mu}M of TRO for 24 hours. Cell cycle was evaluated with flow cytometry. Reactive oxygen species (ROS) was measured using 2',7'-dichlorofluorescin diacetate. Cell survival by radiation was measured with clonogenic assay. By 5 {mu}M TRO for 24 hours, the mRNA, protein expression and activity of catalase were increased in all three cell lines. G0- G1 phase cells were increased in HeLa and Me180 by 5 {mu}M TRO for 24 hours, but those were not increased in SiHa. By pretreatment with 5 {mu}M TRO radiation sensitivity was increased in HeLa and Me180, but it was decreased in SiHa. In Me180, with 2 {mu}M TRO which increased catalase but not increased G0-G1 cells, radiosensitization was not observed. ROS produced by radiation was decreased with TRO. TRO increases radiation sensitivity through G0-G1 arrest or decreases radiation sensitivity through catalasemediated ROS scavenging according to TRO dose or cell types. The change of radiation sensitivity by combined with TRO is not dependent on the PPAR {gamma} expression level.

  2. The brachytherapy with low dose-rate iridium for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Momma, Tetsuo; Saito, Shiro; Ohki, Takahiro; Satoh, Hiroyuki; Toya, Kazuhito; Dokiya, Takushi [National Tokyo Medical Center (Japan); Murai, Masaru

    2000-11-01

    Brachytherapy as an option for the treatment of prostate cancer has been commonly performed in USA. As the permanent seeding of the radioactive materials is strictly restricted by the law in Japan, brachytherapy must be performed by the temporary implant. This treatment has been performed at a few facilities in Japan mostly using high dose-rate iridium. Only our facility has been using low dose-rate iridium (LDR-Ir) for prostate cancer. This study evaluates the clinical results of the treatment. Since December 1997 to December 1999, 26 patients with histologically diagnosed as prostate cancer (Stage B, 92%; Stage C, 8%) underwent brachytherapy. Twenty-two patients received brachytherapy alone, three were treated with a combination of brachytherapy and external beam radiotherapy (ERT) and one was treated with a combination of brachytherapy and neoadjuvant endocrine therapy. Patients ranged in age from 61 to 84 (median 76) years old. Treatment was initiated with perineal needle placement. From 10 to 14 needles were placed through the holes on the template which was fixed to the stabilizer of the transrectal ultrasound probe. After the needle placement, CT scan was performed to draw distribution curves for the treatment planning. LDR-Ir wires were introduced to the sheath and indwelled during the time calculated from dosimetry. Peripheral dose was 70 Gy for the monotherapy of brachytherapy. For the combination therapy, 40 Gy was given by brachytherapy and 36 Gy with ERT afterwards. LDR-Ir wires were removed after completion of the radiation and patients were followed with serum PSA level and annual biopsy. During 2 to 26 (median 12) months follow-up, 8 out of 9 patients with initial PSA level above 20 ng/ml showed PSA failure. All 13 patients with initial PSA level lower than 20 ng/ml were free from PSA failure. Eight out of 11 patients with Gleason's score 7 or higher showed PSA failure, and all 14 patients (including three patients with combined therapy) with

  3. Irradiation of cancer of the uterine cervix and immunological mechanism

    International Nuclear Information System (INIS)

    The movement of lymphocytes in blood, the cellular immunity by the reaction of a tuberculin test, and the change of productivity of specific antibody by anti-DNA antibody were examined in 29 cases of cancer of the uterine cervix which had received radio therapy. Blood sedimentation rate at one hour were accelerated by irradiation. It seemed that blood sedimentation rate did not correlate with the total amount of protein in blood, and some changes should occur in blood. Lymphocytes which were celles in charge of immunity showed marked decrease by irradiation in peripheral blood. In spite of marked decrease of lymphocytes in blood, the reaction of a tuberculin test was hardly in flanced. There were various kinds of immunoglobulin which were decreased by irradiation. Above-mentioned changes were recognized similarly in the cases irradiated after the operation, in which tumor cells were extremely few. One case, in which anti-DNA antibody was positive, showed a rise in its antibody titer by irradiation. It was presumed that fall of various kinds of immunological functions by irradiation was relative one by decrease of the total number of lymphocytes, and cellular immunity to specific antibody stimulation, and antibody productivity would be preserved in various lymphatic tissues outside irradiation fields. (Tsunoda, M.)

  4. High-dose 5-fluorouracil plus low dose methotrexate plus or minus low-dose PALA in advanced colorectal cancer : a randomised phase II-III trial of the EORTC Gastrointestinal Group

    NARCIS (Netherlands)

    Wils, J; Blijham, GH; Wagener, T; De Greve, J; Jansen, RLH; Kok, TC; Nortier, JWR; Bleiberg, H; Couvreur, ML; Genicot, B; Baron, B

    2003-01-01

    The aim of this study was to investigate whether N-(phosphonacetyl)-L-aspartic acid (PALA) can enhance the activity of low-dose methotrexate (LD-MTX) modulated infusional 5-fluorouracil (5-FU) in patients with advanced colorectal cancer. 198 patients were randomised either to (i) 5-FU 60 mg/kg as a

  5. [Early lung cancer detection in an occupational asbestos exposed population: clinical impact of low-dose computed tomography screening].

    Science.gov (United States)

    Pira, E; Coggiola, M; Bosio, D

    2010-01-01

    Lung cancer is the primary cause of cancer mortality in developed countries. Early detection and surgical resection is essential for the treatment of lung cancer. The introduction of low-dose spiral computed tomography (LDCT) is considered one of the most promising clinical research developments in early diagnosis of lung cancer. Our study is aimed at the evaluation of spiral CT in a cohort of subjects with a past occupational exposure to asbestos at high risk of developing lung cancer. 149 subjects were enrolled between 2007 and 2009 (the criteria for enrollment were date of birth between 1930-1961, no previous cancer and general good health, latency from the beginning of exposure > 10 years, exposure duration > 1 year, possibility to undergo to surgery). A helical low-dose CT (LDCT) of the chest was performed yearly and an evaluation protocol derived from IEO with a morphological analysis of nodules have been adopted. 13 nodules were diagnosed in the first CT, 7 in the second and 3 in the third but no invasive procedures have been taken and no lung cancer have been detected. Our early follow-up data aren't able yet to evaluate the effect of screening with LDCT on mortality but have do not confirm some of the literature initial results such as the Increase in cases of overdiagnosis (false positive) due to the high prevalence of benign lesions. PMID:21438306

  6. Surgery for Pre-Cancers and Cancers of the Cervix

    Science.gov (United States)

    ... ACS » Cervical Cancer + - Text Size Download Printable Version [PDF] » Treating Cervical Cancer TOPICS Document Topics GO » SEE A LIST » ... surgery results in infertility. Because some of the nerves to the bladder are ... IIA cervical cancer, especially in young women. Sexual impact of ...

  7. Low dose rate irradiation of advanced head and neck cancers: present status

    International Nuclear Information System (INIS)

    A total of 46 patients with advanced epidermoid carcinomas of the head and neck were treated with semi-continuous low dose rate cobalt teletherapy with curative intent. The dose rate was 90 to 130 rad per hr, the patients were treated 6 to 8 hr per day, and received total doses of 6500 to 7000 rad in either single or split courses. Thirty-four of these patients had a minimum follow-up of one year and form the basis of this report. While the survival of these patients was poor (22% at 3 years), the local control rate of 58% was encouraging. The immediate tolerance of the mucosa frequently was exceeded in a single course treatment; furthermore, there was a high necrosis rate. Skin reactions, however, remained characteristically mild. Split course treatment succeeded in reducing mucosal reactions to a tolerable level without decreasing local control, but it did not reduce the high risk of necrosis (actually greater than 50% at 2 years). Residual tumor at 3 months carried a grave prognosis. All non-sterilizations and recurrences within the low dose rate treated volumes occurred with tumors 5 cm or more in greatest dimension; local control was obtained in all 10 patients who had less extensive primary lesions. Necroses occurred with equal frequencies in both the larger and relatively smaller tumors. Low dose rate treatment has been proven feasible and currently is being used in a randomized prospective trial to test its possible superiority over conventional fractionation

  8. Computer-aided detection of nodule in low-dose CT screening for lung cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the performance of computer-aided detection (CAD) system for detection of pulmonary nodules in 64-slice low-dose CT screening and to investigate whether CAD can improve the performance of radiologists in detecting pulmonary nodules. Methods: One hundred low-dose screening CT examinations were randomly selected from the database containing 578 consecutive cases between Jun 2007 and Jun 2008. All the examinations were performed on a 64-MSCT scanner with the exposure of 120 kVp, 30 or 40 mA, or automatic exposure control. Before the study started, the screening reports had been made with double reading by two radiologists. All the selected images were analyzed with the lung VCAR software from GE Healthcare with a nodule diameter threshold 3.0 mm. All discrepancies between the screening reports and the CAD results were reviewed and the true non-calcified nodules were determined in consensus by two experienced chest radiologists. Detected nodules were classified by density, size and location.The performance of the double reading and the CAD system were compared and analyzed statistically. McNemar-Bowker test was used for the statistical analysis. Results: A total of 257 true noncalcified nodules were determined in all 100 low-dose screening CT examinations. The detection rate of CAD system was 91.1% (234/257), with the missed rate of 8.9% (23/257). Twenty three nodules were missed by CAD, in which 10 were solid with the diameter ranged from 2.4 to 6.0 mm, and 13 were nonsolid with the diameter ranged from 2.1 to 8.6 mm.Of the 23 nodules, 17 were located in the outer zones of lungs and 6 in the inner zones. The double reading showed a detection rate of 59.1% (152/257) and a missed rate of 40.9% (105/257), which was significantly lower than CAD. The diameter of all the 105 missed nodules by radiologists were ranged from 2.4 to 11.8 mm, in which 94 nodules were solid, 10 were partly solid and 1 was nonsolid, with 69 located in outer zones of lungs

  9. Radiation-induced cancer from low doses of ionizing radiation: risk analysis using the cell dose concept

    International Nuclear Information System (INIS)

    High doses of ionizing radiations are known to bear the risk of cancer to the exposed individual. In order to appreciate potential carcinogenesis from low doses also, the action of ionizing radiation in the human body has to be considered in holistic approach: energy depositions to individual cells trigger effects within a hierachical structure of interacting levels of biological systems, consisting consecutively of atoms, molecules, cells and organ tissue. The present paper describes the cell dose concept which is an essential factor in assessing the risk due to the ionizing radiation to the cells and tissues. Low dose of ionizing radiation induces adaptive response in individual cells which could be linked to the action of molecular radicals. Enzyme activities in bone marrow cells and bilayer lipid membranes and radicals are directly related to radiation effects. Temporary improvements of the detoxification of molecular radicals also improve the cellular defence. The risk analysis calls for more attention as it is important for radiation protection and other beneficial effects due to low doses of irradiation. (author). 18 refs

  10. Cancer of the Cervix – From Bleak Past to Bright Future; a Review, with an Emphasis on Cancer of the Cervix in Malaysia

    Science.gov (United States)

    Nor Hayati, Othman

    2003-01-01

    Cancer of the cervix has the potential to be eradicated since the initiating cause is known. There was not much known about this cancer until the time of the Renaissance. In Malaysia, it is the second most common cancer among females after breast cancer. The strategies on prevention in this country are still not optimal. This article highlights the problems and also discusses the pathogenesis of this disease. The key to prevention is screening and the future is the era of molecular pap smear. PMID:23365496

  11. Changes in serum trace elemental content of uterine cervix cancer patients using PIXE

    International Nuclear Information System (INIS)

    The objective of this study was to evaluate the levels of trace elements in blood sera of uterine cervix cancer patients, analyze their alteration with respect to healthy controls and identify the best predictors amongst these for disease occurrence and progression. Particle induced X-ray emission (PIXE) technique was used in this work to identify and quantify trace elements Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Br in the blood sera of uterine cervix cancer subjects and healthy control subjects. The observed alterations are discussed with respect to the possible mechanisms by which these elements might influence the carcinogenic process. (author)

  12. DoReMi workshop on multidisciplinary approaches to evaluating cancer risks associated with low-dose internal contamination

    International Nuclear Information System (INIS)

    A workshop dedicated to cancer risks associated with low-dose internal contamination was organised in March 2011, in Paris, in the framework of the DoReMi (Low Dose Research towards Multidisciplinary Integration) European Network of Excellence. The aim was to identify the best epidemiological studies that provide an opportunity to develop a multidisciplinary approach to improve the evaluation of the cancer risk associated with internal contamination. This workshop provided an opportunity for in-depth discussions between researchers working in different fields including (but not limited to) epidemiology, dosimetry, biology and toxicology. Discussions confirmed the importance of research on the health effects of internal contamination. Several existing epidemiological studies provide a real possibility to improve the quantification of cancer risk associated with internal emitters. Areas for future multidisciplinary collaborations were identified, that should allow feasibility studies to be carried out in the near future. The goal of this paper is to present an overview of the presentations and discussions that took place during this workshop. (authors)

  13. Study on the anti-cancer mechanisms of low dose-rate γ irradiation

    International Nuclear Information System (INIS)

    To investigate appropriate dose range in low-dose-rate γ irradiation and to establish a useful method for the research of radioactive biological effect produced by low does-rate γ irradiation, the authors have studied apoptosis of Hela carcinoma cells induced by different low dose rates of γ irradiation in vitro. The cultured cells were exposed to defined radiation doses from a 60Co therapy source. The radiation source delivered a dose rate of 1 Gy/min and gave total dose of 1, 2, 5, 10 and 15 Gy respectively. Using Annexin V labeled by fluorescein and PI, followed by flow cytometry and DNA ladder analysis and confocal microscope, apoptotic cells were detected and quantified. The results are as follows: (1) Determination of apoptosis by flow cytometry indicated that percentage of apoptotic cells was increasing with dose and time. When cells were cultured for 168 h after irradiation, the highest percentage of apoptosis was yielded in all groups. When the cells were irradiated with 1-2 Gy, no significant increase in the number of apoptotic cells could be seen. After a total dose of 5 Gy, however, a significant increase in the ratio of apoptotic/nonapoptotic cells was observed, and apoptosis reached a peak level of (72.57 ± 2.04)% (P60Co sources to Hela cells can induce a significant apoptosis rate, and a maximum level of apoptosis as high as (72.57±2.04)% for an irradiation dose of 5 Gy can be reached. (authors)

  14. Estimation of non-cancer stochastic effects of prolonged occupational exposure in low dose range

    International Nuclear Information System (INIS)

    This study is aimed at estimation of acute myocardial infarction (AMI) incidence and risk among persons exposed to prolonged low dose rate ionizing radiation. Prevalence and social and medical relevance, and available data on the increased cardio-vascular diseases mortality among nuclear workers determined the chosen clinical model (Howe G.R.,et. Al., 2004). A study was carried out into AMI incidence in closed population of Seversk in 1998-2004, the study was supported by the Federal Agency for Science and Innovations (grant MK-4931.2007.7). Siberian Group of Chemical Enterprises (SGCE) is a town-forming enterprise. Because of this the whole population was divided into residents and SGCE workers, of whom great majority was exposed to long term ionizing radiation in low doses (total cumulative external dose was up to 1 Sv). In the study period, increased incidence was found in both groups (from 5.12 up to 7.11 per 1 000 workers, and from 1.86 up to 2.44 per 1 000 residents). Cross-group analysis (SGCE workers - residents) revealed that general AMI incidence in SGCE employees was significantly greater (χ2 = 64.44-89.05-86.22-65.17-39.78-114.89-96.14; r 2 = 3.54-3.97-3.27-4.59-0.59-18.19-17.58; r = 0.0601-0.0462-0.0706-0.0322-0.4443-0.0000-0.0000 in 1998-2004 respectively). Analysis of standardized relative risk coefficients of developing AMI demonstrated their significant increase in the main group production (auxiliary production incidence was taken as the standard): 1.5 in 1999 (CI 95% 1.15-2.79), 1.8 in 2000 (CI 95% 1.07-2.47), 2.0 in 2001 (CI 95% 1.31-2.99), 2.1 in 2003 (CI 95% 1.42-3.11), 1.9 in 2004 (CI 95% 1.27-2.89). At present, there is data indicating close relationship between AMI development and dose accumulation rate; however, because of irradiation dose homogeneity of the study groups (great majority of AMI patients had doses up to 200 mSv) and limited number of cases in the sample, it was not possible to establish association between AMI development

  15. Synchronous HPV-associated cancer of the cervix and anal canal in a non-HIV infected patient treated simultaneously

    Directory of Open Access Journals (Sweden)

    Bhavana Rai

    2013-01-01

    Full Text Available Synchronous malignancies are uncommon. The oncogenic viruses like Human Papilloma Virus (HPV 16 and 18 have been implicated in the development of cancers of the cervix and anal canal and an increased risk occurs in Human Immunodeficiency Virus-infected (HIV individuals. Though cervical screening for HPV infection is recommended in female patients with anal cancers, synchronous presentation of cancer cervix and anal canal is rare. We present a case of a 72-year-old lady with synchronous cancer cervix and anal canal with HPV 16 positivity by polymerase chain reaction (PCR treated with external radiotherapy, followed by brachytherapy to both the sites.

  16. Inhibition of subsequent nodal metastasis by low dose of elective neck irradiation for tongue cancers

    International Nuclear Information System (INIS)

    To study the influence of elective neck irradiation (ENI) with a dose of ≤30 Gy on subsequent nodal metastasis for tongue carcinomas. Forty-nine patients controlled at the primary site were evaluated. They were treated with interstitial irradiation and ENI of ≤30 Gy from 1979 to 1991. Subsequent nodal metastases developed in 14 patients (29%) 1 to 23 months after radiotherapy. The nodal recurrence rates were 4/10 (40%) for 0 Gy, 4/9 (44%) for 10-15 Gy, 6/22 (27%) for 16-20 Gy, and 0/8 (0%) for 21-30 Gy. The rates according to tumor thickness were 5/28 (18%) for superficial tumors and 9/21 (41%) for deeply invasive tumors. These factors were shown to be significant by multivariate analysis. The nodal recurrence from irradiated fields developed late compared with that from outside the fields. Successful salvage was obtained in 11/14 (79%), depending on the recurrent nodal stage. The five-year survival rate was significantly better in patients with irradiation of >15 Gy (96%) than those with 15 Gy or less (79%). ENI of low dose (15-30 Gy) significantly reduced nodal recurrence rate and prolonged survival. An elective dose of 30 Gy including the upper and middle neck was able to reduce subsequent nodal metastases about 10% (from 37% to 27% in our review). (author)

  17. Metastatic squamous cell carcinoma thyroid from functionally cured cancer cervix

    International Nuclear Information System (INIS)

    The authors report a very unusual occurrence of a metastatic squamous carcinoma to thyroid gland from a treated squamous cell carcinoma cervix 12 years before with no recurrence at the primary site. The case also has an additional complexity of rapid progression of the metastatic thyroid carcinoma to wide spread dissemination to lungs and bones while on concurrent chemo radio therapy confirming the aggressiveness of the entity

  18. Packing effects on the intracavitary radiation therapy of the uterine cervix cancer

    International Nuclear Information System (INIS)

    Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachytherapy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192Ir gives medical treatment intracavity. Intracavitary radiation of the uterine cervix cancer, critical organ take 20% below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherapy make use of packing.

  19. The different biological effects of single, fractioned and continuous low dose rate radiation on CL187 colorectal cancer cell line

    International Nuclear Information System (INIS)

    Objective: To investigate the effect and underlying mechanism of single, fractioned and continuous low dose rate radiation on CL187 colorectal cancer cell line. Methods: CL187 cells were exposed to 6 MV X-rays at a high dose rate of 4 Gy/min and 125I seed at a low dose rate of 2.77 cGy/h with three groups:single dose radiation group (SDR), fractioned dose radiation group (FDR) by 2 Gy/f, and continuous low dose rate radiation group (CLDR). The radiation doses were 0, 2, 4 and 8 Gy. Total cell number and cell viability were determined by trypan blue. Clone forming assay was used to evaluate the cell proliferation ability. The percentage of apoptosis cells was analyzed by flow cytometry. Western blot was used to detect the protein expression levels of PHLPP2, PTEN and Bax. Results: Compared with SDR and FDR groups, the total cell number and survival fraction of CLDR group decreased. The relative biological effect (RBE) for 125I seeds compared with 6 MV X-rays was 1.41. The percentage of apoptosis cells of CLDR group was significantly increased (t=-15.08, -11.99, P<0.05). The expression level of Bax increased in CLDR group, while no obvious changes were observed on PHLPP2 and PTEN among three groups. Conclusions: The expression level of PHLPP2 increases in SDR, FDR and CLDR group, while it seems that it was not influenced by dose rate. The expression level of Bax increased in three groups, while more colorectal CL187 cells in CLDR group may be killed due to the increase of Bax expression. (authors)

  20. High dose and low dose radiation exposure in the induction of breast cancer

    International Nuclear Information System (INIS)

    In today's modern practice of Radiation Oncology it is becoming increasingly common to follow many patients with breast cancer. There is a proven association between prior radiation and the development of breast cancer, although in many instances the available sources of data are confusing. Characteristic features of radiation induced breast cancer are the importance of age at first exposure to radiation and the long latency period. The risk of breast cancer is highest in women exposed in the first decade of life and lessens progressively with increased age at exposure. The latency period is typically 10 years or more; a time in which other age dependent factors may influence the expression of the malignant phenotype. Genetic factors may also (in theory) increase a particular patient's susceptibility. (author)

  1. The more frequent types of human papillomavirus in Cuban samples of cervix cancer

    International Nuclear Information System (INIS)

    Cervix cancer (UCC) is considered a sexually transmitted disease due to factors involved in its appearance and development and this infection is recognized as the main etiological agent of this entity. In Cuba this type of tumor is placed in 2nd category in incidence and in 4th place in mortality among the malignant disease affecting the female sex. The objective of present study is to determine the types of human virus papilloma (HVP) present in samples of cervix tumors in Cuban women, as well as to describe the behavior of different risk factors associated with this disease. Forty five samples of cervix cancer were analyzed and the presence of 20 types of HVP was determined by polymerase chain reaction with specific primers founding in them a 91,1% of positivity. Genotype 16 was the more prevalent, followed by the 18, 45, 31, 39, 51, 56, 59, PAP23A. The low risk type 6 and 11 weren't founded in samples. Promiscuity was the more interesting risk factor in our study. Knowledge of the viral types present in cervix cancer in our patients is very important when we approach the development and the use of prophylactic and therapeutical vaccines

  2. Concurrent chemoradiotherapy with low dose weekly gemcitabine in stage III non-small cell lung cancer

    International Nuclear Information System (INIS)

    Combined chemoradiotherapy (CRT) is the treatment of choice for stage III NSCLC. Gemcitabine (G) is a novel deoxycitidine analogue that has been proven to be a potent radiosensitizer. Twenty-two consecutive patients were treated with concurrent CRT to demonstrate the tolerability and efficacy of low dose G given weekly as radiosensitizer in stage III NSCLC. Patients with KPS ≥70, adequate bone marrow reserve, with no prior radiotherapy (RT) and surgery were included. Eighteen patients had received prior induction chemotherapy (CT). G (75 mg/m2/week) was infused over 1 hour for 6 weeks. Thoracic RT was given two hours later over 6 weeks at 1.8 Gy/day fractions (total dose of 61.2 Gy). Pulmonary toxicity was evaluated with computed tomography scans in 6 weeks. Median age was 60 years (range, 48–75), median follow-up was 15 months (range, 2–40). Sixty-eight percent of patients were male and median KPS score was 90. Conformal 3D-RT planning was used in 64% of patients. G was given for a median of 5 weeks (range 1–9). Twelve patients (54.6%) received all planned CT. G was stopped because of intolerance in 6 and death in 2 patients. Seven patients (31.8%) had radiation pneumonitis. Twenty patients were evaluated for overall response, 1 patient (4.5%) had clinical CR, 81.8% had PR while 9.5% had SD. Median overall survival (OS) was 14 ± 5 months (95% CI 3–25). One- and 2-year OS rates were 55% and 38%. Sixteen patients died of disease-related events (6 with progression of primary tumor, 8 due to metastatic disease), 2 patients died of other causes. One- and 2-year progression-free survival and local control rates were 56%, 27% and 79%, 51%, respectively. G might be used as radiosensitizer for patients with stage III NSCLC who could not receive full doses CT with concurrent RT

  3. Correlation between radon level and confounders of cancer. A note on epidemiological inference at low doses

    International Nuclear Information System (INIS)

    Complete text of publication follows. Objective. The aim of this study was to examine and further clarify the extent of radon and progeny induced carcinogenesis, both separated from and combined with other confounders and health risk factors. This work was financed by National Development Agency, Hungary, with GVOP-3.1.1.-2004-05-0384/3.0. Methods. A case-control study was conducted in a Hungarian countryside region where the proportion of houses with yearly average radon level above 200 Bq.m-3 was estimated to be higher than 20% by our preceding regional surveys. Radon levels were measured with CR39 closed etched detectors for three seasons separately yielding yearly average by estimating the low summer level. The detectors were placed in the bedrooms, where people were expected to spend one third of a day. 520 patients with diagnosed cancers were included in these measurements, amongst which 77 developed lung or respiratory cancers. The control group consisted 6333 individuals, above 30 years of age. Lifestyle risk factors of cancers were collected by surveys including social status, pollution from indoor heating, smoking and alcohol history, nutrition, exercise and mental health index 5. Except smoking and alcohol habits, these cofactors were only available for the control group. Comparing disease occurrences the authors selected the multivariate generalised linear models. The case and control proportions along a given factor are binomially distributed, thus the logit link function was used. For radon both log and linear terms were probed for. Results. Many known health confounders of cancers correlated with radon levels, with an estimated total net increase of 50-150 Bq m-3 with increased risks. For lung cancers the model with the terms radon, age, gender and smoking was found to have the lowest Akaike Information Criterion (AIC). Heavy dependency on age, gender and smoking contribute largely to observed lung cancer incidence. However log linear relationship

  4. Experiences of low dose exposure mammography on the cancer mass screening of breast

    International Nuclear Information System (INIS)

    This paper summarizes experiences in the use of the mammograph for the mass screening of breast cancer. The exposure dose per experience was only 1/8.4 (0.21 mSv) that of conventional mammography. Application to 243 persons resulted in 95.6% (43/45 patients) of TPR, 57.1% (113/198 patients) of TNR and 1.7% (2/115 patients) of false negative. Although the authors consider that the mammograph has a bright future, a few points for improvement follow herein. To increase the accuracy of mass screening of breast cancer, photography techniques and decipherment of X-rays should be considered. (author)

  5. Lung cancer induced in hamsters by low doses of alpha radiation from 210Po

    International Nuclear Information System (INIS)

    Lung cancers have been induced in 9 to 53 percent of hamsters given multiple intratracheal instillations of polonium-210 in amounts yielding lifetime exposures of 15 to 300 rads to the lungs. Cigarette smokers have previously been estimated to receive 20 rads to areas of the bronchial epithelium from deposited polonium-210. This finding thus supports the hypothesis that alpha radiation resulting from the polonium-210 or lead-210 present in cigarette smoke may be a significant causative factor in human lung cancer. (U.S.)

  6. Comparison of Measurements of the Uterus and Cervix Obtained by Magnetic Resonance and Transabdominal Ultrasound Imaging to Identify the Brachytherapy Target in Patients With Cervix Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dyk, Sylvia van, E-mail: sylvia.vandyk@petermac.org [Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Kondalsamy-Chennakesavan, Srinivas [Rural Clinical School, University of Queensland, Toowoomba, Queensland (Australia); Schneider, Michal [Department of Medical Imaging and Radiation Science, Monash University, Clayton, Victoria (Australia); Bernshaw, David [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Narayan, Kailash [Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia); Department of Obstetrics and Gynaecology, Melbourne University, Melbourne, Victoria (Australia)

    2014-03-15

    Purpose: To compare measurements of the uterus and cervix obtained with magnetic resonance imaging (MRI) and transabdominal ultrasound to determine whether ultrasound can identify the brachytherapy target and be used to guide conformal brachytherapy planning and treatment for cervix cancer. Methods and Materials: Consecutive patients undergoing curative treatment with radiation therapy between January 2007 and March 2012 were included in the study. Intrauterine applicators were inserted into the uterine canal while patients were anesthetized. Images were obtained by MRI and transabdominal ultrasound in the longitudinal axis of the uterus with the applicator in treatment position. Measurements were taken at the anterior and posterior surface of the uterus at 2.0-cm intervals along the applicator, from the external os to the tip of the applicator. Data were analyzed using Bland Altman plots examining bias and 95% limits of agreement. Results: A total of 192 patients contributed 1668 measurements of the cervix and uterus. Mean (±SD) differences of measurements between imaging modalities at the anterior and posterior uterine surface ranged from 1.5 (±3.353) mm to 3.7 (±3.856) mm, and −1.46 (±3.308) mm to 0.47 (±3.502) mm, respectively. The mean differences were less than 3 mm in the cervix. The mean differences were less than 1.5 mm at all measurement points on the posterior surface. Conclusion: Differences in the measurements of the cervix and uterus obtained by MRI and ultrasound were within clinically acceptable limits. Transabdominal ultrasound can be substituted for MRI in defining the target volume for conformal brachytherapy treatment of cervix cancer.

  7. Lung cancer incidence after exposure of rats to low doses of radon: influence of dose rate

    International Nuclear Information System (INIS)

    To study the effect on lung cancer incidence of a long exposure to low levels of radon, 500 male 3-months-old Sprague-Dawley rats, were exposed to a cumulative dose of 25 WLM of radon and its daughters, 6 hours a day, 5 days a week, during 18 months. Exposure conditions were controlled in order to maintain a defined PAEC: 42 x 106 J.m-3 (2 WL), in the range of domestic and environmental exposures. Animals were kept until they died or given euthanasia when moribund. Mean survival times were similar in both irradiated and control groups: 828 days (SD = 169) and 830 days (SD = 137), as well as lung cancer incidence, 0.60% at 25 WLM and 0.63% for controls. The incidence of lung lesions was compared statistically with controls and those previously obtained at cumulative exposures of 25 and 50 WLM delivered over a 4-6 month period, inducing a significant increase of lung cancer, 2.2% and 3.8% respectively. Such a comparison showed a decreased lung cancer incidence related to a decrease in the dose rate for low levels of radon exposure. (author)

  8. [Phantom Study on Dose Reduction Using Iterative Reconstruction in Low-dose Computed Tomography for Lung Cancer Screening].

    Science.gov (United States)

    Minehiro, Kaori; Takata, Tadanori; Hayashi, Hiroyuki; Sakuda, Keita; Nunome, Haruka; Kawashima, Hiroko; Sanada, Shigeru

    2015-12-01

    We investigated dose reduction ability of an iterative reconstruction technology for low-dose computed tomography (CT) for lung cancer screening. The Sinogram Affirmed Iterative Reconstruction (SAFIRE) provided in a multi slice CT system, Somatom Definition Flash (Siemens Healthcare) was used. An anthropomorphic chest phantom (N-1, Kyoto Kagaku) was scanned at volume CT dose index (CTDIvol) of 0.50-11.86 mGy with 120 kV. For noise (standard deviation) and contrast-to-noise ratio (CNR) measurements, CTP486 and CTP515 modules in the Catphan (The Phantom Laboratory) were scanned. Radiological technologists were participated in the perceptual comparison. SAFIRE reduced the SD values by approximately 50% compared with filter back projection (FBP). The estimated dose reduction rates by SAFIRE determined from the perceptual comparison was approximately 23%, while 75% dose reduction rate was expected from the SD value reduction of 50%. PMID:26685831

  9. Long-term prognosis of patients with lung cancer detected on low-dose chest computed tomography screening.

    Science.gov (United States)

    Nawa, Takeshi; Nakagawa, Tohru; Mizoue, Tetsuya; Kusano, Suzushi; Chonan, Tatsuya; Fukai, Shimao; Endo, Katsuyuki

    2012-02-01

    The effectiveness of lung cancer screening using low-dose chest computed tomography (CT) remains elusive. The present study examined the prognosis of patients with lung cancer detected on CT screening in Japanese men and women. Subjects were 210 patients with primary lung cancer identified on CT screening at two medical facilities in Hitachi, Japan, where a total of 61,914 CT screenings were performed among 25,385 screenees between 1998 and 2006. Prognostic status of these patients was sought by examining medical records at local hospitals, supplemented by vital status information from local government. The 5-year survival rate was estimated according to the characteristics of patients and lung nodule. A total of 203 (97%) patients underwent surgery. During a 5.7-year mean follow-up period, 19 patients died from lung cancer and 6 died from other causes. The estimated 5-year survival rate for all patients and for those on stage IA was 90% and 97%, respectively. Besides cancer stage, smoking and nodule appearance were independent predictors of a poor survival; multivariable-adjusted hazard ratio (95% confidence interval) was 4.7 (1.3, 16.5) for current and past smokers versus nonsmokers and 4.6 (1.6, 13.9) for solid nodule versus others. Even patients with solid shadow had a 5-year survival of 82% if the lesion was 20mm or less in size. Results suggest that lung cancers detected on CT screening are mostly curative. The impact of CT screening on mortality at community level needs to be clarified by monitoring lung cancer deaths. PMID:21813201

  10. Case of ileal perforation during low dose irradiation for pelvic recurrence of rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hosokawa, Tetsuya; Kobatake, Toshio; Isomoto, Hiroharu; Shirouzu, Kazuo; Kakegawa, Teruo

    1989-01-01

    A 42-year-old man was evaluated for perineal pain. Computed tomography of the pelvis revealed recurrence of rectal cancer, which was impossible to treat sugically. Though irradiation therapy was started. As it had to be discontinued because of the appearance of inflammation in the perineal region and lower abdominal pain after 800 rad. Small intestinal gastrography revealed a perforation of the ileum, and intestinal resection was performed. Pathological studies showed cancer invasion, bleeding and edema due to acute radiation damage. The radiosensitive nature of the small intestine in this case led to a fatal outcome. Effective therapeutic and examination methods have not yes been established for cases such as this one. It is concluded that lowdose radiation may induce severe intestinal complications. (author).

  11. A case of ileal perforation during low dose irradiation for pelvic recurrence of rectal cancer

    International Nuclear Information System (INIS)

    A 42-year-old man was evaluated for perineal pain. Computed tomography of the pelvis revealed recurrence of rectal cancer, which was impossible to treat sugically. Though irradiation therapy was started. As it had to be discontinued because of the appearance of inflammation in the perineal region and lower abdominal pain after 800 rad. Small intestinal gastrography revealed a perforation of the ileum, and intestinal resection was performed. Pathological studies showed cancer invasion, bleeding and edema due to acute radiation damage. The radiosensitive nature of the small intestine in this case led to a fatal outcome. Effective therapeutic and examination methods have not yes been established for cases such as this one. It is concluded that lowdose radiation may induce severe intestinal complications. (author)

  12. The risk of childhood cancer from low doses of ionizing radiation received in utero

    International Nuclear Information System (INIS)

    Radiological protection is based upon the assumption that any additional exposure to ionising radiation leads to an increased risk of stochastic adverse health effects. The validity of this assumption is supported by the epidemiological association between childhood cancer and X-ray exposure of the fetus in utero for diagnostic purposes. Evidence for a direct causal interpretation of this association is compelling: the association has high statistical significance, it is consistent across many case-control studies carried out worldwide, and an appropriate dose-response relationship is indicated. Evidence against bias and confounding as alternative explanations is strong. Nonetheless, objections to causality have been raised. Four grounds for controversy are examined in detail, with the conclusion that they do not provide persuasive evidence against a cause and effect relationship. We conclude that acute doses of the order of 10 mGy received by the fetus in utero cause a subsequent increase in the risk of cancer in childhood, and that, in these circumstances, the excess absolute risk coefficient for childhood cancer incidence is 6-12% per Gy. (author)

  13. Radiation-related cancer risks at low doses among atomic bomb survivors.

    Science.gov (United States)

    Pierce, D A; Preston, D L

    2000-08-01

    To clarify the information in the Radiation Effects Research Foundation data regarding cancer risks of low radiation doses, we focus on survivors with doses less than 0.5 Sv. For reasons indicated, we also restrict attention mainly to survivors within 3, 000 m of the hypocenter of the bombs. Analysis is of solid cancer incidence from 1958-1994, involving 7,000 cancer cases among 50,000 survivors in that dose and distance range. The results provide useful risk estimates for doses as low as 0.05-0.1 Sv, which are not overestimated by linear risk estimates computed from the wider dose ranges 0-2 Sv or 0-4 Sv. There is a statistically significant risk in the range 0-0.1 Sv, and an upper confidence limit on any possible threshold is computed as 0.06 Sv. It is indicated that modification of the neutron dose estimates currently under consideration would not markedly change the conclusions. PMID:10931690

  14. Are we justified for concomitant chemo-radiation in advanced stage cancer cervix?

    International Nuclear Information System (INIS)

    the survival rates have achieved a plateau of 30-45% at five years. Over the last decade there have been studies on the use of chemo-radiotherapy in carcinoma cervix. Over 19 randomized trials have been published addressing the issue of chemo-radiotherapy. However, heterogeneous data, poor randomization, inadequate number of patients, sub-optimal radiotherapy, non-uniform use of chemotherapeutic drugs, its sequencing and poor documentation have not yet provided the evidence to substantially alter the practice. The Cochrane and Canadian meta-analyses have to a large extent tried to address the role of concomitant chemo-radiation, but carcinoma cervix stage III accounted for only 30?35%. Moreover, evaluation with optimal radiation schedules and comparison of late toxicities still remain unanswered. What is more important is that the cisplatin is relatively inexpensive and is available worldwide. This means that cisplatin-based chemo-radiation is affordable in the developing countries where carcinoma cervix still forms the major cancer. However, the role of chemo-radiation in carcinoma cervix stage IIIB in developing countries including India still remains unexplored. With an aim to evaluate the role and benefit of chemo-radiation in- patients with cervical cancer we proposed this randomized study

  15. Erectile dysfunction following treatment with low-dose brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Of 260 prostate cancer patients, 26% had potency before brachytherapy when defined as an sexual health inventory for men (SHIM) score of ≥12. Three years after brachytherapy, 44% patients had preserved erectile function (EF-pts) and 56% were erectile dysfunction (ED-pts). Between ED-pts and EF-pts, we compared the doses delivered to the penile bulb or neurovascular bundle using a dose-volume histogram obtained from brachytherapy postplan and patients' characteristics. The mean age and prostate volume of ED-pts were significantly higher than those of EF-pts. No difference was observed in the respective doses between the 2 groups.(author)

  16. Optimization strategies for pulsed low-dose-rate IMRT of recurrent lung and head and neck cancers.

    Science.gov (United States)

    Kang, Shengwei; Lang, Jinyi; Wang, Pei; Li, Jie; Lin, Muhan; Chen, Xiaoming; Guo, Ming; Chen, Fu; Chen, Lili; Ma, Charlie Ming

    2014-01-01

    Pulsed low-dose-rate radiotherapy (PLDR) has been proven to be a valid method of reirradiation. Previous studies of recurrent cancer radiotherapy were mainly based on conventional 3D CRT and VMAT delivery techniques. There are difficulties in IMRT planning using existing commercial treatment planning systems (TPS) to meet the PLDR protocol. This work focuses on PLDR using ten-field IMRT and a commercial TPS for two specific sites: recurrent lung cancers and head and neck cancers. Our PLDR protocol requires that the maximum dose to the PTV be less than 0.4 Gy and the mean dose to be 0.2 Gy per field. We investigated various planning strategies to meet the PLDR requirements for 20 lung and head and neck patients. The PTV volume for lung cases ranged from 101.7 to 919.4 cm3 and the maximum dose to the PTV ranged from 0.22 to 0.39 Gy. The PTV volume for head and neck cases ranged from 66.2 to 282.1 cm3 and the maximum dose to the PTV ranged from 0.21 to 0.39 Gy. With special beam arrangements and dosimetry parameters, it is feasible to use a commercial TPS to generate quality PLDR IMRT plans for lung and head and neck reirradiation. PMID:24892337

  17. Low-dose-rate brachytherapy for patients with transurethral resection before implantation in prostate cancer: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Prada, Pedro J.; Anchuelo, Javier; Blanco, Ana Garcia; Paya, Gema; Cardenal, Juan; Acuña, Enrique; Ferri, Maria [Department of Radiation Oncology, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain); Vazquez, Andres; Pacheco, Maite; Sanchez, Jesica [Department of Radiation Physics, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria (Spain)

    2016-01-15

    Objectives: We analyzed the long-term oncologic outcome for patients with prostate cancer and transurethral resection who were treated using low-dose-rate (LDR) prostate brachytherapy. Methods and Materials: From January 2001 to December 2005, 57 consecutive patients were treated with clinically localized prostate cancer. No patients received external beam radiation. All of them underwent LDR prostate brachytherapy. Biochemical failure was defined according to the 'Phoenix consensus'. Patients were stratified as low and intermediate risk based on The Memorial Sloan Kettering group definition. Results: The median follow-up time for these 57 patients was 104 months. The overall survival according to Kaplan-Meier estimates was 88% (±6%) at 5 years and 77% (±6%) at 12 years. The 5 and 10 years for failure in tumour-free survival (TFS) was 96% and respectively (±2%), whereas for biochemical control was 94% and respectively (±3%) at 5 and 10 years, 98% (±1%) of patients being free of local recurrence. A patient reported incontinence after treatment (1.7%). The chronic genitourinary complains grade I were 7% and grade II, 10%. At six months 94% of patients reported no change in bowel function. Conclusions: The excellent long-term results and low morbidity presented, as well as the many advantages of prostate brachytherapy over other treatments, demonstrates that brachytherapy is an effective treatment for patients with transurethral resection and clinical organ-confined prostate cancer. (author)

  18. Longitudinal follow-up study of smoking-induced emphysema progression in low-dose CT screening of lung cancer

    Science.gov (United States)

    Suzuki, H.; Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, Masahiro; Moriyama, N.

    2014-03-01

    Chronic obstructive pulmonary disease is a major public health problem that is predicted to be third leading cause of death in 2030. Although spirometry is traditionally used to quantify emphysema progression, it is difficult to detect the loss of pulmonary function by emphysema in early stage, and to assess the susceptibility to smoking. This study presents quantification method of smoking-induced emphysema progression based on annual changes of low attenuation volume (LAV) by each lung lobe acquired from low-dose CT images in lung cancer screening. The method consists of three steps. First, lung lobes are segmented using extracted interlobar fissures by enhancement filter based on fourdimensional curvature. Second, LAV of each lung lobe is segmented. Finally, smoking-induced emphysema progression is assessed by statistical analysis of the annual changes represented by linear regression of LAV percentage in each lung lobe. This method was applied to 140 participants in lung cancer CT screening for six years. The results showed that LAV progressions of nonsmokers, past smokers, and current smokers are different in terms of pack-year and smoking cessation duration. This study demonstrates effectiveness in diagnosis and prognosis of early emphysema in lung cancer CT screening.

  19. Chemo-endocrine therapy with low-dose cisplatin, UFT, and dexamethasone for hormone-refractory prostate cancer patients

    International Nuclear Information System (INIS)

    Since September 2005, twenty-two patients with hormone-refractory prostate cancer (aged 55-81 years) were treated with LH-RH agonist and low-dose cisplatin, tegafur-uracil (UFT), and dexamethasone after proving resistant to estramustine phosphate therapy. The regimen of this therapy consists of 5 mg/body of cisplatin intravenously once a week, 300 mg/day of UFT and 1 mg/day of dexamethasone orally, every day. All patients suffered from clinical progression such as local recurrence in 11 patients who had already received radiation therapy, lymph node metastasis in 7 patients, and bone metastasis in 15 patients. Initial prostate specific antigen (PSA) value ranged from 1.7 ng/mL to 215.1 ng/mL. The PSA response rate, which decreased more than 50% in PSA values was 72.7% (16/22). The follow-up term ranged from 2 to 43 months, and nine patients died of cancer progression. The median time to progression was 11 months, and median overall survival was 19 months. There were no severe adverse effects, and stoppages of the therapy for 13 patients were all due to disease progression. Following this therapy, 9 patients received best supportive care and 4 patients received docetaxel chemotherapy. We considered this therapy to be effective for patients with hormone-refractory prostate cancer because it maintained their good quality of life (QOL). (author)

  20. Lung Cancer Screening With Low-Dose CT: Implementation Amid Changing Public Policy at One Health Care System.

    Science.gov (United States)

    Begnaud, Abbie; Hall, Thomas; Allen, Tadashi

    2016-01-01

    Screening for lung cancer with low-dose CT has evolved rapidly in recent years since the National Lung Screening Trial (NLST) results. Subsequent professional and governmental organization guidelines have shaped policy and reimbursement for the service. Increasingly available guidance describes eligible patients and components necessary for a high-quality lung cancer screening program; however, practical instruction and implementation experience is not widely reported. We launched a lung cancer screening program in the face of reimbursement and guideline uncertainties at a large academic health center. We report our experience with implementation, including challenges and proposed solutions. Initially, we saw less referrals than expected for screening, and many patients referred for screening did not clearly meet eligibility guidelines. We educated primary care providers and implemented system tools to encourage referral of eligible patients. Moreover, in response to the Centers for Medicare & Medicaid Services (CMS) final coverage determination, we report our programmatic adaptation to meet these requirements. In addition to the components common to all quality programs, individual health delivery systems will face unique barriers related to patient population, available resources, and referral patterns. PMID:27249755

  1. The different biological effects of single, fractionated and continuous low dose rate irradiation on CL187 colorectal cancer cells

    International Nuclear Information System (INIS)

    To determine the biological effectiveness of single, fractionated and continuous low dose rate irradiation on the human colorectal cancer cell line CL187 in vitro and explore the cellular mechanisms. The CL187 cells were exposed to radiation of 6 MV X-ray at a high dose rate of 4Gy/min and 125I seed at a low dose rate of 2.77 cGy/h. Three groups were employed: single dose radiation group (SDR), fractionated dose radiation group (FDR) by 2Gy/f and continuous low dose rate radiation group (CLDR). Four radiation doses 2, 4, 6 and 8Gy were chosen and cells without irradiation as the control. The responses of CL187 cells to distinct modes of radiation were evaluated by the colony-forming assay, cell cycle progression as well as apoptosis analysis. In addition, we detected the expression patterns of DNA-PKcs, Ku70 and Ku80 by Western blotting. The relative biological effect for 125I seeds compared with 6 MV X-ray was 1.42. 48 hrs after 4Gy irradiation, the difference between proportions of cells at G2/M phase of SDR and CLDR groups were statistically significant (p = 0.026), so as the FDR and CLDR groups (p = 0.005). 48 hrs after 4Gy irradiation, the early apoptotic rate of CLDR group was remarkably higher than SDR and FDR groups (CLDR vs. SDR, p = 0.001; CLDR vs. FDR, p = 0.02), whereas the late apoptotic rate of CLDR group increased significantly compared with SDR and FDR group (CLDR vs. SDR, p = 0.004; CLDR vs. FDR, p = 0.007). Moreover, DNA-PKcs and Ku70 expression levels in CLDR-treated cells decreased compared with SDR and FDR groups. Compared with the X-ray high dose rate irradiation, 125I seeds CLDR showed more effective induction of cell apoptosis and G2/M cell cycle arrest. Furthermore, 125I seeds CLDR could impair the DNA repair capability by down-regulating DNA-PKcs and Ku70 expression

  2. Concurrent chemoradiotherapy using protracted infusion of low-dose CDDP and 5-FU and radiotherapy for esophageal cancer

    International Nuclear Information System (INIS)

    We evaluated the effects and safety of concurrent chemoradiotherapy for patients with esophageal cancer. Between March 1994 and April 1998, concurrent chemoradiotherapy using protracted infusion of low-dose cisplatin (CDDP: 3-6 mg/m2/24 h), 5-fluorouracil (5-FU: 200 mg/m2/24 h) and radiotherapy was given to 26 patients. The median age was 70 yr, with a range from 58 to 86 yr. With regard to TNM classification (1987), 6 patients were stage II, 5 stage III, and 15 stage IV. Radiotherapy was performed by external irradiation alone in 23 patients and external irradiation plus brachytherapy in three patients. One patient underwent surgery after a dose of 40 Gy owing to the possibility of idiopathic bleeding from the stomach. Locally, primary effects resulted in complete response in 11 patients (42.3%) and partial response in 15 (57.7%). Acute toxicity was primarily hematologic. Leukopenia and thrombocytopenia of grade 3 of 4 occurred in eight (30.7%) and six (23.0%) of 26 patients, respectively. In patients administered CDDP at more than 5 mg/m2/day, hemotoxicity was severe because in five of the 10 patients administered 5 mg/m2 CDDP and one of the 2 patients administered 6 mg/m2 CDDP, thrombocytopenia of grade 3 or 4 occurred. Protracted infusion of low-dose CDDP and 5-FU with concomitant radiation therapy is effective, but from the point of acute toxicity, the optimal dose of CDDP and 5-FU needs further investigation. (author)

  3. Radical radiotherapy for cervix cancer: The effect of waiting time on outcome

    International Nuclear Information System (INIS)

    Purpose: To assess the effect of treatment waiting time on clinical outcome for patients with cervix cancers treated with radical radiotherapy. Methods and materials: A retrospective analysis was conducted on all cervix cancer patients treated with radical radiotherapy between 1990 and 2001 at the Ottawa Regional Cancer Centre. Analyses were performed according to the three following separate definitions of waiting times: interval from start of radiotherapy to (1) date of initial biopsy (2) date of examination under anesthesia, and (3) date of radiation oncology consultation. Associations between waiting times and patient characteristics and disease control were investigated using t-tests, analyses of variance, and Cox regression analyses. Results: A total of 195 patients were studied. The vast majority of patients were treated within 5, 6, and 8 weeks of their consultation (91%), examination under anesthesia (88%), and biopsy (81%), respectively. On average, delays between initial biopsy and treatment start were greater for older patients (p = 0.025) (5.8 weeks for 70 years old) and those with smaller tumors (p 4 cm vs. 6.3 weeks for ≤4 cm). Univariate analysis revealed no adverse effect of treatment delay on tumor control. Multivariate analysis, with the inclusion of multiple prognostic tumor and treatment parameters, revealed an adverse effect of treatment delay on survival outcomes. Conclusions: Longer radiotherapy waiting times were found to be associated with diminished survival outcomes for patients treated radically for cervix cancer. The significance of this observed association requires further investigation

  4. Results from phase III clinical trials with radachlorine for photodynamic therapy of pre-cancer and early cancer of cervix

    OpenAIRE

    E. V. Filonenko; L. G. Serova; V. I. Ivanova-Radkevich

    2015-01-01

    The results of clinical study for efficacy of photodynamic therapy (PDT) with radachlorine in patients with pre-cancer and cancer of cervix are represented. The study enrolled 30 patients including 4 patients with cervical erosion, 5 patients with cervical intraepithelial neoplasia II, 13 patients with cervical intraepithelial neoplasia III, 4 patients with carcinoma in situ and 4 patients with cervical cancer stage Ia. Radachlorine was administrated as single 30 minute intravenous injection ...

  5. Low-dose CT screening in an Asian population with diverse risk for lung cancer: A retrospective cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Chin A. [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Myung-Hee; Cho, Yun Yung [Sungkyunkwan University School of Medicine, Department of Social and Preventive Medicine, Seoul (Korea, Republic of); Choi, Yoon-Ho [Sungkyunkwan University School of Medicine, Center for Health Promotion, Seoul (Korea, Republic of); Kwon, O. Jung [Sungkyunkwan University School of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Kyung Eun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Kyung Hee University Hospital, Department of Diagnostic Radiology, Seoul (Korea, Republic of)

    2015-08-15

    To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. (orig.)

  6. Osteoporosis markers on low-dose lung cancer screening chest computed tomography scans predict all-cause mortality

    Energy Technology Data Exchange (ETDEWEB)

    Buckens, C.F. [University Medical Center Utrecht, Radiology Department, Utrecht (Netherlands); University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Graaf, Y. van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Verkooijen, H.M.; Mali, W.P.; Jong, P.A. de [University Medical Center Utrecht, Radiology Department, Utrecht (Netherlands); Isgum, I.; Mol, C.P. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Verhaar, H.J. [University Medical Center Utrecht, Department of Geriatric Medicine, Utrecht (Netherlands); Vliegenthart, R.; Oudkerk, M. [Medical Center Groningen, Department of Radiology, Utrecht (Netherlands); Aalst, C.M. van; Koning, H.J. de [Erasmus MC Rotterdam, Department of Public Health, Rotterdam (Netherlands)

    2015-01-15

    Further survival benefits may be gained from low-dose chest computed tomography (CT) by assessing vertebral fractures and bone density. We sought to assess the association between CT-measured vertebral fractures and bone density with all-cause mortality in lung cancer screening participants. Following a case-cohort design, lung cancer screening trial participants (N = 3,673) who died (N = 196) during a median follow-up of 6 years (inter-quartile range: 5.7-6.3) were identified and added to a random sample of N = 383 from the trial. We assessed vertebral fractures using Genant and acute;s semiquantative method on sagittal reconstructions and measured bone density (Hounsfield Units (HU)) in vertebrae. Cox proportional hazards modelling was used to determine if vertebral fractures or bone density were independently predictive of mortality. The prevalence of vertebral fractures was 35 % (95 % confidence interval 30-40 %) among survivors and 51 % (44-58 %) amongst cases. After adjusting for age, gender, smoking status, pack years smoked, coronary and aortic calcium volume and pulmonary emphysema, the adjusted hazard ratio (HR) for vertebral fracture was 2.04 (1.43-2.92). For each 10 HU decline in trabecular bone density, the adjusted HR was 1.08 (1.02-1.15). Vertebral fractures and bone density are independently associated with all-cause mortality. (orig.)

  7. Low-dose CT screening in an Asian population with diverse risk for lung cancer: A retrospective cohort study

    International Nuclear Information System (INIS)

    To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. (orig.)

  8. Smoking cessation interventions within the context of Low-Dose Computed Tomography lung cancer screening: A systematic review.

    Science.gov (United States)

    Piñeiro, Bárbara; Simmons, Vani N; Palmer, Amanda M; Correa, John B; Brandon, Thomas H

    2016-08-01

    The integration of smoking cessation interventions (SCIs) within the context of lung cancer screening programs is strongly recommended by screening guidelines, and is a requirement for Medicare coverage of screening in the US. In Europe, there are no lung cancer screening guidelines, however, research trials are ongoing, and prominent professional societies have begun to recommend lung cancer screening. Little is known about the types and efficacy of SCIs among patients receiving low-dose computed tomography (LDCT) screening. This review addresses this gap. Based on a systematic search, we identified six empirical studies published prior to July 1, 2015, that met inclusion criteria for our review: English language, SCI for LDCT patients, and reported smoking-related outcomes. Three randomized studies and three single-arm studies were identified. Two randomized controlled trials (RCTs) evaluated self-help SCIs, whereas one pilot RCT evaluated the timing (before or after the LDCT scan) of a combined (counseling and pharmacotherapy) SCI. Among the single-arm trials, two observational studies evaluated the efficacy of combined SCI, and one retrospectively assessed the efficacy of clinician-delivered smoking assessment, advice, and assistance. Given the limited research to date, and particularly the lack of studies reporting results from RCTs, assumptions that SCIs would be effective among this population should be made with caution. Findings from this review suggest that participation in a lung screening trial promotes smoking cessation and may represent a teachable moment to quit smoking. Findings also suggest that providers can take advantage of this potentially teachable moment, and that SCIs have been successfully implemented in screening settings. Continued systematic and methodologically sound research in this area will help improve the knowledge base and implementation of interventions for this population of smokers at risk for chronic disease. PMID:27393513

  9. Bladder and rectal complications following radiotherapy for cervix cancer

    International Nuclear Information System (INIS)

    One-hundred and thirty-two patients with cervix carcinoma who were treated with whole pelvis irradiation and two intracavitary applications had bladder and rectal dosimetry during brachytherapy with contrast agents placed into the bladder and rectum prior to orthogonal simulator radiographs. Doses were computer calculated at points A and B, F (bladder), R1 (rectum), and R2 (rectosigmoid). Late occurring bladder and rectal complications were graded on a severity scale of 1 to 3, and 14% had grade 2 or 3 injuries (9% developed fistulas). Statistical evaluation of the data showed that severe bladder and rectal injuries occur more commonly in stage IIIA and IIIB disease and in those receiving high external beam doses (5000 rad +). Analysis of variance tests revealed a significant correlation of brachytherapy dose to points R1 and R2 with severe rectal injuries but there was not a correlation of dose to F with bladder injuries. Nor was there correlation of injuries with dose to point A or the milligram-hour dose. We conclude that our technique for rectal dosimetry is adequate but that an improved technique of bladder dosimetry is needed. Also, when combining whole pelvis irradiation with two intracavitary applications (4000 rad to point A), the whole pelvis dose should probably not exceed 4000-4500 rad

  10. Low dose hyper-radiosensitivity in human lung cancer cell line A549 and its possible mechanisms

    International Nuclear Information System (INIS)

    Objective: To study the low dose hyper-radiosensitivity in human lung cancer cell line A549, and its possible mechanisms. Methods: Exponentially growing A549 cells were irradiated with 60Co γ-rays at doses of 0-2 Gy. Together with flow cytometry for precise cell sorting, cell survival fraction was measured by mean of conventional colony-formation assay. ATM1981 Ser-P protein expression was examined by Western blot. Apoptosis was identified by Hoechst 33258 fluorescent staining, and Annexin V-FITC and propidium iodide staining flow cytometry. Cell cycle distribution was observed by flow cytometry. Results: There was an excessive cell killing per unit dose when the doses were below about 0.3 Gy, and the cells exhibited more resistant response at the doses between 0.3 and 0.5 Gy, the cell survival fraction was decreased as the doses over 0.5 Gy. The expression of ATM1981Ser-P protein was first observed at 0.2 Gy, followed by an increase over 0.2 Gy, and reached the peak at 0.5 Gy (compared with 0.2 Gy group, t=7.96, P0.05). 24 hours after irradiation, part cells presented the characteristic morphological change of apoptosis, and the apoptosis curve was coincident with the dose-survival curve. Compared with the control group, the cell cycle had no change post-irradiation to 0.1 and 0.2 Gy. G2/M phase arrest was manifested at 6 and 12 hours post-irradiation to 0.3, 0.4 and 0.5 Gy (t=2.87, 2.88, 4.92 and 3.70, 3.12, 8.11, P2/M phase was decreased at 24 hours post-irradiation (t=3.87, 4.77, 3.01, P<0.05). Conclusions: A549 cells displays the phenomenon of hyper-radiosensitivity (HRS) /induced radioresistance (IRR). The model of cell death induced by low dose irradiation is mainly apoptosis. The activity of ATM and cell cycle change might play an important role in HRS/IRR. (authors)

  11. Extended continuous infusion low-dose recombinant interleukin-2 in advanced cancer: prolonged immunomodulation without significant toxicity.

    Science.gov (United States)

    Caligiuri, M A; Murray, C; Soiffer, R J; Klumpp, T R; Seiden, M; Cochran, K; Cameron, C; Ish, C; Buchanan, L; Perillo, D

    1991-12-01

    In previous clinical trials, recombinant interleukin-2 (rIL-2) has been infused at high doses over short periods of time to generate lymphokine-activated killer (LAK) cells in vivo. These trials have been limited by severe toxicities, and the immunologic effects of rIL-2 have been transient. The present study was designed to assess the toxicity and immunologic effects of prolonged administration of low doses of rIL-2. In this phase I study, patients with advanced cancer were scheduled to receive intravenous (IV) infusion of rIL-2 without interruption for 3 months in an outpatient setting. Twenty-one patients received rIL-2 at doses ranging from 0.5 x 10(5) to 6.0 x 10(5) U/m2/d. Treatment was extremely well tolerated, and no patient experienced grade 3 or grade 4 toxicity. The lowest dose level (0.5 x 10(5) U/m2/d) did not have demonstrable immunologic activity. At doses of 1.5 x 10(5) and 4.5 x 10(5) U/m2/d, rIL-2 infusion resulted in the specific expansion of natural-killer (NK) cells (sixfold and ninefold increases, respectively, at these two dose levels) without any changes in B cells, T cells, neutrophils, or monocytes. Grade 2 toxicity was observed at the dose of 6.0 x 10(5) U/m2/d, as three patients required interruption of therapy and two patients who completed therapy developed transient hypothyroidism. In patients with increased NK cells, enhancement of non-major histocompatibility complex (MHC)-restricted cytotoxicity and increased generation of LAK cells in vitro were also demonstrated. Therapy with low-dose rIL-2 can be given safely in an uninterrupted fashion for prolonged periods of time in an outpatient setting. This results in selective expansion of NK cells in vivo with minimal toxicity. Further investigation of this schedule for immunomodulation in vivo should be pursued in phase II studies of both malignant and immunodeficient disease states. PMID:1960552

  12. Fractionated Radioimmunotherapy With 90Y-Clivatuzumab Tetraxetan and Low-Dose Gemcitabine Is Active in Advanced Pancreatic Cancer

    Science.gov (United States)

    Ocean, Allyson J.; Pennington, Kenneth L.; Guarino, Michael J.; Sheikh, Arif; Bekaii-Saab, Tanios; Serafini, Aldo N.; Lee, Daniel; Sung, Max W.; Gulec, Seza A.; Goldsmith, Stanley J.; Manzone, Timothy; Holt, Michael; O’Neil, Bert H.; Hall, Nathan; Montero, Alberto J.; Kauh, John; Gold, David V.; Horne, Heather; Wegener, William A.; Goldenberg, David M.

    2014-01-01

    BACKGROUND It has been demonstrated that the humanized clivatuzumab tetraxetan (hPAM4) antibody targets pancreatic ductal carcinoma selectively. After a trial of radioimmunotherapy that determined the maximum tolerated dose of single-dose yttrium-90-labeled hPAM4 (90Y-hPAM4) and produced objective responses in patients with advanced pancreatic ductal carcinoma, the authors studied fractionated radioimmunotherapy combined with low-dose gemcitabine in this disease. METHODS Thirty-eight previously untreated patients (33 patients with stage IV disease and 5 patients with stage III disease) received gemcitabine 200 mg/m2 weekly for 4 weeks with 90Y-hPAM4 given weekly in Weeks 2, 3, and 4 (cycle 1), and the same cycle was repeated in 13 patients (cycles 2–4). In the first part of the study, 19 patients received escalating weekly 90Y doses of 6.5 mCi/m2, 9.0 mCi/m2, 12.0 mCi/m2, and 15.0 mCi/m2. In the second portion, 19 additional patients received weekly doses of 9.0 mCi/m2 or 12.0 mCi/m2. RESULTS Grade 3/4 thrombocytopenia or neutropenia (according to version 3.0 of the National Cancer Institute’s Common Terminology Criteria for Adverse Events) developed in 28 of 38 patients after cycle 1 and in all retreated patients; no grade >3 nonhematologic toxicities occurred. Fractionated dosing of cycle 1 allowed almost twice the radiation dose compared with single-dose radioimmunotherapy. The maximum tolerated dose of 90Y-hPAM4 was 12.0 mCi/m2 weekly for 3 weeks for cycle 1, with ≤9.0 mCi/m2 weekly for 3 weeks for subsequent cycles, and that dose will be used in future trials. Six patients (16%) had partial responses according to computed tomography-based Response Evaluation Criteria in Solid Tumors, and 16 patients (42%) had stabilization as their best response (58% disease control). The median overall survival was 7.7 months for all 38 patients, including 11.8 months for those who received repeated cycles (46% [6 of 13 patients] ≥1 year), with improved efficacy at

  13. Association between invasive cancer of the cervix and HIV-1 infection in Tanzania: the need for dual screening

    Directory of Open Access Journals (Sweden)

    Ngoma Twalib

    2008-07-01

    Full Text Available Abstract Background Cancer of the cervix is the second commonest malignancy in females worldwide and is the leading malignancy among women in Tanzania. Cancer of the cervix has been strongly associated with Human Papilloma Virus (HPV which is a sexually transmitted disease. However, the role of HIV-1 in the aetiology of cancer of the cervix is less clear. Studies suggest that HPV and HIV-1 infection are synergistic and therefore their dual occurrence may fuel increased incidence of cancer of the cervix and AIDS. We therefore conducted a study to determine the association between cancer of the cervix and HIV-1. Methods The study was carried out in Ocean Road Cancer Institute, Dar-es-salaam, Tanzania between January and March 2007. A hospital-based case control design was used to study 138 cases and 138 controls. The cases were consenting women 18 years and above with histologically confirmed squamous cell carcinoma of the cervix, while the controls were consenting non-cancer adult women attendants or visitors. The participants were counselled and tested for HIV-1 and interviewed to assess risk factors for cancer of the cervix and HIV-1. Estimation of risk was done by computing odds ratios and confidence intervals. Confounding and interaction between the factors were assessed using logistic regression. Results HIV-1 prevalence was much higher among the cases (21.0% than among the controls (11.6%. In logistic regression, HIV-1 was associated with cancer of the cervix (OR = 2.9, 95% CI = 1.4–5.9. Among the cases the mean age was lower for HIV-1 infected (44.3 years than HIV-1 uninfected women (54 years, p = 0.0001. Conclusion HIV-1 infection is associated with invasive cancer of the cervix. Resource-constrained countries with a high burden of HIV-1 and cervical cancer should adopt a high-risk approach that targets HIV-1 positive women for screening of cervical cancer initially by utilizing HIV/AIDS resources.

  14. Curcumin and epithelial-mesenchymal transition in breast cancer cells transformed by low doses of radiation and estrogen.

    Science.gov (United States)

    Gallardo, Marcela; Calaf, Gloria M

    2016-06-01

    Breast cancer is a major cause of global mortality in women. Curcumin exerts anti-proliferative, anti-migratory and apoptotic effects. The aim of this study was to evaluate gene expression involved in epithelial-mesenchymal transition (EMT). An in vitro model was developed with the MCF-10F immortalized breast epithelial cell line exposed to low radiation doses of high LET (linear energy transfer) α-particles (150 keV/µm) and cultured in the presence of 17β-estradiol (estrogen). The following cell lines were used: i) MCF-10F, normal; ii) Alpha5, pre-tumorigenic, and iii) Tumor2 derived from Alpha5 injected into the nude mice. Our previous results have shown that Alpha5 and Tumor2 increased cell proliferation, anchorage independency, invasive capabilities and tumor formation in nude mice in comparison to control. Results indicated that curcumin decreased expression of EMT-related genes in Tumor2 cell line when compared to its counterpart as E-cadherin, N-cadherin, ZEB2, Twist1, Slug, Axl, vimentin, STAT-3, fibronectin; and genes p53 and caveolin-1, as well as apoptotic genes caspase-3, caspase-8, and others such as cyclin D1 and NFκB. All these changes induced a decrease in migratory and invasive capabilities of such a cell line. Thus, it seems that curcumin may impinge upon apoptosis and metastatic properties of the malignant cells exerting antitumor activity in breast cancer cells transformed by low doses of α-particles and estrogen in vitro. PMID:27082017

  15. Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer

    International Nuclear Information System (INIS)

    Purpose: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70% efficacy rate with a 10% pathologic complete response rate. Patients and Methods: Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Results: Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5%, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3%) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3% (4 patients), and the R0 resection rate was 100% (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7% for leukocytopenia, 33.3% for thrombocytopenia, 23.3% for nausea and appetite loss, and 6.7% for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97% (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Conclusion: Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10% would be expected, even for large tumors with metastatic lesions

  16. Permanent interstitial low-dose-rate brachytherapy for patients with low risk prostate cancer. An interim analysis of 312 cases

    International Nuclear Information System (INIS)

    The biochemical relapse-free survival (bRFS) rate after treatment with permanent iodine-125 seed implantation (PSI) or combined seeds and external beam radiotherapy (COMB) for clinical stage T1-T2 localized prostate cancer is a clinically relevant endpoint. The goal of this work was to evaluate the influence of relevant patient- and treatment-related factors. The study population comprised 312 consecutive patients treated with permanent seed implantation. All patients were evaluable for analysis of overall survival (OS) and disease-specific survival (DSS), 230 for bRFS, of which 192 were in the PSI group and 38 in the COMB group. The prescribed minimum peripheral dose was 145 Gy for PSI, for COMB 110 Gy implant and external beam radiotherapy of 45 Gy. The median follow-up time was 33 months (range 8-66 months). bRFS was defined as a serum prostate-specific antigen (PSA) level ≤ 0.2 ng/ml at last follow-up. Overall, the actuarial bRFS at 50 months was 88.4 %. The 50-month bRFS rate for PSI and COMB was 90.9 %, and 77.2 %, respectively. In the univariate analysis, age in the categories ≤ 63 and > 63 years (p < 0.00), PSA nadir (≤ 0.5 ng/ml and > 0.5 ng/ml) and PSA bounce (yes/no) were the significant predicting factors for bRFS. None of the other patient and treatment variables (treatment modality, stage, PSA, Gleason score, risk group, number of risk factors, D90 and various other dose parameters) were found to be a statistically significant predictor of 50-month bRFS. The biochemical failure rates were low in this study. As a proof of principle, our large monocenteric analysis shows that low-dose-rate brachytherapy is an effective and safe procedure for patients with early stage prostate cancer. (orig.)

  17. Quality of Life in Hematologic Cancer Patients: A Randomized Clinical Trial of Low Dose Naltrexone Versus Placebo

    Directory of Open Access Journals (Sweden)

    Mohammad A. Seifrabiei

    2008-01-01

    Full Text Available This study aimed to investigate its effect on hematologic cancer patients. This was a randomized controlled trial assessing quality of life in patients with hematologic malignancies from a single institute in Hamedan. Patients were allocated into two study arms and in addition to their routine treatment received either daily naltrexone 3 mg capsules (treatment group or 3 mg starch (placebo group and were followed up for 5 months. Quality of life was measured using the EORTC QLQ-C30 in four points in time (at admission, 1, 3 and 5 months follow-up. Data were analyzed to compare quality of life in two groups. Totally, 89 patients were studied (45 in treatment group and 44 in placebo group. There were no significant differences between two groups either in demographic and clinical characteristics or in baseline quality of life scores. However, at 1 month, 3 and 5-month follow-up assessments significant differences were observed. In one month follow-up two groups were significantly different in social functioning (p<0.05 indicating a better condition in the treatment group. In the 3-month follow-up, social functioning, role functioning, nausea and vomiting and appetite loss were better in the treatment group (all p-values <0.05. In the 5-month follow-up, physical functioning, social functioning, role functioning, global quality of life, nausea and vomiting and appetite loss were significantly better in the nalterxone group. Low dose naltrexone is an effective drug in improving quality of life in patients with hematologic cancers.

  18. Low-dose radiation enhances susceptibility to cisplatin in resistant ovarian cancer cells via downregulation of ERCC1 and Bcl-2

    Institute of Scientific and Technical Information of China (English)

    Xiaoran Liu; Donghai Liang; Tao Jiang; Qing Dong; Hongsheng Yu 

    2016-01-01

    Objective Ovarian cancer is one of the leading causes of mortality in patients with malignant gyneco-logical tumors. After surgical intervention for ovarian cancer, cisplatin (DDP)-based chemotherapy is the first-line treatment. However, a major chal enge to treating ovarian cancer is the development of chemore-sistance. Thus, the first aim of this study was to determine whether low-dose radiation could enhance the susceptibility of resistant ovarian cancer cel s to DDP. The second aim was to provide new strategies for treating DDP-resistant ovarian cancer by examining its mechanism. Methods A cel counting kit-8 (CCK8) assay was performed to measure cel proliferation. Flow cytometry was utilized to quantify the apoptosis of DDP-resistant ovarian cancer cel s (SKOV3/DDP) using Annexin V and propidium iodide staining. Real-time quantitative (qPCR) was used to analyze the messenger RNA (mRNA) expression levels of excision repair cross complementing-group 1 (ERCC1) and B-cel lymphoma 2 (Bcl-2) in SKOV3/DDP. Results The IC50 values of the control, conventional-dose, and low-dose groups were 9.367 ± 0.16, 9.289 ± 0.16, and 3.847 ± 0.15, respectively (P Conclusion Low-dose radiation enhanced the sensitivity of resistant ovarian cancer cel s to DDP, pos-sibly by decreasing the DNA repair capacity of tumor cel s and promoting apoptosis.

  19. Cancer of the cervix: Early detection and cost-effective solutions.

    Science.gov (United States)

    Denny, Lynette; Prendiville, Walter

    2015-10-01

    Cervical cancer is known to be a preventable disease through the detection of cervical cancer precursors, historically using cytology of the cervix as the primary screening test. Over 85% of cervical cancer cases and deaths occur in low-resource countries. Alternatives to cytology have been investigated with the strongest possibilities being visual inspection with acetic acid (VIA) and HPV DNA testing. HPV DNA testing has been shown in randomized trials to be significantly more sensitive for the detection of cervical cancer precursors than either cytology or VIA. In this paper we argue that prevention really does cost less than cure, or that prevention and treatment of cancer costs less than no prevention, in effect just treatment, of cancer. The true cost savings of prevention will include a more difficult assessment of the socioeconomic savings associated with longer, healthier lives for women in their prime who have a major role in supporting their families. PMID:26433500

  20. Incidence of invasive cancers following carcinoma in situ of the cervix.

    OpenAIRE

    Levi, F; Randimbison, L.; La Vecchia, C; Franceschi, S.

    1996-01-01

    Women with carcinoma in situ (CIS) of the cervix uteri, notified to the population-based Cancer Registry of the Swiss Canton of Vaud between 1974 and 1993, were actively followed up to 31 December 1993 for the occurrence of subsequent invasive neoplasms. Among 2190 incident cases of CIS, followed for a total of 22,225 person-years, 95 metachronous cancers were observed vs 77.9 expected, corresponding to a significant standardised incidence ratio (SIR) of 1.2. Ten cases of invasive cervical ca...

  1. Low-Dose Chest Computed Tomography for Lung Cancer Screening Among Hodgkin Lymphoma Survivors: A Cost-Effectiveness Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wattson, Daniel A., E-mail: dwattson@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Hunink, M.G. Myriam [Departments of Radiology and Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands and Center for Health Decision Science, Harvard School of Public Health, Boston, Massachusetts (United States); DiPiro, Pamela J. [Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Das, Prajnan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hodgson, David C. [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Mauch, Peter M.; Ng, Andrea K. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2014-10-01

    Purpose: Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Methods and Materials: Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (>10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs. LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life year (QALY). Results: Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. Conclusions: HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening

  2. Low-Dose Chest Computed Tomography for Lung Cancer Screening Among Hodgkin Lymphoma Survivors: A Cost-Effectiveness Analysis

    International Nuclear Information System (INIS)

    Purpose: Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Methods and Materials: Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (>10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs. LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life year (QALY). Results: Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. Conclusions: HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening

  3. Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Naganawa, Shinji; Sato, Chiho; Ishigaki, Takeo [Nagoya University School of Medicine, Department of Radiology, Nagoya (Japan); Kumada, Hisashi; Miura, Shunichi [Toyohashi Municipal hospital, Department of Radiology, Toyohashi, Aich (Japan); Takizawa, Osamu [Siemens-Asahi Medical Technologies Ltd, Tokyo (Japan)

    2005-01-01

    A relation between apparent diffusion coefficient (ADC) values and tumor cellular density has been reported. The purpose of this study was to measure the ADC values of cervical cancers in the uterus and compare them with those of normal cervical tissues, and to test whether ADC could differentiate between normal and malignant cervical tissues in the uterus. Twelve consecutive female patients with cervical cancer of the uterus and ten female patients with other pelvic abnormalities were included in this study. ADC was measured at 1.5 T with b-factors of 0, 300 and 600 s/mm{sup 2} using single-shot echo-planar diffusion-weighted imaging and a parallel imaging technique. The mean ADC value of cervical cancer lesions was 1.09{+-}0.20 x 10{sup -3} mm{sup 2}/s, and that of normal cervix tissue was 1.79{+-}0.24 x 10{sup -3} mm{sup 2}/s (P<0.0001). In nine patients treated by chemotherapy and/or radiation therapy, the mean ADC value of the cervical cancer lesion increased significantly after therapy (P<0.001). The present study showed, with a small number of patients, that ADC measurement has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix. Further study is necessary to determine the accuracy of ADC measurement in monitoring the treatment response. (orig.)

  4. Role of neoadjuvant chemotherapy in cancer cervix: A brief review

    OpenAIRE

    Aramita Saha; Anindya Mukherjee

    2013-01-01

    Neoadjuvant chemotherapy (NACT) represents a promising modality apart from or radiotherapy as initial treatment of locally advanced cervical cancer. The primary objectives of NACT in the treatment of cervical cancer include improvement in tumor characteristics, to allow avoidance of radiotherapy, to prolong disease-free and overall survival, and facilitation of fertility-sparing surgery. Though several studies have shown promising results of NACT on tumor response, downstaging, decrease in lo...

  5. Permanent interstitial low-dose-rate brachytherapy for patients with low risk prostate cancer. An interim analysis of 312 cases

    Energy Technology Data Exchange (ETDEWEB)

    Badakhshi, Harun; Graf, Reinhold; Budach, Volker; Wust, Peter [University Hospital Berlin, Department for Radiation Oncology of Charite School of Medicine, Berlin (Germany)

    2015-04-01

    The biochemical relapse-free survival (bRFS) rate after treatment with permanent iodine-125 seed implantation (PSI) or combined seeds and external beam radiotherapy (COMB) for clinical stage T1-T2 localized prostate cancer is a clinically relevant endpoint. The goal of this work was to evaluate the influence of relevant patient- and treatment-related factors. The study population comprised 312 consecutive patients treated with permanent seed implantation. All patients were evaluable for analysis of overall survival (OS) and disease-specific survival (DSS), 230 for bRFS, of which 192 were in the PSI group and 38 in the COMB group. The prescribed minimum peripheral dose was 145 Gy for PSI, for COMB 110 Gy implant and external beam radiotherapy of 45 Gy. The median follow-up time was 33 months (range 8-66 months). bRFS was defined as a serum prostate-specific antigen (PSA) level ≤ 0.2 ng/ml at last follow-up. Overall, the actuarial bRFS at 50 months was 88.4 %. The 50-month bRFS rate for PSI and COMB was 90.9 %, and 77.2 %, respectively. In the univariate analysis, age in the categories ≤ 63 and > 63 years (p < 0.00), PSA nadir (≤ 0.5 ng/ml and > 0.5 ng/ml) and PSA bounce (yes/no) were the significant predicting factors for bRFS. None of the other patient and treatment variables (treatment modality, stage, PSA, Gleason score, risk group, number of risk factors, D90 and various other dose parameters) were found to be a statistically significant predictor of 50-month bRFS. The biochemical failure rates were low in this study. As a proof of principle, our large monocenteric analysis shows that low-dose-rate brachytherapy is an effective and safe procedure for patients with early stage prostate cancer. (orig.) [German] Das biochemisch rezidivfreie Ueberleben (bRFS) nach der Brachytherapie mit permanenter Iod-125-Seed-Implantation (PSI) oder in Kombination mit externer Radiotherapie (COMB) ist beim Patienten mit fruehem Prostatakarzinom (T1/T2) ein relevanter

  6. Clinical application of low-dose CT combined with computer-aided detection in lung cancer screening

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical value of chest low-dose CT (LDCT) combined with computer-aided detection (CAD) system for lung cancer screening in high risk population. Methods: Two hundred and nineteen healthy candidates underwent 64-slice LDCT scan. All images were reviewed in consensus by two radiologists with 15 years of thoracic CT diagnosis experience. Then the image data were analyzed with CAD alone. Finally images were reviewed by two radiologists with 5 years of CT diagnosis experience with and without CT Viewer software. The sensitivity, false positive rate of CAD for pulmonary nodule detection were calculated. SPSS 11.5 software and Chi-square test were used for the statistics. Results: Of 219 candidates ,104(47.5% ) were detected with lung nodules. There were 366 true nodules confirmed by the senior radiologists. The CAD system detected 271 (74.0%) true nodules and 424 false-positive nodules. The false-positive rate was 1.94/per case. The two junior radiologists indentifid 292 (79.8%), 286(78.1%) nodules without CAD and 336 (91.8%), 333 (91.0%) nodules with CAD respectively. There were significant differences for radiologists in indentifying nodules with or without CAD system (P<0.01). Conclusions: CAD is more sensitive than radiologists for indentifying the nodules in the central area or in the hilar region of the lung. While radiologists are more sensitive for the peripheral and sub-pleural nodules,or ground glass opacity nodules, or nodules smaller than 4 mm. CAD can not be used alone. The detection rate can be improved with the combination of radiologist and CAD in LDCT screen. (authors)

  7. The Dosimetric Consequences of Intensity Modulated Radiotherapy for Cervix Cancer: The Impact of Organ Motion, Deformation and Tumour Regression

    Science.gov (United States)

    Lim, Karen Siah Huey

    Hypothesis: In intensity modulated radiotherapy (IMRT) for cervix cancer, the dose received by the tumour target and surrounding normal tissues is significantly different to that indicated by a single static plan. Rationale: The optimal use of IMRT in cervix cancer requires a greater attention to clinical target volume (CTV) definition and tumour & normal organ motion to assure maximum tumour control with the fewest side effects. Research Aims: 1) Generate consensus CTV contouring guidelines for cervix cancer; 2) Evaluate intra-pelvic tumour and organ dynamics during radiotherapy; 3) Analyze the dose consequences of intra-pelvic organ dynamics on different radiotherapy strategies. Results: Consensus CTV definitions were generated using experts-in-the-field. Substantial changes in tumour volume and organ motion, resulted in significant reductions in accumulated dose to tumour targets and variability in accumulated dose to surrounding normal tissues. Significance: Formalized CTV definitions for cervix cancer is important in ensuring consistent standards of practice. Complex and unpredictable tumour and organ dynamics mandates daily soft-tissue image guidance if IMRT is used. To maximize the benefits of IMRT for cervix cancer, a strategy of adaptation is necessary.

  8. Case Report of Diffuse Large B Cell Lymphoma of Uterine Cervix Treated at a Semiurban Cancer Centre in North India

    Directory of Open Access Journals (Sweden)

    Vibhor Sharma

    2016-01-01

    Full Text Available Lymphoma of the uterine cervix is very rare. We report a case of diffuse large B cell lymphoma (DLBCL involving the uterine cervix treated at a newly commissioned semiurban cancer centre in north India in 2015. Data for this study was obtained from the hospital electronic medical records and the patient’s case file. We also reviewed published case reports of uterine and cervical lymphoma involving forty-one patients. We treated a case of stage IV DLBCL cervix with six cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone and intrathecal methotrexate followed by consolidation with radiotherapy. The patient showed complete response to chemotherapy. We conclude that, in advanced stage lymphoma involving uterus and cervix, combination of chemotherapy and radiotherapy is effective in short term.

  9. Locally advanced cervix cancer: chemotherapy prior to definitive surgery or radiotherapy. A single institutional experience

    International Nuclear Information System (INIS)

    Primary or neoadjuvant chemotherapy prior to definitive local therapy has potential advantages for locally advanced cervix cancer. It can down stage a cancer and allow definitive local therapy to be technically possible (surgery), or potentially more effective (radiotherapy). It can also eradicate subclinical systemic metastases. This report reviews a single institution's experience of neoadjuvant chemotherapy prior to definitive local therapy for cervix cancer over a 13-year period. One hundred and six patients were treated with this intent. The patients were analysed for their response to chemotherapy, treatment received, survival, relapse and toxicity. The chemotherapy was feasible and the majority of patients had a complete or partial response (58.5%). Eight patients did not proceed to local treatment. Forty-six patients had definitive surgery and 52 had definitive radiotherapy. The 5-year overall survival was 27% and the majority of patients died with disease. The first site of relapse was usually in the pelvis (46.2%). Late complications that required ongoing medical therapy (n = 6) or surgical intervention (n = 2) were recorded in eight patients (7.5%). On univariate analysis stage (P= 0.04), tumour size (P = 0.01), lymph node status (P=0.003), response to chemotherapy (P = 0.045) and treatment (P = 0.003) were all significant predictors of survival. On multivariate analysis, tumour size (P < 0.0001) and nodal status (P = 0.02) were significant predictors of survival. Despite the impressive responses to chemotherapy of advanced cervix cancer, there is evidence from randomized trials that it does not improve or compromise survival prior to radiotherapy. As its role prior to surgery remains unclear, it should not be used in this setting outside a prospective randomized trial. Copyright (2001) Blackwell Science Pty Ltd

  10. Low dose, radiation-induced adaptive response against cancer in high-dose-exposed, cancer-prone, Trp53 heterozygous mice

    International Nuclear Information System (INIS)

    Full text: Mice that are heterozygous for Trp53 are both cancer-prone and sensitive to high radiation doses. Groups of 7-8-week-old female Trp53 heterozygous mice were exposed to 4 Gy of 60Co-gamma radiation at either high (0.5 Gy/min) or low (0.5 mGy/min) dose rate. Other groups received a 10-mGy or 100-mGy dose, given at low dose rate (0.5 mGy/min) 24 h prior to the 4 Gy dose. Tumor frequency and latency were measured over the lifespan of the animals. Compared to animals receiving only 4 Gy at high dose rate, mice receiving a prior 10-mGy adapting exposure had significantly extended lifespan and increased latency for all malignant tumors taken together. However, the latency responses were tumor type specific. The prior 10-mGy exposure increased latency for lymphomas and hemangiosarcomas, but decreased latency for spinal osteosarcomas. Increasing the adapting dose to 100 mGy eliminated the tumor latency increase and significantly reduced lifespan. A 10-mGy adapting dose given prior to a 4 Gy exposure at low dose rate generally showed either a reduced effect or no effect. Adapting exposures had no significant effect on tumor frequency. We conclude that adaptive responses are induced by low doses of radiation in radiation sensitive, cancer prone Trp53 +/ - mice, and that these responses are expressed as an increase in tumor latency that reduces the carcinogenic effects of a subsequent large exposure. The dose at which protective effects give way to detrimental effects is tumor type specific

  11. Mortality risk coefficients for radiation-induced cancer at high doses and dose-rates, and extrapolation to the low dose domain.

    Science.gov (United States)

    Liniecki, J

    1989-01-01

    Risk coefficients for life-long excessive mortality due to radiation-induced cancers are presented, as derived in 1988 by the U.N. Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), principally on the basis of follow-up from A-bomb survivors in Japan, over the period from 1950 through 1985. The data are based on the new, revised dosimetry (DS 86) in the two cities, and reflect the effects of high and intermediate doses of basically low LET radiation delivered instantaneously. The author presents arguments relevant to the extrapolation of the risk to the low dose (dose rate) domain, as outlined by UNSCEAR in its 1986, and the NCRP (USA) in its 1980, (no 64), reports. The arguments are based on models and dose-response relationships for radiation action, derived from data on cellular radiobiology, animal experiments on radiation-induced cancers and life shortening, as well as the available limited human epidemiological evidence. The available information points to the lower effectiveness of sparsely ionizing radiation at low doses and low dose-rates, as compared with that observed for high, acutely delivered doses. The possible range of the reduction values (DREF) is presented. For high LET radiations, the evidence is less extensive and sometimes contradictory; however, it does not point to a reduction of the effectiveness at low doses/dose-rates, relative to the high dose domain. Practical consequences of these facts are considered. PMID:2489419

  12. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology

    International Nuclear Information System (INIS)

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid 99mTc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  13. Does initial haemoglobin level modify the efficacy of radiosensitizers. An analysis of the MRC misonidazole studies in head and neck cancer and cervix cancer

    International Nuclear Information System (INIS)

    The authors report a new analysis of the data from two Medical Research Council (MRC) studies of misonidazole in the treatment of head and neck cancer (MRC Working Party 1984a) and cancer of the cervix (MRC Working Party 1984 b). There were no clear differences in local failure or survival rates between the groups of patients receiving misonidazole and placebo in either head and neck or cervix study. (author)

  14. Regeneration in cervix cancer after 252Cf neutron brachytherapy

    International Nuclear Information System (INIS)

    Regeneration of clonogens in human cervical cancer was assessed by the pathological evaluation of the hysterectomy specimen after intracavitary 252Cf neutron brachytherapy implants separated by varying time intervals followed by extrafascial hysterectomy. In this study, patients with bulky/barrel shaped Stage IB cervical cancers received 252Cf implants plus approximately 45 Gy of whole pelvis linear accelerator radiotherapy in approximately 25 fractions in 5 weeks followed by hysterectomy 4-6 weeks after radiotherapy. The specimens were studied grossly and microscopically for residual tumor. It was found that the fraction of positive specimens increased with elapsed time interval between implants. These findings support the hypothesis that there is repopulation of surviving clonogens with increased time interval between the implants. The observation also supports current concerns that rapid depopulation of tumor can lead to rapid repopulation, that is, rapid shrinkage of tumor can alter the physiological environment such that clonogens can rapidly regenerate

  15. METASTATIC BREAST CANCER TO THE UTERINE CERVIX MIMICKING A GIANT CERVICAL LEIOMYOMA

    Science.gov (United States)

    HORIKAWA, MAI; MORI, YUKIKO; NAGAI, SACHI; TANAKA, SHIHO; SAITO, SHIGEKO; OKAMOTO, TOMOMITSU

    2012-01-01

    ABSTRACT Metastasis to the uterine cervix is a complication of breast cancer that is not commonly known. Detection of cervical metastasis before the diagnosis of the primary tumor is even rarer. The present report describes a case of a 52-year-old woman who had a large cervical tumor appearing as a leiomyoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination of the cervical tumor showed patterns characteristic of invasive lobular carcinoma of the breast, leading to the discovery of the primary in the left breast. She subsequently underwent mastectomy, hormone therapy and chemotherapy, and is alive at 7-year follow-up. PMID:23092107

  16. RESULTS OF 192IR CONTACT RADIATION THERAPY FOR CERVIX UTERI CANCER

    Directory of Open Access Journals (Sweden)

    O. A. Kravets

    2014-09-01

    Full Text Available The paper presents the results of treatment for locally advanced cervix uteri cancer, by applying a 192Ir radioactive source for contact radiation. Three- and five-year overall and relapse-free survival rates have been obtained for stages: 82.5 and 82.5%; 78.4 and 78.4% for Stage IIb; 57 and 52.3%; 41.6 and 41.6 for IIIb; 53.3 and 47.3%; 42.4 and 37.7% for IVb, respectively.

  17. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Science.gov (United States)

    Herrera, Higmar; Yañez, Elvia; López, Jesús

    2012-10-01

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerología de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  18. Radiobiological compensation: A case study of uterine cervix cancer with concurrent chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Herrera, Higmar; Yanez, Elvia; Lopez, Jesus [Centro Estatal de Cancerologia de Durango, Victoria de Durango, Durango (Mexico); ISSSTE General Hospital Dr. Santiago Ramon y Cajal, Victoria de Durango, Durango (Mexico)

    2012-10-23

    The case of a patient diagnosed with uterine cervix cancer is presented as an example of the clinical application of the radiobiological compensation method implemented at Centro Estatal de Cancerologia de Durango. Radiotherapy treatment was initially modified to compensate for the chemotherapy component and, as medical complications arose during treatment delivery resulting in an 18 days gap, new compensation followed. All physical and radiobiological assumptions to calculate the Biologically Effective Dose in the external beam and brachytherapy parts of the treatment are presented. Good local control of the tumor was achieved, the theoretical tolerance limits for the organs at risk were not surpassed and the patient manifested no extensive morbidity.

  19. Local use of metronidazole in dimethylsulfoxide in radiotherapy of cervix uteri cancer patients

    International Nuclear Information System (INIS)

    A method of the local use of metronidazole dissolved in dimethylsulfoxide (DMSO) for cervix uteri cancer patients was worked out. Applications of 1-2 g of metronidazole were well tolerated by the patients. Metronidazole concentrations in cervical tumors were high (about 1000 μg/g), in the blood they did not exceed 16 μg/ml. Experiments showed that metronidazole in DMSO diffused in the tissue, its concentrations at a distance of 2-3 cm from the surface were 180-260 μg/g. The local use of metronidazole in DMSO caused an increase in the rate of tumor radiation regression

  20. Radiation with cisplatin or carboplatin for locally advanced cervix cancer: the experience of a tertiary cancer centre

    International Nuclear Information System (INIS)

    Definitive treatment with concurrent cisplatin and radiation is the standard of care for locally advanced cervix cancer. The optimal management of patients with a contraindication to cisplatin has not been established. We conducted a retrospective audit of concurrent chemotherapy in a cohort of patients with locally advanced cervix cancer. All patients with locally advanced cervix cancer treated with definitive radiation were entered into a prospective database. Information regarding their demographics, stage, histology, recurrence and survival were recorded. Pharmacy records were reviewed to determine concurrent chemotherapy use. A total of 442 patients were included in the audit. Two hundred sixty-nine patients received cisplatin, 59 received carboplatin and 114 received no concurrent chemotherapy. Overall survival was significantly improved with the use of concurrent cisplatin compared with radiation alone (adjusted hazard ratio 0.53, P=0.001), as was disease-free survival and rate of distant failure. The use of carboplatin was not associated with any significant benefit in terms of overall survival or disease-free survival. The results of this audit are consistent with the known significant survival benefit with concurrent cisplatin chemotherapy. However, there did not appear to be any significant benefit with carboplatin although there were potential confounding factors. The available evidence in the literature would favour the use of non-platinum chemotherapy rather than carboplatin in patients with contraindications to cisplatin.

  1. Computer-assisted dosimetry in the radiotherapy of cancer of the cervix

    International Nuclear Information System (INIS)

    Cancer of the cervix is the third leading cause of cancer in the Philippines. The Department of Radiotherapy of the Jose R. Reyes Memorial Medical Center has participated in the Regional Coordinated Research project sponsored by the International Atomic Energy Agency (IAEA) to undertake a study to compare computer treatment planning and manual calculations in radiotherapy of the cancer of the cervix; and to perform actual measurements on bladder and rectal points using TLDs. Twenty-seven patients with Stage II-B to III-B were included in the study. External beam teletherapy of 40 Gy without shielding for 4 weeks and 50 Gy with blocks plus brachytherapy of 20-40 Gy were given using LDR or HDR machine. Point A, bladder and rectal points were defined following ICRU 38 recommendations. The results showed dose calculations between commercially available computers and IAEA - provided computers agree to within 20%. Results of TLD measurement in bladder and rectum have shown wide range of variation. (author). 3 refs.; 4 tabs.; 8 figs

  2. Clinical Application of {sup 18}F-FDG PET in Cervix Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Oh, So Won [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Seok Ki [Research Institute and Hospital National Cancer Center, Goyang (Korea, Republic of)

    2008-12-15

    Cervix cancer is one of common gynecological cancers in the world, and staged with FIGO or TNM system. However, these clinical staging systems lack information about lymph node or distant metastases, thus imaging modalities are considered to make an appropriate therapeutic plan and enhance overall survival rate. In this context, FDG PET is recommended to pre-treatment stating and prognosis prediction, for it could noninvasively evaluate the status of lymph nodes, especially abdominal paraaortic nodes which are closely related with prognosis. Moreover, the degree of FDG uptake is correlated with prognosis. Although there is no consistent method for surveillance of cervix cancer, FDG PET seems a very important tool in detecting tumor recurrence because it is much more advantageous than conventional imaging modalities such as MRI for discerning recurrent tumor from fibrosis caused by radiation or surgery. Furthermore, FDG PET could be used to evaluate treatment response. On the other hand, recently introduced PET/CT is expected to play an ancillary role to FIGO staging by adding anatomical information, and enhance diagnostic performance of PET by decreasing false positive findings.

  3. Low Dose Hyper-radiosensitivity in Human Lung Cancer Cell Line A549 and Its Possible Mechanisms

    Institute of Scientific and Technical Information of China (English)

    Xiaofang DAI; Dan TAO; Hongge WU; Jing CHENG

    2009-01-01

    The low dose hyper-radiosensitivity (HRS) in human lung cancer cell line A549 was in-vestigated,the changes of ATM kinase,cell cycle and apoptosis of cells at different doses of radiation were observed,and the possible mechanisms were discussed.A549 cells in logarithmic growth phase were irradiated with 60Co γ-rays at doses of 0-2 Gy.Together with flow cytometry for precise cell sorting,cell survival fraction was measured by means of conventional colony-formation assay.The expression of ATM1981Ser-P protein was examined by Western blot 1 h after radiation.Apoptosis was detected by Hoechst 33258 fluorescent staining,and Annexin V-FITC/PI staining flow cytometry 24 h after radiation.Cell cycle distribution was observed by flow cytometly 6,12 and 24 h after ra-diation.The results showed that the expression of ATM1981Ser-P protein was observed at 0.2 Gy,followed by an increase at >0.2 Gy,and reached the peak at 0.5 Gy,with little further increase as the dose exceeded 0.5 Gy.Twenty-four h after radiation,partial cells presented the characteristic mor-phological changes of apoptosis,and the cell apoptosis curve was coincident with the survival curve.As compared with control group,the cell cycle almost had no changes after exposure to 0.1 and 0.2 Gy radiation (P>0.05).After exposure to 0.3,0.4 and 0.5 Cry radiation,G2/M phase arrest occurred 6 and 12 h after radiation (P<0.05),and the ratio of G2/M phase cells was decreased 24 h after radiation (P<0.05).It was concluded that A549 cells displayed the phenomenon of HRS/IRR.The mode of cell death was mainly apoptosis.The activity of ATM and cell cycle change may take an important role in HRS/IRR.

  4. Impact of learning curve and technical changes on dosimetry in low-dose brachytherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Le Fur, E. [CHU Brest (France). Radiation Therapy Dept.; Universite de Bretagne Occidentale, Brest (France). Faculte de Medecine et des Sciences de la Sante; Malhaire, J.P.; Baverez, D.; Schlurmann, F. [CHU Brest (France). Radiation Therapy Dept.; Delage, F.; Perrouin-Verbe, M.A. [CHU Brest (France). Urology Dept.; Guerif, S. [University Hospital La Miletrie, Poitiers (France). Radiation Therapy Dept.; Poitiers Univ. (France); Fournier, G.; Valeri, A. [CHU Brest (France). Urology Dept.; Universite de Bretagne Occidentale, Brest (France). Faculte de Medecine et des Sciences de la Sante; Universite Europeenne de Bretagne, Rennes (France); APHP, Hopital Tenon, Paris (France). CeRe.PP; Pradier, O. [CHU Brest (France). Radiation Therapy Dept.; Universite de Bretagne Occidentale, Brest (France). Faculte de Medecine et des Sciences de la Sante; Universite Europeenne de Bretagne, Rennes (France); CHU Brest (France). LaTIM, INSERM U650

    2012-12-15

    Purpose: To assess the impact of experience and technical changes on peri- and postimplantation (1 month later) dosimetry for permanent prostate brachytherapy (PPB). Patients and methods: From July 2003 to May 2010, 150 prostate cancer patients underwent low-dose, loose-seed I{sup 125} PPB as monotherapy with intraoperative planning. Patients were divided into three groups - P1 (n = 64), P2 (n = 45), P3 (n = 41) - according to the technical changes that occurred during the study period: use of an automatic stepper at the beginning of P2 and a high-frequency ultrasound probe in P3. Peri- and postimplantation dosimetric parameters (on day 30) were reported: D90 (dose received by 90% of prostate volume), V100 and V150 (prostate volume receiving, respectively, 100% and 150% of the prescribed dose), D2 cc and D0.1 cc (doses received by 2 cc and 0.1 cc of the rectum), R100 (rectum volume that received 100% of the prescribed dose), and D10 and D30 (doses received by 10% and 30% of the urethra, only during peri-implantation). Results: We observed a decrease in the number of needles and seeds used over time. The mean peri-implantation D90 was 187.52 Gy without a significant difference between the three periods (p = 0.48). The postimplantation D90, V100, and V150 parameters were, respectively, 168.3 Gy, 91.9%, and 55% with no significant difference between the three periods. The peri-implantation and postimplantation D0.1 cc and R100 significantly decreased over time; on day 30: D0.1 cc P1 = 223.1 Gy vs. D0.1 cc P3 = 190.4 Gy (p = 8.10- 5) and R100 P1 = 1.06 cc vs. R100 P3 = 0.53 cc (p = 0.0008). Conclusion: We observed a learning curve for the implantation parameters, which led to a significant decrease in the rectal doses without having any impact on the prostate dosimetric parameters. (orig.)

  5. Impact of learning curve and technical changes on dosimetry in low-dose brachytherapy for prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To assess the impact of experience and technical changes on peri- and postimplantation (1 month later) dosimetry for permanent prostate brachytherapy (PPB). Patients and methods: From July 2003 to May 2010, 150 prostate cancer patients underwent low-dose, loose-seed I125 PPB as monotherapy with intraoperative planning. Patients were divided into three groups - P1 (n = 64), P2 (n = 45), P3 (n = 41) - according to the technical changes that occurred during the study period: use of an automatic stepper at the beginning of P2 and a high-frequency ultrasound probe in P3. Peri- and postimplantation dosimetric parameters (on day 30) were reported: D90 (dose received by 90% of prostate volume), V100 and V150 (prostate volume receiving, respectively, 100% and 150% of the prescribed dose), D2 cc and D0.1 cc (doses received by 2 cc and 0.1 cc of the rectum), R100 (rectum volume that received 100% of the prescribed dose), and D10 and D30 (doses received by 10% and 30% of the urethra, only during peri-implantation). Results: We observed a decrease in the number of needles and seeds used over time. The mean peri-implantation D90 was 187.52 Gy without a significant difference between the three periods (p = 0.48). The postimplantation D90, V100, and V150 parameters were, respectively, 168.3 Gy, 91.9%, and 55% with no significant difference between the three periods. The peri-implantation and postimplantation D0.1 cc and R100 significantly decreased over time; on day 30: D0.1 cc P1 = 223.1 Gy vs. D0.1 cc P3 = 190.4 Gy (p = 8.10- 5) and R100 P1 = 1.06 cc vs. R100 P3 = 0.53 cc (p = 0.0008). Conclusion: We observed a learning curve for the implantation parameters, which led to a significant decrease in the rectal doses without having any impact on the prostate dosimetric parameters. (orig.)

  6. Phase I-II study of everolimus and low-dose oral cyclophosphamide in patients with metastatic renal cell cancer

    International Nuclear Information System (INIS)

    For patients with metastatic renal cell cancer (mRCC) who progressed on vascular endothelial growth factor (VEGF) receptor tyrosine kinase inhibitor therapy, the orally administered mammalian target of rapamycin (mTOR) inhibitor everolimus has been shown to prolong progression free survival. Intriguingly, inhibition of mTOR also promotes expansion of immunosuppressive regulatory T cells (Tregs) that can inhibit anti-tumor immune responses in a clinically relevant way in various tumor types including RCC. This study intends to investigate whether the antitumor efficacy of everolimus can be increased by preventing the detrimental everolimus induced expansion of Tregs using a metronomic schedule of cyclophosphamide. This phase I-II trial is a national multi-center study of different doses and schedules of low-dose oral cyclophosphamide in combination with a fixed dose of everolimus in patients with mRCC not amenable to or progressive after a VEGF-receptor tyrosine kinase inhibitor containing treatment regimen. In the phase I part of the study the optimal Treg-depleting dose and schedule of metronomic oral cyclophosphamide when given in combination with everolimus will be determined. In the phase II part of the study we will evaluate whether the percentage of patients progression free at 4 months of everolimus treatment can be increased from 50% to 70% by adding metronomic cyclophosphamide (in the dose and schedule determined in the phase I part). In addition to efficacy, we will perform extensive immune monitoring with a focus on the number, phenotype and function of Tregs, evaluate the safety and feasibility of the combination of everolimus and cyclophosphamide, perform monitoring of selected angiogenesis parameters and analyze everolimus and cyclophosphamide drug levels. This phase I-II study is designed to determine whether metronomic cyclophosphamide can be used to counter the mTOR inhibitor everolimus induced Treg expansion in patients with metastatic renal cell

  7. Comparison of low dose with standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer under surveillance

    Energy Technology Data Exchange (ETDEWEB)

    O' Malley, Martin E. [Joint Department of Medical Imaging, Toronto, ON (Canada); Chung, Peter; Warde, Padraig [Princess Margaret Hospital, Department of Radiation Oncology, Toronto, ON (Canada); Haider, Masoom; Jhaveri, Kartik; Khalili, Korosh [Princess Margaret Hospital, Joint Department of Medical Imaging, Toronto, ON (Canada); Jang, Hyun-Jung [Toronto General Hospital, Joint Department of Medical Imaging, Toronto, ON (Canada); Panzarella, Tony [Princess Margaret Hospital, Department of Biostatistics, Toronto, ON (Canada)

    2010-07-15

    To compare the image quality and acceptability of a low dose with those of standard dose abdominal/pelvic multidetector CT in patients with stage 1 testicular cancer managed by surveillance. One hundred patients (median age 31 years; range 19-83 years), 79 with seminoma and 21 with non-seminoma, underwent abdominal/pelvic imaging with low and standard dose protocols on 64-slice multidetector CT. Three reviewers independently evaluated images for noise and diagnostic quality on a 5-point scale and for diagnostic acceptability. On average, each reader scored noise and diagnostic quality of standard dose images significantly better than corresponding low dose images (p < 0.0001). One reader found all CT examinations acceptable; two readers each found 1/100 (1%) low dose examinations unacceptable. Median and mean dose-length product for low and standard dose protocols were 416.0 and 452.2 (range 122.9-913.4) and 931.9 and 999.8 (range 283.8-1,987.7) mGy cm, respectively. The low dose protocol provided diagnostically acceptable images for at least 99% of patients and achieved mean dose reduction of 55% compared with the standard dose protocol. (orig.)

  8. The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

    OpenAIRE

    Wu, Rui-Yi; Wang, Guo-Min; Xu, Lei; ZHANG, BO-HENG; Xu, Ye-Qing; Zeng, Zhao-Chong; Chen, Bing

    2011-01-01

    The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam r...

  9. Mid-dose rate intracavitary therapy for uterine cervix cancer with a Selectron; An early experience of Osaka University

    Energy Technology Data Exchange (ETDEWEB)

    Teshima, Teruki; Inoue, Takehiro; Sasaki, Shigeru; Ohtani, Masatoshi; Kozuka, Takahiro; Inoue, Toshihiko; Ikeda, Hiroshi; Yamazaki, Hideya (Osaka Univ. (Japan). Faculty of Medicine); Murayama, Shigeyuki

    1993-05-01

    From May 1991 through September 1992, a total of 17 previously untreated patients with invasive uterine cervix cancer and with intact uterus were treated with mid-dose rate intracavitary therapy administered with a Selectron. Early primary tumor responses for all patients were complete. No acute or subacute radiation injury was observed except one patient with aplastic anemia who developed rectal ulcer. Two patients of Stage IIIb died from tumor because of local, paraaortic lymph node and distant metastases. Our early experience concluded that Selectron MDR can be used for cervix cancer patients as safely and effectively as our previously used high-dose rate machine. (author).

  10. Tissue and serum fluorescence spectroscopy as a marker to monitor radiation therapy in cancer of human uterine cervix

    International Nuclear Information System (INIS)

    During the development of neoplasia epithelial tissues undergo biochemical and structural changes that can manifest in tissue auto-fluorescence. Several research groups have reported the tissue fluorescence spectroscopy for the discrimination of carcinoma or human uterine cervix. And also there have been several reports on using different biomarkers for the detection of cervical cancer. It is attempted to make use of fluorescence spectroscopy technique to monitor the radiation therapy in patients with squamous cell carcinoma of cervix. The clinical samples from 10 patients with stage II and stage III B cervical cancer were analysed. The results showed significant changes in spectral characteristics in tissue fluorescence before and after radiation

  11. Spectropolarimetry biopsies of the cervix at an early cancer and dysplasia

    Science.gov (United States)

    Yermolenko, S. B.; Peresunko, O. P.; Babechko, N. J.

    2015-11-01

    The analysis of the spectral anisotropic properties of layers of oncologic modified biological tissues with precancerous condition (CIN) and with cancer formation (G) of cervix according to linear dichroism determined in the wavelength range 300-800 nm was conducted. Comparison of results of animal testing of samples of biological samples oncologic modified human tissue was conducted, introduction of differentiation criterion spectropolarimetric precancerous condition and the stage cancer formation in the spectral band of 390-410 nm was proposed. Appropriate diagnostically important changes in the value ranges of linear dichroism at each stage of cancer formation (high- and low-grade dysplasia, high and low-grade adenocarcinoma) was determined. A differential method for diagnosis of epithelial cells in the above diseases was suggested.

  12. SEXUALITY AND COUPLE COMMUNICATION IN WOMEN WITH CERVIX CANCER

    Directory of Open Access Journals (Sweden)

    DENNYS DEL ROCÍO GARCÍA PADILLA

    2003-07-01

    Full Text Available The aim of this quasiexperimental research of single case with n replications was to evaluate a psychologicalintervention with emphasis on sexuality and marital communication for women diagnosed withcervical cancer under treatment. Four women patients of the Javeriano Oncology Centre participatedvoluntarily. The instrument was a semi-structured interview validate by experts judgement and wasapplied individually in order to collect relevant and pertinent data according to the objectives. Based onthe information from the interview special patient’s needs were detected which guided the selection ofthe intervention program contents. Intervention was applied and evaluated in different moments, as isrequired to decrease threatens to internal validity (Kazdin 2001. The intervention program consistedof three-session psycho-educational workshop with pre-post-test measures specially designed for eachoccasion. Evaluations were applied immediately after each session, 15 days after, 30 days after the lastsession. Results were presented graphically and in tables and were analysed descriptively without statisticsthrough categories derived from the answers. The intervention effectivity was demonstrated in positivechanges in each participant, especially in general information and beliefs; there were changes respect tosexuality favourable to couple relation, however some deficits in communication and sexual relationpersisted. Practical and theoretical implications were analysed in different moments during the research.

  13. Brachytherapy in cervix cancers: techniques and concepts evolution

    International Nuclear Information System (INIS)

    Brachytherapy plays an important role in the treatment of patients with cervical carcinoma. Technical modalities have evolved during the last years and have benefited from imaging modalities development, specially MRI. Imaging modalities contribute to a better knowledge of tumoral extension and critical organs. Ultrasound during brachytherapy has led to the almost complete eradication of uterine perforation. In the future, a more systematic use of systems allowing optimization may induce a better dose distribution in the tumor as well as in the critical organs. Recent data provided information in favor of a better analysis in the relative role of dose-rate, total dose and treated volume and their influence on the local control and complication incidence. Concomitant radio-chemotherapy represents a standard in the treatment of patients with tumoral size exceeding 4 cm. Some questions still remain: is concomitant chemotherapy of benefit during brachytherapy? Is there any place for complementary surgery, specially in patients with complete response after external irradiation with concomitant chemotherapy and brachytherapy? In order to answer the former question, a phase III randomized trial is going to start, with the Federation Nationale des Centres de Lutte Contre le Cancer as a promoter. (authors)

  14. The role of neoadjuvant chemotherapy in the management of locally advanced cervix cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Mohammed Osman

    2014-09-01

    Full Text Available Cervical cancer is the second most common cancer in women. Neoadjuvant chemotherapy for patients with locally advanced cervix cancer has comparable benefits to concurrent chemoradiotherapy (CCRT, but with fewer side effects. This systematic review aims to provide a comprehensive summary of the benefits of neoadjuvant chemotherapy for the management of locally advanced cervix cancer from stage IB2 (tumor >4.0 cm to IIIB (tumor extending to the pelvic wall and/or hydronephrosis. Our primary objective was to assess benefits in terms of survival. The data source included the USA national library of medicine, Medline search, and the National Cancer Institute PDQ Clinical Protocols. Inclusion criteria for consideration in the current systematic review included studies published between January 1997 and December 2012. In terms of histology, they had to be focused on squamous cell carcinoma, adenosquamous carcinoma, and/or adenocarcinoma. Patients should be either chemotherapy naïve or cervix cancer chemotherapy naïve, and have a performance status ≤2. The search in the above-mentioned scientific websites led to identify 49 publications, 19 of which were excluded, as they did not meet the inclusion criteria of this systematic review. Therefore only 30 studies were deemed eligible. Data was collected from 1760 patients enrolled in the current systematic review study. The mean age was 45.2 years. The mean tumor size was 4.7 cm. The most commonly used chemotherapies were cisplatin doublets. Paclitaxel was the most commonly used chemotherapeutic agent in the doublets. The mean chemotherapy cycles were 2.7. After chemotherapy, patients underwent surgery after a mean time of 2.5 weeks. The standard operation was radical hysterectomy with pelvic lymphadenectomy. Chemotherapy achieved an objective response rate of 84%. The 5-year progression-free survival and overall survival were 61.9% and 72.8% respectively. The treatment protocol was associated

  15. Tumor regression dynamics with external radiotherapy in cancer cervix and its implications

    International Nuclear Information System (INIS)

    BACKGROUND: To study the external radiotherapy (EXTRT) regression patterns in cancer of the cervix. AIMS: Evaluate EXTRT tumor regression doses (TRD) for 50% (TRD50). 80% response (TRD80), normalized dose response gradient (γ50) and slope (slope 50) with clinical outcome. SETTINGS AND DESIGN: Patients, treated solely with radiotherapy and enrolled for other prospective studies having weekly tumor regressions recorded were considered. MATERIAL AND METHODS: Seventy-seven patients received 50Gy of EXTRT at 2 Gy/fraction followed by 18Gy of high-dose rate intracavitary brachytherapy at 6 Gy/fraction. Loco-regional regressions were assessed clinically at weekly intervals during EXTRT to generate EXTRT dose-response curves. STATISTICAL ANALYSIS USED: Student's t test, logistic regression, Kaplan Meier and Cox's proportional hazard model. Scatter plots were fitted using cubic fit. RESULTS: Age (P=0.052) and absence or presence of gross residual tumor (AGRT and PGRT respectively) following EXTRT (P50. (P80 (P50 (P=0.001). Response status to EXTRT was a prognosticator for loco-regional disease free survival (LDFS) (AGRT vs. PGRT; P=0.046). On multivariate analysis, both TRD50 and TRD80 emerged as significant predictors for tumor status at end of EXTRT while TRD80 was the sole determinant of LDFS. CONCLUSION: Extent of tumor regression to EXTRT is an important predictor for treatment outcome in cancer cervix as evident from TRD50 and TRD80 values of EXTRT tumor regression curves. (author)

  16. PRECANCEROUS AND CANCEROUS LESIONS OF CERVIX DIAGNOSED BY PAP’S SMEAR - A HOSPITAL BASED STUDY

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    Komal Singh

    2014-02-01

    Full Text Available BACKGROUND: Cervical intra - epithelial neoplasia (CIN and cervical cancer remain important health problems for women worldwide. It is largely a preventable disease that is characterized by a long lead time. The objective of this study was to determine the frequency of precancerous lesions of cervix by Pap smear screening. METHODS : A retrospective hospital based study was conducted at Department of Pathology, in a Tertiary Care Institute and associated hospital, Bhopal. Data was collected from the records of Pap’s smear testing done on 388 patients in years 2011 & 2012. Analysis was done by entering data in SPSS software and Chi - square test was applied to find statistical significance. RESULTS: Most common lesions on Pap’s smear was Low grade squamous intraepithelial les ion (LSIL in 104 (26.8% of cases and High grade squamous intraepithelial lesion (HSIL in 15 (3.9% of cases. 44 (11.3% were senile Atopic Changes, parasitic Infection in 27 (7% of cases and 2 (0.5% were carcinoma cervix cases. All the cervical lesion s were most common in age of 31 - 40 yrs. and were significantly associated with age. CONCLUSIONS: Pap’s smear examination information should be spread in community apart from hospitals. Especially the young women should be motivated for regular Pap’s smear. Pap’s smear is the single most important screening method for early detection of precancerous & cancerous cervical lesions

  17. Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers

    International Nuclear Information System (INIS)

    The aim of this study was analysis of incidence results in a prospective one-arm feasibility study of lung cancer screening with low-radiation-dose spiral computed tomography in heavy smokers. Eight hundred seventeen smokers (≥40 years, ≥20 pack years of smoking history) underwent baseline low-dose CT. Biopsy was recommended in nodules >10 mm with CT morphology suggesting malignancy. In all other lesions follow-up with low-dose CT was recommended. Annual repeat CT was offered to all study participants. Six hundred sixty-eight (81.8%) of the 817 subjects underwent annual repeat CT with a total of 1735 follow-up years. Follow-up of non-calcified nodules present at baseline CT demonstrated growth in 11 of 792 subjects. Biopsy was performed in 8 of 11 growing nodules 7 of which represented lung cancer. Of 174 new nodules, 3 represented lung cancer. The 10 screen-detected lung cancers were all non-small cell cancer (6 stage IA, 1 stage IB, 1 stage IIIA, 2 stage IV). Five symptom-diagnosed cancers (2 small cell lung cancer: 1 limited disease, 1 extensive disease, 3 central/endobronchial non-small cell lung cancer, 2 stage IIIA, 1 stage IIIB) were diagnosed because of symptoms in the 12-month interval between two annual CT scans. Incidence of lung cancer was lower than prevalence, screen-detected cancers were smaller, and stage I was found in 70% (7 of 10) of screen-detected tumors. Only 27% (4 of 15) of invasive procedures was performed for benign lesions; however, 33% (5 of 15) of all cancers diagnosed in the population were symptom-diagnosed cancers (3 central NSCLC, all stage III, 2 SCLC) demonstrating the limitations of CT screening. (orig.)

  18. Low-dose effects of Bisphenol A on human primary vascular endothelial cells and colon cancer cells

    OpenAIRE

    Varandas, Edna Soraia Gregório Ribeiro Varandas

    2014-01-01

    Bisphenol A (BPA) is an extensively utilized endocrine disruptor for which human exposure is considered generalized through ingestion. Information regarding BPA effects on vascular and digestive tract tissues is scarce. Therefore, in this work primary Human Umbilical Vein Endothelial Cells (HUVEC) and human colon adenocarcinona cell line HT29 were used to evaluate BPA effects at two distinct low-dose concentrations relevant in terms of human health risk assessment. BPA di...

  19. Hearing loss due to concurrent daily low-dose cisplatin chemoradiation for locally advanced head and neck cancer

    International Nuclear Information System (INIS)

    Background and purpose: Cisplatin-based chemo-irradiation (CRT) is increasingly used for head and neck squamous cell carcinoma (HNSCC). We aimed to assess hearing deterioration due to low-dose cisplatin chemoradiation and to compare the observed hearing loss with hearing loss in our previously described high-dose cisplatin CRT cohort. Materials and methods: A prospective analysis of hearing thresholds at low and (ultra)-high frequencies obtained before and after treatment in 60 patients. Patients received low-dose cisplatin (6 mg/m2, daily infusions, 20-25 days) with concomitant accelerated radiotherapy (70 Gy). Results: Audiometry up to 16 kHz was performed before therapy and 31 days (median) post-treatment. The total incidence of ototoxicity in CTCAEv3.0 was 31% in audiograms up to 8 kHz, and 5% of ears tested qualified for HAs due to treatment. The mean hearing loss at speech frequencies was 2.6 dB (SD 5.7) and 2.3 dB (SD 9.2) at PTA 1-2-4 kHz air-conduction and bone-conduction, respectively. The mean hearing loss at ultra-high frequencies (PTA AC 8-10-12.5 kHz) was 9.0 dB (SD 8.1). Low-dose cisplatin CRT caused less acute hearing loss (CTCAE 31%), compared to high-dose cisplatin CRT (CTCAE 78%). Conclusions: Low-dose cisplatin chemo-irradiation for HNSCC is a relatively safe treatment protocol with respect to ototoxicity

  20. Immunohistochemical expression of MIB-1 and PCNA in precancerous and cancerous lesions of uterine cervix

    Directory of Open Access Journals (Sweden)

    Madhu Mati Goel

    2013-01-01

    Full Text Available Background and Objective: The present study was done to analyze the immunoexpression of diagnostic markers (MIB-1: molecular immunology borstel and PCNA: proliferating cell nuclear antigen in grading cervical intraepithelial lesion (CIN and squamous cell carcinoma (SCC in cervix. Setting and Design: Total 150 cervical biopsies were divided into four groups respectively; Group I-Normal (n = 32, Group II- CIN (n = 60, Group III- SCC (n = 44, Group IV- CA cervix (n = 14 respectively. Materials and Methods: These biopsies were stained with monoclonal antibodies by streptavidin--biotin method. Mean labeling index was calculated and grading was performed using the I--III scoring system. Statistical Analysis: Findings were correlated with age and menopausal status. Statistical analysis was done by using student sample′t′ test and analysis of variance (ANOVA by SPSS 10 package. Results: MIB-1 immunostaining was positive in 112/150 (74.6% cases and PCNA in 118 /150 (78.6% cases. Labeling indices showed linear progression from normal to CIN to SCC to cancer lesion. Few cases of low-grade CIN lesion had high proliferative index. A significant positive correlation was found between age and PCNA and MIB-1 values (P < 0.05 when comparison was made for all the cases. Conclusion: These markers may be useful in identifying low-grade CIN lesion with high proliferative index. These cases should be kept for follow up studies so that proper intervention can be taken at an early stage. This method is simple and cost effective and can easily be done in formaline-fixed paraffin embedded tissues in a clinical laboratory for grading CIN and SCC lesions in cervix.

  1. In vivo light scattering for the detection of cancerous and precancerous lesions of the cervix

    Energy Technology Data Exchange (ETDEWEB)

    Mourant, Judith R [Los Alamos National Laboratory

    2008-01-01

    A noninvasive optical diagnostic system for detection of cancerous and precancerous lesions of the cervix was evaluated in vivo. The optical system included a fiber-optic probe designed to measure polarized and unpolarized light transport properties of a small volume of tissue. An algorithm for diagnosing tissue based on the optical measurements was developed that used four optical properties, three of which were related to light scattering properties and the fourth of which was related to hemoglobin concentration. A sensitivity of {approx}77% and specificities in the mid 60% range were obtained for separating high grade squamous intraepithelial lesions and cancer from other pathologies and normal tissue. The use of different cross-validation methods in algorithm development is analyzed, and the relative difficulties of diagnosing certain pathologies are assessed. Furthermore, the robustness of the optical system for use by different doctors and to changes in fiber-optic probe are also assessed, and potential improvements in the optical system are discussed.

  2. A correlation between residual DNA double-strand breaks and clonogenic measurements of radiosensitivity in fibroblasts from preradiotherapy cervix cancer patients

    International Nuclear Information System (INIS)

    Purpose: To study the relationship between residual DNA damage and clonogenic measurements of radiosensitivity in fibroblasts from pretreatment cervix cancer patients. Methods and Materials: Early passage vaginal fibroblasts from nine preradiotherapy cervix cancer patients and two radiosensitive skin fibroblast cell strains were studied. Cell survival was measured by clonogenic assay following both high and low dose rate irradiation. Residual DNA damage was measured using pulsed-field gel electrophoresis (PFGE) after irradiating radiolabeled, plateau-phase cells at 37 deg. C and allowing 24 h for repair. DNA damage was expressed both in terms of the residual damage slope (fitted to data from 60 to 150 Gy) and the fraction of activity released (FAR) following 150 Gy. Results: The surviving fraction at 2 Gy (SF2) values after high dose rate irradiation for the vaginal fibroblasts ranged from 0.15 to 0.32 (a 2.2-fold difference). When the two radiosensitive cell strains were included, residual damage, expressed as the residual damage slope, correlated with α (r = 0.82, p = 0.002), D bar (r = -0.91, p 2 (p = -0.79, p = 0.004), and when the vaginal fibroblasts alone were studied, the residual damage slope again correlated with clonogenic survival, although less strongly [α (r 0.66, p = 0.053), D bar (r = -0.83, p = 0.006), and SF2 (r = -0.63, p 0.07)]. Within the group of vaginal fibroblasts there was a 4.0-fold difference in residual DNA damage slope. When residual damage was expressed as FAR at 150Gy, then for all cell strains the correlations were α: r 0.78, p 0.004, D bar: r = -0.86, p = 0.001, and SF2: r = -0.78, p = 0.004, and for the vaginal fibroblast strains alone the correlations were α: r = 0.60, p = 0.088, D bar: r = -0.75, p = 0.02, and SF2: r = 0.62, p = 0.077. Conclusion: This study confirms previous findings that residual DNA damage correlates with clonogenic survival in fibroblasts. In addition, it demonstrates a correlation for fibroblasts from

  3. MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report

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    Petric Primoz

    2014-09-01

    Full Text Available Background. Optimal applicator insertion is a precondition for the success of cervix cancer brachytherapy (BT. We aimed to assess feasibility and efficacy of MRI-assisted pre-planning, based on applicator insertion in para-cervical anaesthesia (PCA.

  4. Diagnosis of uterine cervix cancer using Müller polarimetry: a comparison with histopathology

    Science.gov (United States)

    Rehbinder, Jean; Deby, Stanislas; Haddad, Huda; Teig, Benjamin; Nazac, André; Pierangelo, Angelo; Moreau, François

    2015-07-01

    Today around 275000 women a year in the world keep dying from the cancer of uterine cervix due to the difficulty to meet the logistic requirements of an organized screening in the developing world. Polarimetric imaging is a new promising technique with a tremendous potential for applications in biomedical diagnostics: it is sensitive to slight morphological changes in tissues, can provide wide field images for the screening and requires light sources such as a LED for example. This work intends to characterize the polarimetric response of the uterine cervix in its healthy and pathological states. An extensive series of ex-vivo measurements is in progress the Kremlin Bicêtre hospital near Paris using an imaging multispectral Mueller polarimeter in backscattering configuration. The goal of this study is to evaluate the performances of polarimetric imaging technique in terms of sensitivity and specificity for the detection of healthy epithelia (Healthy Squamous epithelium and Malpighian Metaplasia) with respect to the diagnosis provided by pathologists from histology slides as the "gold standard". We show that, at λ=550nm, performances as high as 62% sensitivity and 64% specificity are achieved by optimizing a simple threshold on the scalar retardance values.

  5. Role of magnetic resonance imaging in the diagnosis of recurrent cancer of the cervix uteri

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    Z. N. Shavladze

    2014-07-01

    Full Text Available Objective: to define a role of magnetic resonance imaging (MRI in the follow-up of patients with cancer of the cervix uteri (CCU, who have undergone radiation therapy and chemoradiation therapy and to describe the types of the MRI pattern of recurrent CCU in the pelvic region.Materials and methods. The results of a follow-up of 82 patients with a 4-47- (median 12 months month history of invasive CCU were analyzed.Results. Out of the 82 patients with invasive CCU, 25 were found to have pelvic recurrences; in 23 cases MRI revealed the latter (in the cervix uteri (n = 6, corpus uteri (n = 2, vagina (n = 2, parametrium (n = 2, iliac (n = 10, paraaortic (n = 5 lymph nodes, and pelvic wall (n=5.Conclusion. The findings suggest that pelvic MRI is an effective technique to detect and estimate the extent of a pelvic recurrence and it is expedient to incorporate it into the scope of a follow-up after radiation therapy and chemoradiation therapy in patients with invasive CCU.

  6. Comparison of visual inspection of cervix and pap smear for cervical cancer screening

    International Nuclear Information System (INIS)

    Objective: To evaluate the performance of visual inspection of cervix (VIA) after application of 3% acetic acid in cervical cancer screening in comparison with PAP smear. Results: Out of 540 subjects, 356 were negative with both screening techniques. One hundred and fifty-six subjects were positive with VIA (28.9%) while PAP smear was positive in seventy-eight subjects (14.4%). The sensitivity of VIA was 93.9% and of PAP smear was 46.9%. Corresponding specificities were 30.4% and 69.5%. There was no significant difference between the positive predictive value (PPV) of both test (p<0.05). The accuracy of VIA was 77.5% compared to 52.8% of PAP smear. The difference was highly significant (p < 0.01). Conclusion: These results indicate that VIA is more sensitive and has a higher accuracy as compared to PAP smear. It could, therefore, be valuable in detection of precancerous lesions of cervix. Low cost, easy applicability and immediate results make VIA a useful screening test in developing countries like Pakistan as compared to PAP smear. (author)

  7. Late effects of radiation therapy for cancer of the uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Zippin, C.; Lum, D.; Kohn, H.I.; Bailar, J.C.

    1981-01-01

    This report presents follow-up information on 497 women diagnosed with cancer of the uterine cervix in Connecticut and California between 1932 and 1951 who received only radiation as their initial course of therapy. Patients entered into the study were all treated before age 55 and all were five-year-survivors following treatment in order to eliminate early deaths due to the cervical cancer. Three radiologic dosage groups (high, medium, and low) were formed with 93, 244, and 160 patients, respectively. For all dosage groups combined 108 subsequent cancers were observed more than 5 yr after cancer treatment compared with 64 expected (P less than 0.01). Sites for which subsequent cancers were significantly (P less than 0.05) in excess of expectation were rectum, ovary, lung, vulva and vagina, small intestine, oropharynx, and central nervous system excluding brain. The ratio of observed to expected cases of subsequent cancers rose only slightly with increasing radiologic dose. No significant differences in overall survival patterns for the three dosage groups were found. For all dosage groups survival was poorer than in the corresponding segment of the general population.

  8. Low-dose prednisolone in first-line docetaxel for patients with metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Kongsted, Per; Svane, Inge Marie; Lindberg, Henriette;

    2015-01-01

    incidence of peripheral edema (32% vs. 15%, P<0.001) and grade 3 nonhematological toxicity (56% vs. 43%, P = 0.022). Patients treated with D alone were also more frequently hospitalized (53% vs. 41%, P = 0.035), mainly owing to a higher incidence of febrile neutropenia in this group (25% vs. 10%, P<0......% CI: 0.76-1.26, P = 0.89, Cox proportional hazard regression model). CONCLUSIONS: Coadministration of low-dose P reduced the incidence of peripheral edema, grade 3 nonhematological toxicity, and the risk of being admitted owing to febrile neutropenia during treatment with D. Adjusted survival analysis...

  9. Cervix-to-rectum measuring device in a radiation applicator for use in the treatment of cervical cancer

    Science.gov (United States)

    Fischell, D. R.; Mazique, J. C. (Inventor)

    1981-01-01

    A cervix-to-rectum measuring device to be used in the treatment of cervical cancer is described. It includes a handle and a probe pivotably connected to the handle for insertion in the rectum. The measuring device further includes means for coupling the handle to an intrauterine radiation applicator when the latter is positioned in the uterine cervix and the probe is inserted in the rectum to pivot the handle about the probe. A gear is provided which is adapted to pivot with the probe. A pinion pivotably connected to the handle meshes with the gear. A pointer fixed to the pinion is displaced in response to the pivoting of the handle about the probe, and this displacement can be read from a scale on the handle, providing an indication of the cervix-to-rectum distance.

  10. Differential effects of repeated low dose treatment with the cannabinoid agonist WIN 55,212-2 in experimental models of bone cancer pain and neuropathic pain

    DEFF Research Database (Denmark)

    Hald, Andreas; Ding, Ming; Egerod, Kristoffer Lihme;

    2008-01-01

    Pain due to bone malignancies is one of the most difficult types of cancer pain to fully control and may further decrease the patients' quality of life. Animal models of chronic pain conditions resulting from peripheral inflammatory reactions or nerve injuries are responsive to treatment with....... Furthermore, this treatment strategy was not found to induce measurable CNS related side effects or tolerance. Cancer cell viability assays and bone volume fraction assessed by micro computed tomography (microCT) demonstrated that these effects were not due to changes in cancer progression. The difference in...... cannabinoid agonists. However, the use of cannabinoid agonists in humans may be hampered by CNS related side effects and development of tolerance. In the present study, we investigated the effect of repeated low dose administration of the synthetic cannabinoid agonist WIN 55,212-2 on bone cancer pain and...

  11. Low-Dose Hyper-Radiosensitivity Is Not a Common Effect in Normal Asynchronous and G2-Phase Fibroblasts of Cancer Patients

    International Nuclear Information System (INIS)

    Purpose: In our previous study, using the micronucleus assay, a low-dose hyper-radiosensitivity (HRS)-like phenomenon was observed for normal fibroblasts of 2 of the 40 cancer patients investigated. In this article we report, for the first time, the survival response of primary fibroblasts from 25 of these patients to low-dose irradiation and answer the question regarding the effect of G2-phase enrichment on HRS elicitation. Methods and Materials: The clonogenic survival of asynchronous as well as G2-phase enriched fibroblast populations was measured. Separation of G2-phase cells and precise cell counting was performed using a fluorescence-activated cell sorter. Sorted and plated cells were irradiated with single doses (0.1-4 Gy) of 6-MV x-rays. For each patient, at least 4 independent experiments were performed, and the induced-repair model was fitted over the whole data set to confirm the presence of HRS effect. Results: The HRS response was demonstrated for the asynchronous and G2-phase enriched cell populations of 4 patients. For the rest of patients, HRS was not defined in either of the 2 fibroblast populations. Thus, G2-phase enrichment had no effect on HRS elicitation. Conclusions: The fact that low-dose hyper-radiosensitivity is not a common effect in normal human fibroblasts implies that HRS may be of little consequence in late-responding connective tissues with regard to radiation fibrosis

  12. Adjuvant postoperative radiation therapy following simple hysterectomy and radical hysterectomy in stage IB cancer of the cervix: Analysis of risk factors and patterns of failure

    International Nuclear Information System (INIS)

    Between 1969 and 1980, 242 cases of stage IB cancer of the cervix were referred to the department of radiation oncology for curative radiation therapy. In 186 cases treatment was with radiation therapy alone. In 56 cases treatment included adjuvant postoperative radiation therapy; a minimum follow-up of 5 years has been carried out in this group. In 17 cases radiation therapy followed a simple hysterectomy for an unexpected stage IB cancer of the cervix. In 39 cases radiation therapy was given after a radical hysterectomy for stage IB cancer of the cervix because of positive margins and/or positive pelvic lymph nodes

  13. Pulsed low dose rate brachytherapy for pelvic malignancies

    International Nuclear Information System (INIS)

    Purpose: The pulsed low dose rate remote afterloading unit was designed to combine the radiation safety and isodose optimization advantages of high dose rate technology with the radiobiologic advantages of continuous low dose rate brachytherapy. This is the first report of a prospective clinical trial evaluating the relative incidence of acute toxicity and local control in patients with pelvic malignancies who underwent interstitial or intracavitary brachytherapy with the pulsed low dose rate remote afterloader. Methods and Materials: From 5/11/92-6/21/95, 65 patients underwent 77 brachytherapy procedures as part of their treatment regimen for pelvic malignancies. Using the pulsed low dose rate Selectron, equipped with a single cable-driven 0.3-1.0 Ci Ir192 source, target volume doses of 0.40-0.85 Gy per pulse were prescribed to deliver the clinically determined dose. Forty-five intracavitary and 32 interstitial procedures were performed. Fifty-four patients had primary and 11 recurrent disease. Patients were followed closely to assess incidence of Grade 3-5 acute and delayed toxicity, local control, and survival. Results: With a median follow-up of 16.1 months (range 1-29), 33 patients are NED, 10 alive with disease, 13 dead with disease, 4 dead of intercurrent disease, and 5 lost to follow-up. Local control was maintained until last follow-up or death in 48 cases, local failure occurred in 11, unknown in 5. Grade 3-5 acute toxicities (requiring medical or surgical intervention) occurred in 5 out of 77 procedures (6.5%), delayed complications in 10 patients (15% actuarial incidence at 2 years). In the 52 procedures performed for 42 patients with cervix cancer, the acute toxicity incidence was 5.8%, with a 14% 2-year actuarial incidence of delayed complications. Of 32 interstitial templates performed on 30 patients for pelvic malignancies, there were three incidences of acute toxicity and five delayed toxicities. Conclusion: Using the parameters described for this

  14. Mild oxidative stress induced by a low dose of cisplatin contributes to the escape of TRAIL-mediated apoptosis in the ovarian cancer SKOV3 cell line.

    Science.gov (United States)

    Lu, Jinzhi; Zhang, Lei; Xie, Fang; Zhu, Liya; Li, Xiaolan; Ouyang, Jingping; He, Xiaohua; Han, Song; Yi, Cunjian

    2016-06-01

    Tumor necrosis factor (TNF)-related apoptosis‑inducing ligand (TRAIL) is expressed in ovarian tissue and is widely thought to exhibit strong antitumor activity in a variety of tumor cell types. Therefore, we hypothesized that the cisplatin resistance of ovarian cancer is linked to the ability to escape from TRAIL-mediated apoptosis. We demonstrated that cisplatin-resistant ovarian cancer cell line SKOV3/DDP tolerated treatment with TRAIL, in contrast to the cisplatin‑sensitive ovarian cancer cell line SKOV3. SKOV3/DDP cells exhibited a much higher cell viability and a lower apoptosis rate than SKOV3 cells after treatment with TRAIL. To determine whether cisplatin induced the tolerance of TRAIL, we pretreated the SKOV3 cells with cisplatin in the presence of TRAIL. This revealed that a low dose of cisplatin (1 µM) increased the TRAIL tolerance of SKOV3 cells. Furthermore, cisplatin induced oxidative stress in both the SKOV3/DDP and SKOV3 cells, although the oxidative stress level of the SKOV3/DDP cells was generally much higher than that noted in the SKOV3 cells. Similarly, a low dose of hydrogen peroxide increased the TRAIL tolerance in SKOV3 cells. Notably, the TRAIL tolerance in the SKOV3 and SKOV3/DDP cells could be abrogated by the oxidative stress scavenger N-acetyl-cysteine. These results suggest that a low dose of cisplatin induces the tolerance of TRAIL in SKOV3 cells at least partly, depending on the oxidative stress signaling pathway. PMID:27035109

  15. Assessment with TLD of radiation exposure to staff during radium insertions in cancer of cervix

    International Nuclear Information System (INIS)

    A radiation protection survey has been carried out using TLD to assess the radiation exposure to staff during radium insertions for cancer of the cervix. The staff monitored were the radiotherapist, anaesthetist and operating theatre assistant. The radiotherapist, who received the highest exposure, had on the average 160 μGy (16 mrad) whole body (chest) dose while the finger tip doses were around 600 μGy (60 mrad) from the insertion of 60 mg radium. TLD was found to be convenient and sensitive for this purpose, including estimation of finger-tip doses. It helps to maintain the confidence of the staff that their doses are 'as low as readily achievable' and also offers a means of checking improvements in practice where found necessary. (author)

  16. Hypoxyradiotherapy of uterine cervix cancer to decrease of acute side-effects and treatment complications

    International Nuclear Information System (INIS)

    The authors have reported on preliminary results of hypoxyradiotherapy in the course of external irradiation in patients with uterine cervix cancer from a view-point of the occurrence of acute reactions and treatment complications. A mixture of nitrogen and oxygen containing 8.0 to 8.5% of O2 was used to provoke acute hypoxia during irradiation. The applied dosis of external irradiation was simultaneously increased by 40%. On the basis of a randomized study with 120 patients, acute hypoxia was found to protect healthy tissues against post-radiation damage. When the dosis of 96 Gy in the paracervical space and that of 75 Gy in the pelvic wall were applied, acute side-effects decreases significantly if compared with a conventional radiotherapeutic procedure (p<0.01). Radiological preconditions for using acute hypoxia in radiotherapy are discussed. (orig.)

  17. Hybrid adaptive radiotherapy with on-line MRI in cervix cancer IMRT

    International Nuclear Information System (INIS)

    Purpose: Substantial organ motion and tumor shrinkage occur during radiotherapy for cervix cancer. IMRT planning studies have shown that the quality of radiation delivery is influenced by these anatomical changes, therefore the adaptation of treatment plans may be warranted. Image guidance with off-line replanning, i.e. hybrid-adaptation, is recognized as one of the most practical adaptation strategies. In this study, we investigated the effects of soft tissue image guidance using on-line MR while varying the frequency of off-line replanning on the adaptation of cervix IMRT. Materials and method: 33 cervical cancer patients underwent planning and weekly pelvic MRI scans during radiotherapy. 5 patients of 33 were identified in a previous retrospective adaptive planning study, in which the coverage of gross tumor volume/clinical target volume (GTV/CTV) was not acceptable given single off-line IMRT replan using a 3 mm PTV margin with bone matching. These 5 patients and a randomly selected 10 patients from the remaining 28 patients, a total of 15 patients of 33, were considered in this study. Two matching methods for image guidance (bone to bone and soft tissue to dose matrix) and three frequencies of off-line replanning (none, single, and weekly) were simulated and compared with respect to target coverage (cervix, GTV, lower uterus, parametrium, upper vagina, tumor related CTV and elective lymph node CTV) and OAR sparing (bladder, bowel, rectum, and sigmoid). Cost (total process time) and benefit (target coverage) were analyzed for comparison. Results: Hybrid adaptation (image guidance with off-line replanning) significantly enhanced target coverage for both 5 difficult and 10 standard cases. Concerning image guidance, bone matching was short of delivering enough doses for 5 difficult cases even with a weekly off-line replan. Soft tissue image guidance proved successful for all cases except one when single or more frequent replans were utilized in the difficult cases

  18. Long-term results of concurrent chemoradiotherapy using low-dose continuous infusion of 5-fluorouracil for stage II-III esophageal cancer

    International Nuclear Information System (INIS)

    To improve the local control of stage II-III esophageal cancer, we tried concurrent chemoradiotherapy with low-dose continuous infusion of 5-fluorouracil (5-FU) during the entire course of conventional radiotherapy. Forty-three eligible patients with stage II-III esophageal cancer were treated with conventional radiotherapy up to 60-70 Gy concurrently with continuous infusion of 5-FU (300 mg/m2 per 24 hours) for 5 days per week given over 5 to 7 weeks. All patients were followed up more than 5 years after starting the treatments. Although there were two treatment-related deaths, 88% of the patients (38/43) could complete the planned course of chemoradiotherapy. Response rate was 90%. The median survival time was 12.2 months, and the 2- and 5-year overall survival rates were 33% and 15%, respectively. Low-dose continuous infusion of 5-FU given during the entire course of conventional radiotherapy is feasible and seems to offer better results than radiotherapy alone in the treatment of stage II-III esophageal cancer. (author)

  19. Intensity modulated whole pelvic radiotherapy in patients with cervix cancer: analysis of acute toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Min; Lee, Hyung Sik; Hur, Won Joo; Cha, Moon Seok; Kim, Hyun Ho [School of Medicine, Dong-A University, Busan (Korea, Republic of)

    2006-12-15

    To evaluate acute toxicities in cervix cancer patients receiving intensity modulated whole pelvic radiation therapy (IM-WPRT). Between August 2004 and April 2006, 17 patients who underwent IM-WPRT were analysed. An intravenous contrast agent was used for radiotherapy planning computed tomography (CT). The central clinical target volume (CTV) included the primary tumor, uterus, vagina, and parametrium. The nodal CTV was defined as the lymph nodes larger than 1 cm seen on CT and the contrased-enhanced pelvic vessels. The planning target volume (PTV) was the 1-cm expanded volume around the central CTV, except for a 5-mm expansion from the posterior vagina, and the nodal PTV was defined as the nodal CTV plus a 1.5 cm margin. IM-WPRT was prescribed to deliver a dose of 50 Gy to more than 95% of the PTV. Acute toxicity was assessed with common toxicity criteria up to 60 days after radiotherapy. Grade 1 nausea developed in 10 (58.9%) patients, and grade 1 and 2 diarrhea developed in 11 (64.7%) and 1 (5.9%) patients, respectively. No grade 3 or higher gastrointestinal toxicity was seen. Leukopenia, anemia, and thrombocytopenia occurred in 15 (88.2%). 7 (41.2%), and 2 (11.8%) patients, respectively, as hematologic toxicities. Grade 3 leukopenia developed in 2 patients who were treated with concurrent chemoradiotherapy. IM-WPRT can be a useful treatment for cervix cancer patients with decreased severe acute toxicities and a resultant improved compliance to whole pelvic irradiation.

  20. Impact of MRI in the management and staging of cancer of the uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Stenstedt, Kristina (Centre of Surgical Gastroenterology, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Hellstroem, Ann-Cathrin (Dept. of Gynecological Oncology, Radiumhemmet, Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden)); Fridsten, Susanne; Blomqvist, Lennart (Dept. of Diagnostic Radiology Karolinska Univ. Hospital and Karolinska Inst., Stockholm (Sweden))

    2011-04-15

    Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (<= 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

  1. Impact of MRI in the management and staging of cancer of the uterine cervix

    International Nuclear Information System (INIS)

    Background. Cervical carcinoma is the only gynecological tumor still being staged mainly by clinical examination and only a limited use of diagnostic radiology. Cross sectional imaging is increasingly used as an aid in the staging procedure. We wanted to assess the impact of magnetic resonance imaging (MRI) in addition to the clinical staging of patients with carcinoma of the uterine cervix. Material and methods. A retrospective single-centre analysis of 183 women referred to a tertiary referral centre for gynecological tumors (≤ 65 years old) with cervical cancer diagnosed between January 1, 2003 and December 31, 2006 who have undergone an MRI investigation before start of treatment. Patient records were retrospectively reviewed and any change of the planned treatment after the MRI examination was noted. Results. In patients with cervical carcinoma FIGO stage Ia2-IIa treated surgically, the treatment plan was altered due to MRI results in 10/125 patients. In the smaller group of patients with clinically more advanced disease receiving radio-chemotherapy, the treatment plan was altered in 12/58 patients. Reasons for changing the treatment plan after MRI were findings indicating a higher (n = 8) or lower (n = 5) local tumor stage, findings of para aortic nodal disease (n = 4) or difficulty to clinically examine the patient due to obesity (n = 2). MRI was also an aid in deciding whether or not to offer fertility preserving treatment in three cases. Conclusion. The use of MRI affects treatment planning in patients with cancer of the uterine cervix. The impact is more obvious in more advanced stages of disease and in patients who are difficult to examine clinically due to, for example body constitution. The result of MRI is also an aid in deciding whether or not a fertility preserving operation is feasible

  2. Value and importance of intracavitary therapy in uterine cervix carcinoma

    International Nuclear Information System (INIS)

    The guiding topic of this report was 'the value and importance of intracavitary therapy in uterine cervix carcinoma'. This implies first of all the task to assess the importance of contact therapy within the scope of all therapeutic measures taken in case of uterine cervix carcinoma. Furthermore it was necessary to compare the importance of the different methods of contact therapy: conventional radium therapy as well as low dose rate and high dose rate afterloading techniques. As to surgical intervention, it is clear that only favorable stages can be taken into consideration for this treatment. It is shown by means of data taken from the Annual Report, Vol. 18, that a considerable number of patients with uterine cervix carcinoma I are irradiated even in hospitals whose field of activity lies preponderantly in surgery, and that by far most of the patients cured from uterine cervix cancer owe their recovery to contact therapy. The consideration of contact therapy methods show clearly that radium should no longer be used in clinical practice. Psychological doubts often hinder the decision if long-term or short-term afterloading therapy is to be applied. It is therefore shown that the very different forms of radium therapy with their chronological and spatial dose distribution were due to the characteristics of radium (e.g. little specific activity) or to other compelling features and that they were not based on radiobiological aspects. The radium dose values obtained by empirical research and the resulting spatial and chronological dose distribution are therefore not imperative. So it is not inevitable to choose the low dose rate afterloading method. On the contrary, the high dose rate technique with an adequate fractionation is very probably the method of choice. To sum up it can be said that contact therapy is still the most important therapeutic method in uterine cervix cancer. (orig.)

  3. Low doses of radiation increase the latency of spontaneous lymphomas and spinal osteosarcomas in cancer-prone, radiation-sensitive Trp53 heterozygous mice

    International Nuclear Information System (INIS)

    Mice heterozygous for Trp53 are radiation-sensitive and cancer-prone, spontaneously developing a variety of cancer types. Osteosarcomas in the spine lead to paralysis, while lymphomas lead rapidly to death, distinct events that provide objective measures of latency. The effects of a single low-dose (10 or 100 mGy), low-dose-rate (0.5 mGy/min) 60Co γ irradiation on lymphoma or spinal osteosarcoma frequency and latency, defined as time of death or of onset of paralysis, respectively, were examined. Compared to spontaneous lymphomas or to spinal osteosarcomas leading to paralysis in unexposed mice, an exposure of 7-8-week-old Trp53+/- mice to 10 or 100 mGy had no significant effect on tumor frequency, indicating no effect on tumor initiation. All tumors are therefore assumed to be of spontaneous origin. However, a 10-mGy exposure reduced the risk of both lymphomas and spinal osteosarcomas by significantly increasing tumor latency, indicating that the main in vivo effect of a low-dose exposure is a reduction in the rate at which spontaneously initiated cells progress to malignancy. The effect of this adaptive response persisted for the entire life span of all the animals that developed these tumors. Exposure to 100 mGy delayed lymphoma latency longer than the 10-mGy exposure. However, the 100-mGy dose increased spinal osteosarcoma risk by decreasing overall latency compared to unexposed control mice. That result suggested that this higher dose was in a transition zone between reduced and increased risk, but that the dose at which the transition occurs varies with the tumor type. (author)

  4. Literature analysis of radiotherapy in uterine cervix cancer for the processing of the patterns of care study in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Doo Ho; Kim, Eun Seog; Kim, Yong Ho [College of Medicine, Soonchunhyang University, Seoul (Korea, Republic of); Kim, Jin Hee [College of Medicine, Keimyung University, Daegu (Korea, Republic of); Yang, Dae Sik [College of Medicine, Korea University, Seoul (Korea, Republic of); Kang, Seung Hee [College of Medicine, Ajou University, Suwon (Korea, Republic of); Wu, Hong Gyun; Kim, Il Han [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2005-06-15

    Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into 3 {approx} 4 categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors. Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wall invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (8) and unconventional fractionation. By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting

  5. Literature analysis of radiotherapy in uterine cervix cancer for the processing of the patterns of care study in Korea

    International Nuclear Information System (INIS)

    Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into 3 ∼ 4 categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors. Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wall invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (8) and unconventional fractionation. By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication

  6. Screenings of lung cancer with low dose spiral CT: results of a three year pilot study and design of the randomised controlled trial Italung-CT

    International Nuclear Information System (INIS)

    Purpose: To report the results of a three-year observational pilot study of lung cancer screening with low dose computed tomography (CT) and to present the study design of a randomised clinical trial named as Italung CT. Materials and methods: Sixty (47 males and 13 females, mean age 64±4.5 years) heavy smokers (at least 20 packs-year) underwent three low-dose spiral CT screening tests one year apart on a single slice or multislice CT scanner. Indeterminate nodules were managed according to the recommendations of the Early Lung Cancer Action Project. Results: Indeterminate nodules were observed in 33 (55%) of the subjects (60% at the baseline screening test, 24% at the first annual test and 16% at the second annual test). The size of the largest indeterminate nodule was <5mm in diameter in 20 subjects. 10 of whom showed the nodule at the baseline test. Forty-five subjects (75%) completed the first annual test and 42 (70%) the second annual test. One (1.6%) prevalent lung cancer (adenosquamous carcinoma) and one (2.2%) incident lung cancer (small cell cancer at the first annual examination) were observed, as well as pulmonary localisation of Hodgkin's lymphoma (at the second annual test). In addition, one subject underwent lung surgery for a chondromatous hamartoma. Conclusions: The results of the pilot study are substantially in line with those of other observational studies of greater sample size. This justifies optimism about the reliability of the results in the screened arm of the Italung Ct trial which hast just began

  7. Nutrient intake and nutrient patterns and risk of lung cancer among heavy smokers: results from the COSMOS screening study with annual low-dose CT

    International Nuclear Information System (INIS)

    The role of nutrients in lung cancer aetiology remains controversial and has never been evaluated in the context of screening. Our aim was to investigate the role of single nutrients and nutrient patterns in the aetiology of lung cancer in heavy smokers. Asymptomatic heavy smokers (≥20 pack-years) were invited to undergo annual low-dose computed tomography. We assessed diet using a self-administered food frequency questionnaire and collected information on multivitamin supplement use. We performed principal component analysis identifying four nutrient patterns and used Cox proportional Hazards regression to assess the association between nutrients and nutrients patterns and lung cancer risk. During a mean follow-up of 5.7 years, 178 of 4,336 participants were diagnosed with lung cancer by screening. We found a significant risk reduction of lung cancer with increasing vegetable fat consumption (HR for highest vs. lowest quartile = 0.50, 95 % CI = 0.31–0.80; P-trend = 0.02). Participants classified in the high “vitamins and fiber” pattern score had a significant risk reduction of lung cancer (HR = 0.57; 95 % CI = 0.36–0.90, P-trend = 0.01). Among heavy smokers enrolled in a screening trial, high vegetable fat intake and adherence to the “vitamin and fiber” nutrient pattern were associated with reduced lung cancer incidence.

  8. Simultaneous compensation for after- irradiation in the treatment of cervix cancer

    International Nuclear Information System (INIS)

    The combined radiation therapy which consists of the intracavitary radium application and external compensatory irradiation has been established in Yonsei Cancer Center. 149 cases received radium application among the total 355 patients of cervix cancer, which had been treated by irradiation from Oct. 1969 to Dec.1972 are examined for the tumor dose on each point by Ernst radium application method. Point A; 5625 rads, Point B; 1864 rads, Co; 8375 rads. These data suggest that the metastatic lymph nodes absorbed insufficient dose from the radium treatment only and proportional irregularity of dose distribution on each point. The pattern of radium arrangement was classified in 8 types as the frequency of use in the selected cases and the above facts were established by the experimental study. And then, for delivery of cancer lethal dose in the primary site and involved pelvic lymphatics simultaneously, the total cancercidal dose was estimated as; Point A; 8,000-9,000 rads, Point B; 5,500-6,000 rads, Co: 12,000-15,000 rads. The compensating devices in accordance with 8 types of radium arrangement are made, to correct the irregularity of estimated tumor dose on each point when external compensatory Co-60 irradiation is done, after-radium irradiation. Details are given of how the treatment is planned and applied. The result as so far obtained are gratifying

  9. Dose-response relationships and risk estimates for the induction of cancer due to low doses of low-LET radiation

    International Nuclear Information System (INIS)

    Risk estimates for radiation-induced cancer at low doses can be obtained only by extrapolation from the known effects at high doses and high dose rates, using a suitable dose-response model. The applicability of three different models, linear, sublinear and supralinear, are discussed in this paper. Several experimental studies tend to favour a sublinear dose-response model (linear-quadratic model) for low-LET radiation. However, human epidemiological studies do not exclude any of the dose-response relationships. The risk estimates based on linear and linear quadratic dose-response models are compared and it is concluded that, for low-LET radiation, the linear dose-response model would probably over-estimate the actual risk of cancer by a factor of two or more. (author)

  10. [A comparative study between low-dose and high-dose medroxyprogesterone acetate (MPA) in the treatment of advanced and recurrent breast cancer--in relation to dose, serum concentration and response. Osaka Breast Cancer Research Group].

    Science.gov (United States)

    Furukawa, J; Yayoi, E; Takatsuka, Y; Aikawa, T; Maeura, Y; Kobayashi, T; Miyauchi, K; Kotsuma, Y

    1997-05-01

    A prospective randomized study was carried out to evaluate the effectiveness of MPA in the treatment of breast cancer by comparing low dose (600 mg/day) with high dose (1,200 mg/day) of MPA. In 35 evaluable cases, the response rate to treatment was 40.0% (8/20) with low dose MPA and 26.7% (4/15) with high dose MPA. There was no significant difference between the two groups. The serum MPA concentration measured by high-performance liquid chromatography (HPLC) assay was 23.2 +/- 17.6 ng/ml in the low-dose group and 89.5 +/- 56.7 ng/ml in the high-dose group. Intrapatient variability in serum MPA concentration was relatively stable, but interpatient variability was large. No correlation was found between the response rate and serum MPA concentration. The above results indicate that a low dose of MPA (600 mg/day) is a useful treatment with high effectiveness and safety in advanced and recurrent breast cancer patients. Though no exact data on the optimal serum concentration could not be obtained, it was obvious that a successful response cannot be expected from a serum MPA concentration of less than 17 ng/ml, which was the average serum concentration in NC and PD patients of the low-dose group. PMID:9170519

  11. Daily low-dose cisplatin and concurrent thoracic irradiation for poor-risk patients with unresectable non-small-cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Takata I

    2002-10-01

    Full Text Available A pilot study was conducted to assess the efficacy and feasibility of daily low-dose cisplatin with concurrent thoracic irradiation for clinically unresectable non-small-cell lung cancer (NSCLC. Patients with inoperable NSCLC who had poor risk factors such as advanced age, poor performance status, poor lung function, or concomitant active malignancy were entered into the study. Low-dose cisplatin (6 mg/m2 was administered daily before concurrent thoracic irradiation (2 Gy/day; total dose of 60 Gy was given. Twenty-five patients were registered. The majority of the patients had either stage IIIA (24.0% or stage IIIB (60.0% disease. Fifteen patients (60.0% completed the planned treatment. Both chemotherapy and radiotherapy were stopped in 3 patients (12.0% due to poor response, and 7 patients (28.0% partly received radiotherapy alone as a result of their toxicity response. The proportion of total administered dose to planned dose was 90.9% for chemotherapy and 99.3% for radiotherapy, which were comparable to those in previous studies for LA-NSCLC patients without poor risk factors. Grade 3 leukopenia and neutropenia developed in 14 patients (56.0% and 10 patients (40.0%, respectively, but grade 4 toxicity was not encountered. Grade 3 pneumonitis and esophagitis were observed in 4 patients (16.0% and 2 patients (8.0%, respectively. The overall response rate was 60.0%. The median survival time was 22 months, and the 2-year survival rate was 50.3%. Daily low-dose cisplatin and concurrent thoracic irradiation were well tolerated even by poor-risk patients with NSCLC, and showed a therapeutic efficacy similar to that for good-risk patients.

  12. Health effect of low dose/low dose rate radiation

    International Nuclear Information System (INIS)

    The clarified and non-clarified scientific knowledge is discussed to consider the cause of confusion of explanation of the title subject. The low dose is defined roughly lower than 200 mGy and low dose rate, 0.05 mGy/min. The health effect is evaluated from 2 aspects of clinical symptom/radiation hazard protection. In the clinical aspect, the effect is classified in physical (early and late) and genetic ones, and is classified in stochastic (no threshold value, TV) and deterministic (with TV) ones from the radioprotection aspect. Although the absence of TV in the carcinogenic and genetic effects has not been proved, ICRP employs the stochastic standpoint from the safety aspect for radioprotection. The lowest human TV known now is 100 mGy, meaning that human deterministic effect would not be generated below this dose. Genetic deterministic effect can be observable only in animal experiments. These facts suggest that the practical risk of exposure to <100 mGy in human is the carcinogenesis. The relationship between carcinogenic risk in A-bomb survivors and their exposed dose are found fitted to the linear no TV model, but the epidemiologic data, because of restriction of subject number analyzed, do not always mean that the model is applicable even below the dose <100 mGy. This would be one of confusing causes in explanation: no carcinogenic risk at <100 mGy or risk linear to dose even at <100 mGy, neither of which is scientifically conclusive at present. Also mentioned is the scarce risk of cancer in residents living in the high background radiation regions in the world in comparison with that in the A-bomb survivors exposed to the chronic or acute low dose/dose rate. Molecular events are explained for the low-dose radiation-induced DNA damage and its repair, gene mutation and chromosome aberration, hypothesis of carcinogenesis by mutation, and non-targeting effect of radiation (bystander effect and gene instability). Further researches to elucidate the low dose

  13. Effects of low doses

    International Nuclear Information System (INIS)

    Actually, even though it is comfortable for the risk management, the hypothesis of the dose-effect relationship linearity is not confirmed for any model. In particular, in the area of low dose rate delivered by low let emitters. this hypothesis is debated at the light of recent observations, notably these ones relative to the mechanisms leading to genetic instability and induction eventuality of DNA repair. The problem of strong let emitters is still to solve. (N.C.)

  14. Low Dose Effects: Testing the Assumptions

    International Nuclear Information System (INIS)

    Our work is to investigate the biological responses of cells and animals to low doses and low dose rates of low linear energy transfer radiation and to compare the results to the predictions of the Linear No-Threshold (LNT) hypothesis. These experiments indicate that at low dose, none of the assumptions of the LNT hypothesis were supported by the data, either in cells or in animals. If these results from human and rodent cells, and from other animals, are applicable to humans, the data further indicate that the use of the LNT hypothesis for radiation protection purposes is not conservative but may actually increase the overall risk of cancer

  15. Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning

    DEFF Research Database (Denmark)

    Ashraf, H; Dirksen, A; Jakobsen, Annika Loft;

    2011-01-01

    In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules....

  16. The WBC raising effect and the side effects of LPS-701 injection of cervix cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    This paper reports that LPS-701, an endotoxin extracted and purified by the authors' laboratory from Salmonella typhoid bacilli, has a marked effect on raising the white blood cell count of cervix cancer patients receiving radiotherapy, while the systemic and local side effects are slight. It is suggested that injection of LPS-701 can be used as a non-specific immunological stimulating agent for patients receiving radiotherapy. (Auth.)

  17. A study of the prognostic role of serum fucose and fucosyl transferase in cancer of the uterine cervix.

    OpenAIRE

    Sen, Urmi; Guha,Subhas; Chowdhury, J Roy

    1985-01-01

    Serum fucose levels and fucosyl transferase activities have been designated as nonspecific markers of malignancy, and play an important role in the diagnosis of different types of malignancies. In the present study, attempts were made to determine the prognostic significance of these markers in patients with cancer of the uterine cervix after therapy. It was found that both serum fucose and fucosyl transferase, which were elevated in untreated patients declined significantly in patients respo...

  18. Chromosomal Radiosensitivity in Lymphocytes of Cervix Cancer Patients—Correlation with Side Effect after Radiotherapy

    Science.gov (United States)

    Wegierek-Ciuk, Aneta; Lankoff, Anna; Lisowska, Halina; Banasik-Nowak, Anna; Arabski, Michał; Kedzierawski, Piotr; Florek, Agnieszka; Wojcik, Andrzej

    2010-01-01

    It is well known that cancer patients receiving similar radiotherapy treatments differ widely in normal tissue reactions ranging from undetectable to unacceptably severe levels. Therefore, an important goal of radiobiological research is to establish a test which would allow identifying individual radiosensitivity of patients prior to radiotherapy. The aim of the presented study is to assess the relationship between lymphocyte intrinsic radiosensitivity in vitro and early reaction of normal tissue in cervix cancer patients treated by radiotherapy. The following endpoints are analyzed in vitro: frequency of micronuclei, the kinetics of DNA repair and apoptosis. Acute normal tissue reaction to radiotherapy in the skin, bladder and rectum are scored according to the EORTC/RTOG scale. Our results show a wide inter-individual variability in chromosomal radiosensitivity in vitro. The majority of patients show a Grade 0, 1 or 2 reaction for all organs studied. No statistically significant correlation has been observed between the in vitro results in lymphocytes and the degree of early normal tissue and organ reaction.

  19. To Screen or not to Screen: Low Dose Computed Tomography in Comparison to Chest Radiography or Usual Care in Reducing Morbidity and Mortality from Lung Cancer.

    Science.gov (United States)

    Dajac, Joshua; Kamdar, Jay; Moats, Austin; Nguyen, Brenda

    2016-01-01

    Lung cancer has the highest mortality rate of all cancers. This paper seeks to address the question: Can the mortality of lung cancer be decreased by screening with low-dose computerized tomography (LDCT) in higher risk patients compared to chest X-rays (CXR) or regular patient care? Currently, CXR screening is recommended for certain high-risk patients. Several recent trials have examined the effectiveness of LDCT versus chest radiography or usual care as a control. These trials include National Lung Screening Trial (NLST), Detection And screening of early lung cancer with Novel imaging TEchnology (DANTE), Lung Screening Study (LSS), Depiscan, Italian Lung (ITALUNG), and Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study). NLST, the largest trial (n=53, 454), demonstrated a decrease in mortality from lung cancer in the LDCT group (RRR=20%, P=0.004). LSS demonstrated a greater sensitivity in detecting both early stage and any stage of lung cancer in comparison to traditional CXR. Although the DANTE trial yielded data consistent with findings in LSS, it also showed that via LDCT screening a greater proportion of patients were placed under unnecessary surgical procedures. The Depiscan trial yielded a high nodule detection rate at the cost of a high false-positive rate compared to CXR screening. The ITALUNG and NELSON trials demonstrated the early detection capabilities of LDCT for lung cancers compared to usual care without surveillance imaging. False-positive findings with unnecessary workup, intervention, and radiation exposure remain significant concerns for routine LDCT screening. However, current data suggests LDCT may provide a highly sensitive and specific means for detecting lung cancers and reducing mortality. PMID:27375974

  20. Reanalysis of cancer mortality in Japanese A-bomb survivors exposed to low doses of radiation: bootstrap and simulation methods

    Directory of Open Access Journals (Sweden)

    Dropkin Greg

    2009-12-01

    Full Text Available Abstract Background The International Commission on Radiological Protection (ICRP recommended annual occupational dose limit is 20 mSv. Cancer mortality in Japanese A-bomb survivors exposed to less than 20 mSv external radiation in 1945 was analysed previously, using a latency model with non-linear dose response. Questions were raised regarding statistical inference with this model. Methods Cancers with over 100 deaths in the 0 - 20 mSv subcohort of the 1950-1990 Life Span Study are analysed with Poisson regression models incorporating latency, allowing linear and non-linear dose response. Bootstrap percentile and Bias-corrected accelerated (BCa methods and simulation of the Likelihood Ratio Test lead to Confidence Intervals for Excess Relative Risk (ERR and tests against the linear model. Results The linear model shows significant large, positive values of ERR for liver and urinary cancers at latencies from 37 - 43 years. Dose response below 20 mSv is strongly non-linear at the optimal latencies for the stomach (11.89 years, liver (36.9, lung (13.6, leukaemia (23.66, and pancreas (11.86 and across broad latency ranges. Confidence Intervals for ERR are comparable using Bootstrap and Likelihood Ratio Test methods and BCa 95% Confidence Intervals are strictly positive across latency ranges for all 5 cancers. Similar risk estimates for 10 mSv (lagged dose are obtained from the 0 - 20 mSv and 5 - 500 mSv data for the stomach, liver, lung and leukaemia. Dose response for the latter 3 cancers is significantly non-linear in the 5 - 500 mSv range. Conclusion Liver and urinary cancer mortality risk is significantly raised using a latency model with linear dose response. A non-linear model is strongly superior for the stomach, liver, lung, pancreas and leukaemia. Bootstrap and Likelihood-based confidence intervals are broadly comparable and ERR is strictly positive by bootstrap methods for all 5 cancers. Except for the pancreas, similar estimates of

  1. The relative contributions of different organ sites to the total cancer mortality associated with low-dose radiation exposure

    International Nuclear Information System (INIS)

    In this paper, the factors involved in the assessment of the relative contributions of mortality from cancer of individual organs are explored, thus providing a basis for new estimates of weighting factors to be made by the ICRP in assessing the total detriment for a given radiation dose. Systems of site-specific relative weights for cancer mortality risk due to radiation exposure were examined with respect to the effects of age, sex, projection model, population characteristics as represented by baseline, cause-specific mortality rates and choice between probability of untimely death and expected loss of life span as a measure of health detriment. (UK)

  2. Increased risk for small cell lung cancer following residential exposure to low-dose radon: A pilot study

    International Nuclear Information System (INIS)

    Alpha track radon detectors were placed in the homes of 35 lung cancer patients and 35 matched controls for a period of 8 to 10 mo. Twenty lung cancer patients had small cell lung carcinoma; 11 had adenocarcinoma, 2 had squamous cell carcinoma, and 2 had unclassified carcinoma among 15 nonsmokers. Mean overall living on ground level was significantly higher in the group with small cell lung carcinoma (50 y ± 15) than among controls (33 y ± 19); the adjusted odds ratio for lung cancer was 5.2 (90% confidence interval [90% CI] = 1.1--24.9) per decade of living on the ground floor for the group with small cell lung carcinoma. Radon exposure of more than 1.0 pci/l in the group with small cell lung carcinoma was associated with increased risk of lung cancer, although it did not reach statistical significance [odds ratio = 1.5 (90% CI = 0.4--5.4)], adjusting for differences in smoking habits. The study supports the presence of a differentially increased risk for small cell lung carcinoma following long-term radon exposure. 12 refs., 2 tabs

  3. Influence of low doses of radiation due to 222Rn on proliferation of fibroblasts and MCF-7 human breast cancer cells in vitro

    International Nuclear Information System (INIS)

    The aim of the present study is to analyze the effects of low doses of radiation due to radon (within the range present in the environment) in the proliferation of normal (fibroblasts) and tumoral (MCF-7 human breast cancer cells) mammalian cells. Both fibroblast and MCF-7 cells were incubated in culture media with different levels of radon (doses of 10-15,000 μGy), or non-radon (control). After incubation the number of cells per plate was measured with a hemocytometer. The dissolution of radon in the culture media decreased the proliferation of MCF-7 cells (not the fibroblasts). Within the range of doses used in this experiment, the lowest as well as the highest doses of radiation had the lowest antiproliferative effects. Intermediate doses strongly decreased the number of final cells with respect to those in the control population

  4. A Systematic Overview of Radiation Therapy Effects in Cervical Cancer (Cervix Uteri)

    International Nuclear Information System (INIS)

    A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU). The procedures for evaluation of the scientific literature are described separately. This synthesis of the literature on radiation therapy for cervical cancer is based on data from 1 meta-analysis and 34 randomized trials. In total, 35 scientific articles are included, involving 7,952 patients. The results were compared with those of a similar overview from 1996 including 34,024 patients. The conclusions reached can be summarized in these points: There are limited scientific data supporting that postoperative pelvic radiotherapy improves disease-free survival in early cervical cancer. No firm conclusion can be drawn. There is moderate scientific evidence that external beam radiotherapy combined with brachytherapy gives a similar disease-free and overall survival rate as radical hysterectomy in early cervical cancer. There is strong scientific evidence that concomitant radiochemotherapy improves disease-free and overall survival compared to radiotherapy alone in early cervical cancer. The NCI has recently published an announcement stating that cisplantin-based chemotherapy should be used concomitantly with radiotherapy in cervical cancer. No solid documentation for this statement can be found concerning locally advanced stages (>IIB). There is a strong scientific evidence that cisplatin-based chemotherapy given concomitantly with radiotherapy is superior to concomitant chemotherapy with hydroxyurea. There is no scientific evidence to show that neoadjuvant chemotherapy followed by radiotherapy improves disease-free or overall survival compared to radiotherapy alone in patients with localized cervical cancer. There is moderate scientific evidence that high-dose-rate brachytherapy gives the same local control rate as low-dose-rate brachytherapy but with fewer rectal complications

  5. Concurrent pelvic radiation with weekly low-dose cisplatin and gemcitabine as primary treatment of locally advanced cervical cancer: A phase II study

    Directory of Open Access Journals (Sweden)

    Hend EL-Hadaad

    2015-09-01

    Full Text Available Purpose: This study was done to evaluate response, compliance and survival of weekly low dose cisplatin (20 mg/m2 and gemcitabine (125 mg/m2 concurrently with pelvic radiation as primary treatment of stage IIB-IIIB cervical cancer.Methods: External radiation consisted of 50 Gy/25 fractions using 6-10 MV photon followed by 600 cGy boost to parametrium if it was still felt thickened. Then, intracavitary radiotherapy to deliver 60 Gy at point A. Chemotherapy consisted of gemcitabine at a dose of 125 mg/ m2 was given by i.v infusion over 30 minutes immediately after cisplatin 20 mg/ m2 weekly for 5 weeks during EBRT. Forty–five eligible patients received the treatment protocol. Results: Toxicity was tolerable and manageable. No grade 4 toxicity while grade 3 was recorded in hematologic one only. In order of frequency; diarrhea, nausea and vomiting, and anemia (50%, 40%, 35.5% were most common adverse events. Overall clinical response rate was 93.4% with pathological complete response of 62.2%. After median follow-up of 20 months, 2-year survival and progression-free survival rates were 90.5% and 81% respectively. Conclusion: Weekly combination of low- dose cisplatin and gemcitabine given concurrently with pelvic radiotherapy in primary treatment of locally advanced cervical cancer resulted in a high response rate with a good compliance. Further exploration is needed for the use of this approach prior to incorporating it into routine clinical care through phase III clinical trial.

  6. A comparative study of low dose weekly paclitaxel versus cisplatin with concurrent radiation in the treatment of locally advanced head and neck cancers

    Directory of Open Access Journals (Sweden)

    R K Jain

    2009-01-01

    Full Text Available Purpose: The purpose of this study was to compare low dose weekly paclitaxel versus cisplatin with concurrent radiation in locally advanced head and neck cancers. Materials and Methods: From August 2005 to July 2006, a total of 100 biopsy proven, locally advanced head and neck cancers were enrolled for the study. All the patients were stratified in two groups, study group A and control group B. Study group patients received injection Paclitaxel 20 mg/m 2 , I/V 1 hr infusion weekly for 6 weeks and control group patients received injection Cisplatin 30 mg/m 2 , I/V 2 hrs infusion weekly for 6 weeks. All patients received 66-70 Gy concurrent radiation at the rate of 2 Gy/day, 5 #/week, in 6-7 weeks by cobalt theratron phoenix - 80 teletherapy units. Result: Complete response achieved in 73% of patients in study group and 64% of patients in control group. There was no statistically significant difference observed between the study group and the control group (χ2 = 1.167, df = 1, level of significance 0.05. On 3-10 months of follow-up 59% of patients in the study group and 42% of patients in the control group are alive and disease free. Local toxicities including mucositis, dysphasia and skin reactions were more in the study group but tolerable. Conclusion: Efficacy of paclitaxel in low dose weekly schedule is comparable to cisplatin in locally advanced head and neck squamous cell carcinoma. Further analysis and follow-up are needed to evaluate if this benefit will translate into prolonged survival.

  7. Long-term results of low dose daily cisplatin chemotherapy used concurrently with modestly accelerated radiotherapy in locally advanced squamous cell carcinomas of the head neck cancer region

    Directory of Open Access Journals (Sweden)

    Pramod Kumar Gupta

    2014-01-01

    Full Text Available Introduction: Concurrent single agent cisplatin (CDDP with radiotherapy (RT improves outcomes in locally advanced squamous cell carcinomas of the head neck (LA-SCCHN. CDDP at 100 mg/m 2 at 3 weekly intervals raise compliance, hospitalization, and supportive care issues. Low dose daily CDDP was delivered with RT to evaluate its compliance, long-term safety and efficacy. Patients and Methods: During the period of month between November 2005 and May 2007, 52 patients of stage III/IV LA-SCCHN were given with conventional RT in a phased manner (dose-70 Gy/35 fractions/6 weeks along with daily CDDP (6 mg/m 2 ; capped 10 mg-30 cycles over 6 weeks. No hospitalization or antiemetic cover was planned. Compliance, acute and late toxicity were recorded as per Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer grading system and survival outcomes were evaluated. Results : The median follow-up was 63 months. 43 (83% cases complied with RT schedule and >28 cycles of CDDP was administered in 38 (73% cases. Confluent mucositis was seen in 65%, Grade III/IV dysphagia in 67%; 77% required enteral feed and hospitalization in 15%. There were four treatment related deaths. At 5 years, the loco-regional control was 25% (median-11 months and the overall survival was 31% (median-11 months. The 5 years actuarial rates of late Grade III/IV toxicity was 24%. Late swallowing difficulty/aspiration were seen in 17%; xerostomia-40%; ototoxicity-6%; nephrotoxicity-4%; and no second malignancy. Conclusion: Low dose cisplatin with moderately accelerated RT schedule appears feasible and logistically suitable "out-patient" option without increasing long-term toxicity in LA-SCCHN cancer region.

  8. Incidence of Second Malignancies in Prostate Cancer Patients Treated With Low-Dose-Rate Brachytherapy and Radical Prostatectomy

    International Nuclear Information System (INIS)

    Purpose: To compare the second malignancy incidence in prostate cancer patients treated with brachytherapy (BT) relative to radical prostatectomy (RP) and to compare both groups with the cancer incidence in the general population. Methods and Materials: From 1998 to 2010, 2418 patients were treated with Iodine 125 prostate BT monotherapy at the British Columbia Cancer Agency, and 4015 referred patients were treated with RP. Cancer incidence was compared with the age-matched general population using standardized incidence ratios (SIRs). Pelvic malignancies included invasive and noninvasive bladder cancer and rectal cancer. Cox multivariable analysis was performed with adjustment for covariates to determine whether treatment (RP vs BT) was associated with second malignancy risk. Results: The median age at BT was 66 years and at RP 62 years. The SIR comparing BT patients with the general population was 1.06 (95% confidence interval [CI] 0.91-1.22) for second malignancy and was 1.53 (95% CI 1.12-2.04) for pelvic malignancy. The SIR comparing RP patients with the general population was 1.11 (95% CI 0.98-1.25) for second malignancy and was 1.11 (95% CI 0.82-1.48) for pelvic malignancy. On multivariable analysis, older age (hazard ratio [HR] 1.05) and smoking (HR 1.65) were associated with increased second malignancy risk (P<.0001). Radical prostatectomy was not associated with a decreased second malignancy risk relative to BT (HR 0.90, P=.43), even when excluding patients who received postprostatectomy external beam radiation therapy (HR 1.13, P=.25). Older age (HR 1.09, P<.0001) and smoking (HR 2.17, P=.0009) were associated with increased pelvic malignancy risk. Radical prostatectomy was not associated with a decreased pelvic malignancy risk compared with BT (HR 0.57, P=.082), even when excluding postprostatectomy external beam radiation therapy patients (HR 0.87, P=.56). Conclusions: After adjustment for covariates, BT patients did not have an increased second

  9. Incidence of Second Malignancies in Prostate Cancer Patients Treated With Low-Dose-Rate Brachytherapy and Radical Prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, Sarah Nicole; Tyldesley, Scott [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Hamm, Jeremy [Department of Population Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Jiang, Wei Ning [Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Keyes, Mira; Pickles, Tom [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Lapointe, Vince [Department of Medical Physics, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Kahnamelli, Adam [Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); McKenzie, Michael [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada); Miller, Stacy [Department of Radiation Oncology, British Columbia Cancer Agency–Centre for the North, Prince George, British Columbia (Canada); Morris, W. James, E-mail: jmorris@bccancer.bc.ca [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Radiation Oncology, British Columbia Cancer Agency–Vancouver Centre, Vancouver, British Columbia (Canada)

    2014-11-15

    Purpose: To compare the second malignancy incidence in prostate cancer patients treated with brachytherapy (BT) relative to radical prostatectomy (RP) and to compare both groups with the cancer incidence in the general population. Methods and Materials: From 1998 to 2010, 2418 patients were treated with Iodine 125 prostate BT monotherapy at the British Columbia Cancer Agency, and 4015 referred patients were treated with RP. Cancer incidence was compared with the age-matched general population using standardized incidence ratios (SIRs). Pelvic malignancies included invasive and noninvasive bladder cancer and rectal cancer. Cox multivariable analysis was performed with adjustment for covariates to determine whether treatment (RP vs BT) was associated with second malignancy risk. Results: The median age at BT was 66 years and at RP 62 years. The SIR comparing BT patients with the general population was 1.06 (95% confidence interval [CI] 0.91-1.22) for second malignancy and was 1.53 (95% CI 1.12-2.04) for pelvic malignancy. The SIR comparing RP patients with the general population was 1.11 (95% CI 0.98-1.25) for second malignancy and was 1.11 (95% CI 0.82-1.48) for pelvic malignancy. On multivariable analysis, older age (hazard ratio [HR] 1.05) and smoking (HR 1.65) were associated with increased second malignancy risk (P<.0001). Radical prostatectomy was not associated with a decreased second malignancy risk relative to BT (HR 0.90, P=.43), even when excluding patients who received postprostatectomy external beam radiation therapy (HR 1.13, P=.25). Older age (HR 1.09, P<.0001) and smoking (HR 2.17, P=.0009) were associated with increased pelvic malignancy risk. Radical prostatectomy was not associated with a decreased pelvic malignancy risk compared with BT (HR 0.57, P=.082), even when excluding postprostatectomy external beam radiation therapy patients (HR 0.87, P=.56). Conclusions: After adjustment for covariates, BT patients did not have an increased second

  10. The Differentially Expressed Genes by Radiotherapy in the Patients with Uterine Cervix Cancer

    International Nuclear Information System (INIS)

    Purpose : To detect differentially expressed genes in the patients with uterine cervical cancer during the radiation therapy. Materials and Methods : In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiation therapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA fragments. Expression pattern of down-regulated clone was examined using RT-PCR in 5 patients undergoing radiotherapy. Results : We identified 18 differentially expressed bands by DDRT-PCR, which were eluted and cloned. There were 10 up-regulated clones and 1 down-regulated clone in reverse northern blot. One cDNA fragment had homology to chemokine receptor CXCR4, four were identified as Human ESTs in the EMBL database in EST clones. Down-regulated CxCa-11 was also down regulated in all patients. Conclusion : Using the DDRT-PCR, we have identified 10 up-regulated and 1 down-regulated clone(s) in the patients with uterine cervix cancer during the radiation therapy. The clinical relevance and the functions of these genes will be further investigated

  11. The Differentially Expressed Genes by Radiotherapy in the Patients with Uterine Cervix Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Eun Young; Cho, Moon June; Lee, Jeung Hoon; Lee, Young Sook; Na, Myung Hoon; Lee, Woong Hee; Kim, Jun Sang; Kim, Jae Sung [Cancer Research Institute, Chungnam National University College of Medicine, Daejeon (Korea, Republic of)

    2001-12-15

    Purpose : To detect differentially expressed genes in the patients with uterine cervical cancer during the radiation therapy. Materials and Methods : In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiation therapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA fragments. Expression pattern of down-regulated clone was examined using RT-PCR in 5 patients undergoing radiotherapy. Results : We identified 18 differentially expressed bands by DDRT-PCR, which were eluted and cloned. There were 10 up-regulated clones and 1 down-regulated clone in reverse northern blot. One cDNA fragment had homology to chemokine receptor CXCR4, four were identified as Human ESTs in the EMBL database in EST clones. Down-regulated CxCa-11 was also down regulated in all patients. Conclusion : Using the DDRT-PCR, we have identified 10 up-regulated and 1 down-regulated clone(s) in the patients with uterine cervix cancer during the radiation therapy. The clinical relevance and the functions of these genes will be further investigated.

  12. Prevalance rate of low-dose CT lung cancer screening. Results of a questionnaire survey of member facilities of Japan society of ningen dock with special concerns regarding the actual status and disincentives for implementing such screening

    International Nuclear Information System (INIS)

    We conducted a survey of member facilities of the Japan Society of Ningen Dock to elucidate the actual status of chest computed tomography (CT) screening and the reasons for not being able to change to low-dose CT. We sent a questionnaire consisting of 9 items to 531 member facilities in July 2010, response by facsimile to obtain an analysis. The prevalence rate of low-dose CT lung cancer screening slightly increased to 35% in comparison with the former survey done in November 2008. Some facilities indicated some shift in tube current to a lower range even though this was insufficient to meet the definition of low-dose CT. This reflects their thinking of ''Even with knowledge, there is strong hesitation to change to low-dose CT''. Among the reasons why they did not change to low-dose CT, a priority for high quality images was the top reason among problems of devices and performance. Informed consent was not yet adequate. It is necessary for manufactures to develop better technology to improve the image quality of low-dose CT and to report enough information to clinicians. On the medical side, perception of the necessity for appropriate reduction of radiation dose and the decision to move to low-dose CT would be of crucial significance for facility heads as well as radiologists and technicians. (author)

  13. Targeting heat shock protein 70 using gold nanorods enhances cancer cell apoptosis in low dose plasmonic photothermal therapy.

    Science.gov (United States)

    Ali, Moustafa R K; Ali, Hala R; Rankin, Carl R; El-Sayed, Mostafa A

    2016-09-01

    Plasmonic photothermal therapy (PPTT) is a promising cancer treatment where plasmonic nanoparticles are used to convert near infrared light to localized heat to cause cell death, mainly via apoptosis and necrosis. Modulating PPTT to induce cell apoptosis is more favorable than necrosis. Herein, we used a mild treatment condition using gold nanorods (AuNRs) to trigger apoptosis and tested how different cell lines responded to it. Three different cancer cell lines of epithelial origin: HSC (oral), MCF-7 (breast) and Huh7.5 (liver) had comparable AuNRs uptake and were heated to same environmental temperature (under 50 °C). However, Huh7.5 cells displayed a significant increase in cell apoptosis after PPTT as compared to the other two cell lines. As HSP70 is known to increase cellular resistance to heat, we determined relative HSP70 levels in these cells and results indicated that Huh7.5 cells had ten-fold decreased levels of HSP70 as compared with HSC and MCF-7 cells. We then down-regulated HSP70 with a siRNA and observed that all three cell lines displayed significant reduction in viability and an increase in apoptosis after PPTT. As an enhancement to PPTT, we conjugated AuNRs with Quercetin, an inhibitor of HSP70 which displayed anti-cancer effects via apoptosis. PMID:27318931

  14. The Cervix Cancer Research Network (CCRN: Increasing access to cancer clinical trials in low- and middle-income countries

    Directory of Open Access Journals (Sweden)

    Gita eSuneja

    2015-02-01

    Full Text Available Introduction: The burden of cervical cancer is large and growing in developing countries, due in large part to limited access to screening services and lack of human papillomavirus (HPV vaccination. In spite of modern advances in diagnostic and therapeutic modalities, outcomes from cervical cancer have not markedly improved in recent years. Novel clinical trials are urgently needed to improve outcomes from cervical cancer worldwide. Methods: The Cervix Cancer Research Network (CCRN, a subsidiary of the Gynecologic Cancer InterGroup (GCIG, is a multi-national, multi-institutional consortium of physicians and scientists focused on improving cervical cancer outcomes worldwide by making cancer clinical trials available in low-, middle-, and high-income countries. Standard operating procedures for participation in CCRN include a pre-qualifying questionnaire to evaluate clinical activities and research infrastructure, followed by a site visit. Once a site is approved, they may choose to participate in one of four currently accruing clinical trials.Results: To date, 13 different CCRN site visits have been performed. Of these 13 sites visited, 10 have been approved as CCRN sites including Tata Memorial Hospital, India; Bangalore, India; Trivandrum, India; Ramathibodi, Thailand; Siriaj, Thailand; Pramongkutklao, Thailand; Ho Chi Minh, Vietnam; Blokhin Russian Cancer Research Center; the Hertzen Moscow Cancer Research Institute; and the Russian Scientific Center of Roentgenoradiology. The four currently accruing clinical trials are TACO, OUTBACK, INTERLACE, and SHAPE.Discussion: The CCRN has successfully enrolled 10 sites in developing countries to participate in four randomized clinical trials. The primary objectives are to provide novel therapeutics to regions with the greatest need and to improve the validity and generalizability of clinical trial results by enrolling a diverse sample of patients.

  15. Clinical experience of Sheriproct suppository to rectitis due to radiotherapy of cancer of the uterine cervix

    International Nuclear Information System (INIS)

    The subject was 30 cases of cancer of the uterine cervix, which were composed of 13 cases of acute rectitis and 17 cases of delayed rectitis due to radiotherapy. Out of them, 25 cases were treated with radiation, alone and 5 cases were treated with postoperative irradiation. The acute cases were administered Sheriproct alone twice a day (in the morning and in the evening) until symptoms disappeared. The delayed cases were administered two or three suppositories per a day together with antihemorrhagics for one to three weeks, decreasing the administration dose according to severity of symptoms. In the delayed cases, this suppository showed effectiveness in prolapsed hemorrhoids with a recovery rate of 88.9%, and it showed effectiveness in a pain with that of 71.4%. However, this depository showed ineffectiveness in hemorrhage, inhibition of mucous stool, and inhibition of secrete, and these symptoms were generally resistant to this suppository. On the other hand, in the acute cases, this suppository showed ineffectiveness only in prolapsed hemorrhoids with a recovery rate of 63.3%, and it showed marked effectiveness in hemorrhage with that of 100%. It also showed effectiveness in a pain, inhibition of mucose stool, and inhibition of secrete. These symptoms responded well to this suppository. Consequently, use of this drug seemed to be significant in making it possible to perform radiotherapy. (Kanao, N.)

  16. ROLE OF COLPOSCOPY USING MODIFIED REID’S INDEX IN SCREENING OF CERVICAL CANCER IN WOMEN WITH ABNORMAL CERVIX ON NAKED EYE EXAMINATION

    OpenAIRE

    Deshpande; Yelikar; Andurkar; Dahitankar

    2014-01-01

    OBJECTIVE: To assess the validity of Colposcopy using Modified Reid's Index as a screening tool in cervical cancer in women with abnormal cervix on naked eye examination . METHODS: This observational study was carried out in Government medical college, Aurangabad from June 2011 to May 2013 . Total 392 women with abnormal cervix on naked eye examination of underwent colposcopy and diagnosis was made on the basis of Modified R eid’s Index. Colposcope directed biops...

  17. Low-dose computed tomography screening for lung cancer in a clinical setting: essential elements of a screening program.

    Science.gov (United States)

    McKee, Brady J; McKee, Andrea B; Kitts, Andrea Borondy; Regis, Shawn M; Wald, Christoph

    2015-03-01

    The purpose of this article is to review clinical computed tomography (CT) lung screening program elements essential to safely and effectively manage the millions of Americans at high risk for lung cancer expected to enroll in lung cancer screening programs over the next 3 to 5 years. To optimize the potential net benefit of CT lung screening and facilitate medical audits benchmarked to national quality standards, radiologists should interpret these examinations using a validated structured reporting system such as Lung-RADS. Patient and physician educational outreach should be enacted to support an informed and shared decision-making process without creating barriers to screening access. Programs must integrate smoking cessation interventions to maximize the clinical efficacy and cost-effectiveness of screening. At an institutional level, budgets should account for the necessary expense of hiring and/or training qualified support staff and equipping them with information technology resources adequate to enroll and track patients accurately over decades of future screening evaluation. At a national level, planning should begin on ways to accommodate the upcoming increased demand for physician services in fields critical to the success of CT lung screening such as diagnostic radiology and thoracic surgery. Institutions with programs that follow these specifications will be well equipped to meet the significant oncoming demand for CT lung screening services and bestow clinical benefits on their patients equal to or beyond what was observed in the National Lung Screening Trial. PMID:25658476

  18. Analysis of risk factors for mandibular bone radionecrosis after exclusive low dose-rate brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Background: Brachytherapy is widely adopted as an exclusive treatment of T1/T2 oral cancer with a high probability of definitive cure. Therefore, any major complication, like mandibular bone necrosis, should be avoided. Many risk factors, either clinical or technical, have been considered in the literature. Materials and methods: One hundred consecutive interstitial iridium LDR treatments for early cancers of the tongue and floor of the mouth performed from January 1989 to November 1993 were reviewed. An analysis of some simple technical parameters (total dose, dose-rate, reference volume, linear activity, total reference kerma) was performed in order to identify the main physical risk factors. Moreover, total dose was recalculated as extrapolated responsive dose for normal tissue complications. Results: Bone necrosis was observed in 10 out of 100 patients with a median follow-up of 38 months. No significant incidence of this complication was observed when tumor site (mobile tongue versus floor of the mouth), dental status or total physical dose were considered. A significant correlation between the incidence of bone necrosis and two main parameters was found, i.e. dose-rate (P 3). Bone necrosis is clearly related to both these parameters since most cases (i.e. 80%) were observed in the subgroup over the volume and dose-rate threshold

  19. Phase Ⅱ study of protracted irinotecan infusion and a low-dose cisplatin for metastatic gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Hiroshi Imamura; Arimichi Takabayashi; Hideaki Tsukuma; Masataka Ikeda; Hiroshi Furukawa; Toshimasa Tsujinaka; Kazumasa Fujitani; Kenji Kobayashi; Hiroyuki Narahara; Michio Kato; Haruhiko Imamoto

    2006-01-01

    AIM: To test protracted irinotecan infusion plus a lowdose cisplatin in this Phase Ⅱ trial to decrease its toxicity.METHODS: The eligibility criteria were: (1) histologically proven measurable gastric cancer; (2) performance status of 0 or 1; (3) no prior chemotherapy or completion of prior therapy at least 4 wk before enrollment; (4)adequate function of major organs; (5) no other active malignancy; and (6) written informed consent. The regimen consisted of irinotecan (60 mg/m2) on d 1 and 15 by 24-h infusion and cisplatin (10 mg/m2) on d 12 2, 3,15, 16, and 17. Treatment was repeated every 4 wk.RESULTS: Thirty-one patients were registered between April 2000 and January 2001. The response rate for all 31 patients, 20 patients without prior chemotherapy, and 11 patients with prior chemotherapy was 52% (16/31),60% (12/20), and 36% (4/11), respectively. The median survival time was 378 d. The median number of courses given to all patients was 2. Grade 4 neutropenia occurred in 11 (35%) patients, while grade 3 to 4 diarrhea or nausea occurred in 1 (3%) and 3 (10%) patients,respectively. Fatigue was minimal as grade 1 fatigue was found only in 3 (10%) patients. Other adverse events were mild and no treatment-related deaths occurred.CONCLUSION: This regimen showed a high level of activity and acceptable toxicity in patients with metastatic gastric cancer.

  20. Simple DVH parameter addition as compared to deformable registration for bladder dose accumulation in cervix cancer brachytherapy

    DEFF Research Database (Denmark)

    Andersen, Else Stougård; Noe, Karsten Østergaaard; Sørensen, Thomas Sangild; Nielsen, Søren Kynde; LU, Fokdal; Paludan, Merete; Lindegaard, Jacob Christian; Tanderup, Kari

    2013-01-01

    Background and purpose: Variations in organ position, shape, and volume cause uncertainties in dose assessment for brachytherapy (BT) in cervix cancer. The purpose of this study was to evaluate uncertainties associated with bladder dose accumulation based on DVH parameter addition (previously...... called "the worst case assumption") in fractionated BT. Materials and methods: Forty-seven patients treated for locally advanced cervical cancer were included. All patients received EBRT combined with two individually planned 3D image-guided adaptive BT fractions. D2 and D0.1 were estimated by DVH...

  1. Randomized Trial of Oral Misoprostol Treatment for Cervical Ripening Before Tandem Application in Cervix Cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate the efficacy of oral misoprostol administered to facilitate tandem application to the cervix as a part of brachytherapy in patients with cervical cancer. Methods and Materials: Eighty patients with cervical cancer who had been planned to undergo brachytherapy at Dr. Luetfi Kirdar Kartal Training and Research Hospital were evaluated in a double-blind, prospective, randomized trial. Patients were divided randomly into two groups of 40 patients. The first and second groups received 400 μg of misoprostol orally and placebo, respectively, 3 h before tandem application. The two groups were compared in terms of age, diameter of tumor, parity, age at first intercourse, amount of bleeding and pain at first tandem application, length of endometrial cavity measured by hysterometer, and size of Hegar dilators used for cervical dilatation. Results: Of all cases, 63.6%, 16.3%, 10%, 6.3%, 2.5%, and 1.3% were Stage IIB, IIIB, IIIA, IVA, IIA and IIC, respectively. Mean (±SD) age (range) was 49.3 ± 13.1 (25-83) years and 56.6 ± 13.2 (30-78) years in the study and control groups, respectively (p = 0.015). Age at first intercourse, diameter of tumor, parity, amount of bleeding at first tandem application, and length of endometrial cavity measured by hysterometer were not significantly different between the two groups. Pain score was significantly higher in the control group (p < 0.001). Application was significantly easier in the study group compared with controls (p < 0.001). Average size of initial Hegar dilators used for cervical dilatation was significantly higher in the study group compared with controls (p = 0.017). Conclusion: Administration of misoprostol 400 μg orally for cervical ripening before tandem application facilitates the procedure, increases patient tolerability and comfort, and may decrease complication rates.

  2. Knowledge and Practices of Nurses Working in an Education Hospital on Early Diagnosis of Breast and Cervix Cancers.

    Directory of Open Access Journals (Sweden)

    Ozlem Ozdemir

    2010-12-01

    Full Text Available AIM: This research has aimed to determine knowledge and practice status of nurses about breast self-examination (BSE, clinical breast examination (CBE, mammography and Pap smear and about influencing status of some variables related to these examinations. METHOD: This descriptive study was conducted in an education hospital in Ankara between March 1st and May 30th, 2008. Three hundred-fifty nurses (82.7% have accepted to participate in the study. Data were collected by a questionnaire form including questions about demographics, their knowledge and practice status about BSE, CBE, mammography and Pap smear. Chi-square test, numbers and percentages were used for evaluating the data. RESULTS: Overall, 46.9% of nurses had enough knowledge about early diagnosis of breast and cervix cancer. 60.2% of them can carry BSE, 18.8% can carry out CBE and 7.3% can carry out mammography. Pap smear is carried out by 23.7% of the nurses. Negligence, fear of cancer and thought of finding them unnecessary were determined as reasons for avoidance. Their knowledge and practice were significantly different (p<0.05 according to their age and service where they work. CONCLUSION: It has been concluded that although knowledge and practices of nurses on breast and cervix cancer are at a good level, this isn’t enough when importance of early diagnosis in breast and cervix cancer are taken into consideration, which are among common cancers in women. [TAF Prev Med Bull 2010; 9(6.000: 605-612

  3. Behavior and awareness of thyroid cancer patients in Korea having non-hospitalized low-dose radioiodine treatment with regard to radiation safety

    International Nuclear Information System (INIS)

    With the recent increase in incidence of thyroid cancer, non-hospitalized low-dose (NH-LD) radioiodine treatment (RIT) has also increased rapidly. The radioactivity limit that is allowed to be administered without hospitalization depends on individual calculation, based partly on patients' behavior. In this study, Korean patients' behavior in relation to radiation safety in NHLD RIT was surveyed. A total of 218 patients who underwent NH-LD RIT of 1.1 GBq 131I in a single center were surveyed. The patients underwent RIT with a standard protocol and the survey was performed by interview when they visited subsequently for a whole-body scan. The survey questionnaire included three parts of questions: general information, behavior relating to isolation during RIT, and awareness of radiation safety. After administration of radioiodine, 40% of patients who returned home used mass transportation, and another 47% went home by taxi or in car driven by another person. Isolation at home was generally sufficient. However, 7% of patients did not stay in a separate room. Among the 218 patients, 34% did not go home and chose self-isolation away from home, mostly due to concerns about radiation safety of family members. However, the places were mostly public places, including hotels, resorts, and hospitals. About half of the patients replied that access to radiation safety information was not easy and their awareness of radiation safety was not satisfactory. As a result, 45% of patients wanted hospitalized RIT. In many countries, including Korea, RIT is continuously increasing. Considering the radiation safety of patients' family members or the public and the convenience of patients, the pretreatment education of patients should be enhanced. In addition, the hospitalization of patients having low-dose therapy is recommended to be seriously considered and expanded, with the expansion of dedicated treatment facilities

  4. A randomized phase II clinical trial of personalized peptide vaccination with metronomic low-dose cyclophosphamide in patients with metastatic castration-resistant prostate cancer.

    Science.gov (United States)

    Noguchi, Masanori; Moriya, Fukuko; Koga, Noriko; Matsueda, Satoko; Sasada, Tetsuro; Yamada, Akira; Kakuma, Tatsuyuki; Itoh, Kyogo

    2016-02-01

    This study investigated the effect of metronomic cyclophosphamide (CPA) in combination with personalized peptide vaccination (PPV) on regulatory T cells (Treg) and myeloid-derived suppressor cells (MDSC), and whether it could improve the antitumor effect of PPV. Seventy patients with metastatic castration-resistant prostate cancer were randomly assigned (1:1) to receive PPV plus oral low-dose CPA (50 mg/day), or PPV alone. PPV treatment used a maximum of four peptides chosen from 31 pooled peptides according to human leukocyte antigen types and antigen-specific humoral immune responses before PPV, for 8 subcutaneous weekly injections. Peptide-specific cytotoxic T lymphocyte (CTL) and immunoglobulin G responses were measured before and after PPV. The incidence of grade 3 or 4 hematologic adverse events was higher in the PPV plus CPA arm than in the PPV alone arm. Decrease in Treg and increase in MDSC were more pronounced in PPV plus CPA treatment than in PPV alone (p = 0.036 and p = 0.048, respectively). There was no correlation between the changes in Treg or MDSC and CTL response. There was no difference in positive immune responses between the two arms, although overall survival in patients with positive immune responses was longer than in those with negative immune responses (p = 0.001). Significant differences in neither progression-free survival nor overall survival were observed between the two arms. Low-dose CPA showed no change in the antitumor effect of PPV, possibly due to the simultaneous decrease in Treg and increase in MDSC, in patients under PPV. PMID:26728480

  5. A randomized controlled trial to investigate the influence of low dose radiotherapy on immune stimulatory effects in liver metastases of colorectal cancer

    International Nuclear Information System (INIS)

    Insufficient migration and activation of tumor specific effector T cells in the tumor is one of the main reasons for inadequate host anti-tumor immune response. External radiation seems to induce inflammation and activate the immune response. This phase I/II clinical trial aims to evaluate whether low dose single fraction radiotherapy can improve T cell associated antitumor immune response in patients with colorectal liver metastases. This is an investigator-initiated, prospective randomised, 4-armed, controlled Phase I/II trial. Patients undergoing elective hepatic resection due to colorectal cancer liver metastasis will be enrolled in the study. Patients will receive 0 Gy, 0.5 Gy, 2 Gy or 5 Gy radiation targeted to their liver metastasis. Radiation will be applied by external beam radiotherapy using a 6 MV linear accelerator (Linac) with intensity modulated radiotherapy (IMRT) technique two days prior to surgical resection. All patients admitted to the Department of General-, Visceral-, and Transplantion Surgery, University of Heidelberg for elective hepatic resection are consecutively screened for eligibility into this trial, and written informed consent is obtained before inclusion. The primary objective is to assess the effect of active local external beam radiation dose on, tumor infiltrating T cells as a surrogate parameter for antitumor activity. Secondary objectives include radiogenic treatment toxicity, postoperative morbidity and mortality, local tumor control and recurrence patterns, survival and quality of life. Furthermore, frequencies of systemic tumor reactive T cells in blood and bone marrow will be correlated with clinical outcome. This is a randomized controlled patient blinded trial to assess the safety and efficiency of low dose radiotherapy on metastasis infiltrating T cells and thus potentially enhance the antitumor immune response. ClinicalTrials.gov: http://www.clinicaltrials.gov/ct2/show/NCT01191632

  6. Implementing low-dose computed tomography screening for lung cancer in Canada: implications of alternative at-risk populations, screening frequency, and duration

    Science.gov (United States)

    Evans, W.K.; Flanagan, W.M.; Miller, A.B.; Goffin, J.R.; Memon, S.; Fitzgerald, N.; Wolfson, M.C.

    2016-01-01

    Background Low-dose computed tomography (ldct) screening has been shown to reduce mortality from lung cancer; however, the optimal screening duration and “at risk” population are not known. Methods The Cancer Risk Management Model developed by Statistics Canada for the Canadian Partnership Against Cancer includes a lung screening module based on data from the U.S. National Lung Screening Trial (nlst). The base-case scenario reproduces nlst outcomes with high fidelity. The impact in Canada of annual screening on the number of incident cases and life-years gained, with a wider range of age and smoking history eligibility criteria and varied participation rates, was modelled to show the magnitude of clinical benefit nationally and by province. Life-years gained, costs (discounted and undiscounted), and resource requirements were also estimated. Results In 2014, 1.4 million Canadians were eligible for screening according to nlst criteria. Over 10 years, screening would detect 12,500 more lung cancers than the expected 268,300 and would gain 9200 life-years. The computed tomography imaging requirement of 24,000–30,000 at program initiation would rise to between 87,000 and 113,000 by the 5th year of an annual nlst-like screening program. Costs would increase from approximately $75 million to $128 million at 10 years, and the cumulative cost nationally over 10 years would approach $1 billion, partially offset by a reduction in the costs of managing advanced lung cancer. Conclusions Modelling various ways in which ldct might be implemented provides decision-makers with estimates of the effect on clinical benefit and on resource needs that clinical trial results are unable to provide.

  7. Long-term observation of 64 patients with roentgenographically occult lung cancer treated with external irradiation and intraluminal irradiation using low-dose-rate iridium

    International Nuclear Information System (INIS)

    Therapeutic results of intraluminal irradiation were analyzed in 64 patients with roentgenographically occult lung cancer (ROLC). The subjects were 64 patients who underwent intraluminal irradiation between 1987 and 2003. Radiotherapy was performed by combining external irradiation with intraluminal irradiation using low-dose-rate iridium (four 370-MBq wires) through a catheter with a spacer. The doses of radiation were 0-70 Gy (median value 46 Gy) by external irradiation and 10-60 Gy (median value 29.3 Gy) by intraluminal irradiation. The therapeutic effect was complete response (CR) in 63 patients and partial response (PR) in 1 patient, and local recurrence was observed in a PR case and in seven of the 63 patients who showed CR. The 5-year overall and relapse-free survival rates were 56 (95% confidence interval (CI), 43-69%) and 55% (95% CI, 43-68%), respectively. Fatal pulmonary hemorrhage was observed in one case. Considering the facts that ROLC often occurs as multiple cancers and that many patients with ROLC have reduced lung function, radiation therapy by a combination of intraluminal and external irradiation may replace surgery as the first choice for the treatment of this disease. (author)

  8. Low-dose computed tomography screening for lung cancer in populations highly exposed to tobacco: A systematic methodological appraisal of published randomised controlled trials.

    Science.gov (United States)

    Coureau, Gaëlle; Salmi, L Rachid; Etard, Cécile; Sancho-Garnier, Hélène; Sauvaget, Catherine; Mathoulin-Pélissier, Simone

    2016-07-01

    Low-dose computed tomography (LDCT) screening recommendations for lung cancer are contradictory. The French National Authority for Health commissioned experts to carry a systematic review on the effectiveness, acceptability and safety of lung cancer screening with LDCT in subjects highly exposed to tobacco. We used MEDLINE and Embase databases (2003-2014) and identified 83 publications representing ten randomised control trials. Control arms and methodology varied considerably, precluding a full comparison and questioning reproducibility of the findings. From five trials reporting mortality results, only the National Lung Screening Trial found a significant decrease of disease-specific and all-cause mortality with LDCT screening compared to chest X-ray screening. None of the studies provided all information needed to document the risk-benefit balance. The lack of statistical power and the methodological heterogeneity of European trials question on the possibility of obtaining valid results separately or by pooling. We conclude, in regard to the lack of strong scientific evidence, that LDCT screening should not be recommended in subjects highly exposed to tobacco. PMID:27211572

  9. Metronomic Treatment with Low-Dose Trofosfamide Leads to a Long-Term Remission in a Patient with Docetaxel-Refractory Advanced Metastatic Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Jochen Greiner

    2010-01-01

    Full Text Available The treatment of metastatic prostate cancer patients refractory to androgen withdrawal and docetaxel therapy is currently discouraging and new therapeutic approaches are vastly needed. Here, we report a long-term remission over one year in a 68-year-old patient with metastatic docetaxel-refractory prostate cancer employing low-dose trofosfamide. The patient suffered from distant failure with several bone lesions and lymph node metastases depicted by a (11 C-Choline positron emission tomography/computerized tomography (PET/CT. After initiation of trofosfamide 100 mg taken orally once a day we observed a steadily decreasing PSA value from initial 46.6 down to 2.1 g/l. The Choline-PET/CT was repeated after 10 months of continuous therapy and demonstrated a partial remission of the bone lesions and a regression of all involved lymph nodes but one. Taken together we found an astonishing and durable activity of the alkylating agent trofosfamide given in a metronomic fashion. We rate the side effects as low and state an excellent therapeutic ratio of this drug in our patient.

  10. Long-term follow-up of non-calcified pulmonary nodules (<10 mm) identified during low-dose CT screening for lung cancer

    International Nuclear Information System (INIS)

    To assess the long-term stability of small (<10 mm) non-calcified pulmonary nodules (NCNs) in high-risk subjects initially screened for lung cancer using low-dose chest computed tomography (LDCCT). A total of 449 subjects initially underwent screening with serial LDCCT over a 2-year period. Participants identified as having NCNs ≥10 mm were referred for formal lung cancer workup. NCNs <10 mm diameter were followed in accordance with the study protocol. Seven years after baseline screening, subjects with previously documented NCNs <10 mm, which were unchanged in size after the 2-year follow-up period, were re-imaged using LDCCT to assess for interval nodule growth. Eighty-three subjects with previously documented stable NCNs <10 mm underwent LDCCT at 7 years. NCNs were unchanged in 78 subjects and had decreased in size in 4 subjects. There was interval growth of an NCN (from 6 mm to 9 mm) in one subject re-imaged at 7 years, but this nodule has remained stable in size over a further 2-year follow-up period. Non-calcified pulmonary nodules <10 mm in size that are unchanged in size or smaller after 2 years of follow-up with LDCCT are most likely benign. (orig.)

  11. Low-dose Photofrin-induced PDT offers excellent clinical response with minimal morbidity in chest wall recurrence of breast cancer

    Science.gov (United States)

    Allison, Ron; Mang, Thomas S.

    2000-03-01

    Limited therapeutic options exist when chest wall recurrence form breast cancer progresses despite standard salvage treatment. As photodynamic therapy offers excellent response for cutaneous lesions this may be a possible indication for PDT. A total of 102 treatment fields were illuminated on 9 women with biopsy proven chest wall recurrence of breast cancer which was progressing despite salvage surgery, radiation, and chemi-hormonal therapy. PDT consisted of outpatient IV infusion of Photofrin at 0.8 mg/kg followed 48 hours laser by illumination at 140-170 J/cm2 via a KTP Yag laser coupled to a dye unit. No patient was lost to follow up. At 6 months post PDT; complete response, defined as total lesion elimination was 89 percent, partial response 8 percent, and no response 3 percent. No photosensitivity was seen and no patient developed scarring, fibrosis, or healing difficulties. Low dose Photofrin induced PDT is very active against chest wall lesions. Despite fragile and heavily pre-treated tissues, excellent clinical and cosmetic outcome was obtained. PDT is an underutilized modality for this indication.

  12. [Low dose ionising radiation and cancer: findings and methods. Report of a meeting and consequences for Switzerland].

    Science.gov (United States)

    Schüler, G; Gutzwiller, F

    1991-01-01

    Today's society is concerned about the dangers of ionising radiation, especially in the aftermath of Chernobyl. On the other hand, there exists a widespread lack of understanding radiation biology and radioepidemiology--the very sciences which provide the data from which today's risk estimates have been derived. The papers in this issue of the Journal were presented at a workshop on "Low level radiation and cancer: data and methods" held on 10th-11th December in Feuisberg, near Zurich. The meeting was organised by the Institute of Social and Preventive Medicine of the University of Zurich under the auspices of the Swiss Federal Office of Public Health. Its aims were threefold. First, to give an introduction to some basic facts and methodological issues in radiation physics, biology and epidemiology. Secondly, to give an overview of the availability of data for radioepidemiological research in Switzerland and, thirdly, to evaluate possible research strategies in this country. A list of some notions and units commonly used in the radiation sciences serves an an introduction to the field (G. Schüler et al.). In using units and notions it is important to distinguish the description of biological experiments and epidemiological observations from definitions and risk projections proposed by international reports and consensus bodies for radioprotection purposes. The next papers deal more specifically with selected aspects of the basic sciences. Dosimetry means quantifying the physical effects of ionizing radiation in human tissue; this is not a straight-forward procedure (I. Cordt). The foundations of general radiation biology are succinctly summarised by C. Michel. An account of our present knowledge and theories of radiation carcinogenesis is provided by W. Burkart. W Lutz compares dose-response models of chemical carcinogenesis with those used in radiation carcinogenesis. During the last decade the epidemiological foundations of radioprotection have changed

  13. A database for a meta-analysis of cancer risk in animals at low doses and dose rates of ionising radiation

    International Nuclear Information System (INIS)

    Results of animal experiments listed in the International Radiobiology Archives (I.R.A.), complemented with data published in peer-reviewed literature since 1996 have been assembled in one data base and the induction of cancer at low doses has been analyzed. In total, approximately 100 separate, independent sets of experimental data have been studied. The main objective of this work is to provide information on radiation risk in the 0-500 mGy range. The data analyzed were those for which no significant reduction of life span was observed in exposed animals; or doses did not exceed 1 Gy; or no cancer was observed in exposed animals. With these criteria data sets with organ doses well in excess of 1 Gy were taken into account. In animals with a low natural incidence of cancer, the difference between the observed number of cancer cases and the prediction of the Linear No-threshold (LNT) hypothesis was compared in each experiment. Following intake of alpha emitters, the number of cancers observed is about 60% of the number of number predicted by the LNT, and only about 56% following intake of beta emitters. In some experiments, statistically weak protective effects were observed following the intake of alpha emitters, whereas apparently statistically strong protective effects were observed in some groups of animals exposed to beta radiation. In animals exposed to low LET radiation and neutrons, both clear excess cancer risk and clear cancer deficits were observed. In a second series of analysis, the several modeling approaches were used to model dose-response. Linear, logistic and probit regression models were examined. For all the data sets examined in this work, the analysis of the data using the LOGISTIC model seems to indicate surplus of negative slopes in the dose-response fits. Finer analyses are underway to determine what parameters are common to experiments which display similar dose-response relationships. If they exist in a sufficient number of experiments

  14. Radiation cancer analysis and low dose risk estimation: new developments and perspectives - conference to be held Feb 2002. Final technical report for period November 1, 2001--October 31, 2002

    International Nuclear Information System (INIS)

    The Proceedings of the 20th LH Gray Conference on Radiation Cancer Analysis and Low Dose Risk Estimation: New Developments and Perspectives (17-21 February 2002, Ede, the Netherlands) comprises 32 peer-reviewed papers on invited and proffered contributions to the conference with a preface by the guest editors. The on-going discussion of low dose radiation risk; the issue of the linear, non-threshold extrapolation; and the anticipated new recommendations, e.g. from BEIR and ICRP, provided the back-drop for the conference. The meeting dealt with topics such as basic mechanisms and bystander effects, cancer modeling, cancer genetics, radon exposure and lung cancer risk, cancer after medical exposure, cancer risk estimation, dose-effect relationships, and application to radiation protection

  15. Reporting small bowel dose in cervix cancer high-dose-rate brachytherapy.

    Science.gov (United States)

    Liao, Yixiang; Dandekar, Virag; Chu, James C H; Turian, Julius; Bernard, Damian; Kiel, Krystyna

    2016-01-01

    Small bowel (SB) is an organ at risk (OAR) that may potentially develop toxicity after radiotherapy for cervix cancer. However, its dose from brachytherapy (BT) is not systematically reported as in other OARs, even with image-guided brachytherapy (IGBT). This study aims to introduce consideration of quantified objectives for SB in BT plan optimization and to evaluate the feasibility of sparing SB while maintaining adequate target coverage. In all, 13 patients were included in this retrospective study. All patients were treated with external beam radiotherapy (EBRT) 45Gy in 25 fractions followed by high dose rate (HDR)-BT boost of 28Gy in 4 fractions using tandem/ring applicator. Magnetic resonance imaging (MRI) and computed tomographic (CT) images were obtained to define the gross tumor volume (GTV), high-risk clinical target volume (HR-CTV) and OARs (rectum, bladder, sigmoid colon, and SB). Treatment plans were generated for each patient using GEC-ESTRO recommendations based on the first CT/MRI. Treatment plans were revised to reduce SB dose when the [Formula: see text] dose to SB was > 5Gy, while maintaining other OAR constraints. For the 7 patients with 2 sets of CT and MRI studies, the interfraction variation of the most exposed SB was analyzed. Plan revisions were done in 6 of 13 cases owing to high [Formula: see text] of SB. An average reduction of 19% in [Formula: see text] was achieved. Meeting SB and other OAR constraints resulted in less than optimal target coverage in 2 patients (D90 of HR-CTV < 77Gyαβ10). The highest interfraction variation was observed for SB at 16 ± 59%, as opposed to 28 ± 27% for rectum and 21 ± 16% for bladder. Prospective reporting of SB dose could provide data required to establish a potential correlation with radiation-induced late complication for SB. PMID:26235549

  16. TH-C-12A-07: Implementation of a Pulsed Low Dose Date Radiotherapy (PLRT) Protocol for Recurrent Cancers Using Advanced Beam Delivery

    International Nuclear Information System (INIS)

    Purpose: Recent in vitro and in vivo experimental findings provided strong evidence that pulsed low-dose-rate radiotherapy (PLDR) produced equivalent tumor control as conventional radiotherapy with significantly reduced normal tissue toxicities. This work aimed to implement a PLDR clinical protocol for the management of recurrent cancers utilizing IMRT and VMAT. Methods: Our PLDR protocol requires that the daily 2Gy dose be delivered in 0.2Gy×10 pulses with a 3min interval between the pulses. To take advantage of low-dose hyper-radiosensitivity the mean dose to the target is set at 0.2Gy and the maximum dose is limited to 0.4Gy per pulse. Practical planning strategies were developed for IMRT and VMAT: (1) set 10 ports for IMRT and 10 arcs for VMAT with each angle/arc as a pulse; (2) set the mean dose (0.2Gy) and maximum dose (0.4Gy) to the target per pulse as hard constraints (no constraints to OARs); (3) select optimal port/arc angles to avoid OARs; and (4) use reference structures in or around target/OARs to reduce maximum dose to the target/OARs. IMRT, VMAT and 3DCRT plans were generated for 60 H and N, breast, lung, pancreas and prostate patients and compared. Results: All PLDR treatment plans using IMRT and VMAT met the dosimetry requirements of the PLDR protocol (mean target dose: 0.20Gy±0.01Gy; maximum target dose < 0.4Gy). In comparison with 3DCRT, IMRT and VMAT exhibited improved target dose conformity and OAR dose sparing. A single arc can minimize the difference in the target dose due to multi-angle incidence although the delivery time is longer than 3DCRT and IMRT. Conclusion: IMRT and VMAT are better modalities for PLDR treatment of recurrent cancers with superior target dose conformity and critical structure sparing. The planning strategies/guidelines developed in this work are practical for IMRT/VMAT treatment planning to meet the dosimetry requirements of the PLDR protocol

  17. TH-C-12A-07: Implementation of a Pulsed Low Dose Date Radiotherapy (PLRT) Protocol for Recurrent Cancers Using Advanced Beam Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Ma, C; Lin, M; Chen, L; Price, R [Fox Chase Cancer Center, Philadelphia, PA (United States); Li, J; Kang, S; Wang, P; Lang, J [Sichuan Provincial Cancer Hospital, Chengdu (China)

    2014-06-15

    Purpose: Recent in vitro and in vivo experimental findings provided strong evidence that pulsed low-dose-rate radiotherapy (PLDR) produced equivalent tumor control as conventional radiotherapy with significantly reduced normal tissue toxicities. This work aimed to implement a PLDR clinical protocol for the management of recurrent cancers utilizing IMRT and VMAT. Methods: Our PLDR protocol requires that the daily 2Gy dose be delivered in 0.2Gy×10 pulses with a 3min interval between the pulses. To take advantage of low-dose hyper-radiosensitivity the mean dose to the target is set at 0.2Gy and the maximum dose is limited to 0.4Gy per pulse. Practical planning strategies were developed for IMRT and VMAT: (1) set 10 ports for IMRT and 10 arcs for VMAT with each angle/arc as a pulse; (2) set the mean dose (0.2Gy) and maximum dose (0.4Gy) to the target per pulse as hard constraints (no constraints to OARs); (3) select optimal port/arc angles to avoid OARs; and (4) use reference structures in or around target/OARs to reduce maximum dose to the target/OARs. IMRT, VMAT and 3DCRT plans were generated for 60 H and N, breast, lung, pancreas and prostate patients and compared. Results: All PLDR treatment plans using IMRT and VMAT met the dosimetry requirements of the PLDR protocol (mean target dose: 0.20Gy±0.01Gy; maximum target dose < 0.4Gy). In comparison with 3DCRT, IMRT and VMAT exhibited improved target dose conformity and OAR dose sparing. A single arc can minimize the difference in the target dose due to multi-angle incidence although the delivery time is longer than 3DCRT and IMRT. Conclusion: IMRT and VMAT are better modalities for PLDR treatment of recurrent cancers with superior target dose conformity and critical structure sparing. The planning strategies/guidelines developed in this work are practical for IMRT/VMAT treatment planning to meet the dosimetry requirements of the PLDR protocol.

  18. Randomized controlled phase I/II study to investigate immune stimulatory effects by low dose radiotherapy in primarily operable pancreatic cancer

    International Nuclear Information System (INIS)

    The efficiencies of T cell based immunotherapies are affected by insufficient migration and activation of tumor specific effector T cells in the tumor. Accumulating evidence exists on the ability of ionizing radiation to modify the tumor microenvironment and generate inflammation. The aim of this phase I/II clinical trial is to evaluate whether low dose single fraction radiotherapy can improve T cell associated antitumor immune response in patients with pancreatic cancer. This trial has been designed as an investigator initiated; prospective randomised, 4-armed, controlled Phase I/II trial. Patients who are candidates for resection of pancreatic cancer will be randomized into 4 arms. A total of 40 patients will be enrolled. The patients receive 0 Gy, 0.5 Gy, 2 Gy or 5 Gy radiation precisely targeted to their pancreatic carcinoma. Radiation will be delivered by external beam radiotherapy using a 6 MV Linac with IMRT technique 48 h prior to the surgical resection. The primary objective is the determination of an active local external beam radiation dose, leading to tumor infiltrating T cells as a surrogate parameter for antitumor activity. Secondary objectives include local tumor control and recurrence patterns, survival, radiogenic treatment toxicity and postoperative morbidity and mortality, as well as quality of life. Further, frequencies of tumor reactive T cells in blood and bone marrow as well as whole blood cell transcriptomics and plasma-proteomics will be correlated with clinical outcome. An interim analysis will be performed after the enrolment of 20 patients for safety reasons. The evaluation of the primary endpoint will start four weeks after the last patient's enrolment. This trial will answer the question whether a low dose radiotherapy localized to the pancreatic tumor only can increase the number of tumor infiltrating T cells and thus potentially enhance the antitumor immune response. The study will also investigate the prognostic and predictive

  19. Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation

    International Nuclear Information System (INIS)

    To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy. Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range -3/mm2/s), respectively, P = 0.02. The median change in ADC 14 days after treatment commencement was significantly higher in the alive group compared to non-survivors, 0.28 and 0.14 (x 10-3/mm2/s), respectively, P = 0.02. There was no evidence of a difference between survivors and non-survivors for pretreatment baseline or post-therapy ADC values. Functional DWI early in the treatment of advanced cancer of the cervix may provide useful information in predicting survival. (orig.)

  20. Reliable categorisation of visual scoring of coronary artery calcification on low-dose CT for lung cancer screening: validation with the standard Agatston score

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Yi-Luan; Wu, Fu-Zong; Wang, Yen-Chi [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung 813 (China); National Yang Ming University, Faculty of Medicine, School of Medicine, Taipei (China); Ju, Yu-Jeng [National Taiwan University, Department of Psychology, Taipei (China); Mar, Guang-Yuan [Kaohsiung Veterans General Hospital, Division of Cardiology, Department of Medicine, Kaohsiung 813 (China); Chuo, Chiung-Chen [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung 813 (China); Lin, Huey-Shyan [Fooyin University, School of Nursing, Kaohsiung (China); Wu, Ming-Ting [Kaohsiung Veterans General Hospital, Department of Radiology, Kaohsiung 813 (China); National Yang Ming University, Faculty of Medicine, School of Medicine, Taipei (China); National Yang Ming University, Institute of Clinical Medicine, Taipei (China)

    2013-05-15

    To validate the reliability of the visual coronary artery calcification score (VCACS) on low-dose CT (LDCT) for concurrent screening of CAC and lung cancer. We enrolled 401 subjects receiving LDCT for lung cancer screening and ECG-gated CT for the Agatston score (AS). LDCT was reconstructed with 3- and 5-mm slice thickness (LDCT-3mm and LDCT-5mm respectively) for VCACS to obtain VCACS-3mm and VCACS-5mm respectively. After a training session comprising 32 cases, two observers performed four-scale VCACS (absent, mild, moderate, severe) of 369 data sets independently, the results were compared with four-scale AS (0, 1-100, 101-400, >400). CACs were present in 39.6 % (146/369) of subjects. The sensitivity of VCACS-3mm was higher than for VCACS-5mm (83.6 % versus 74.0 %). The median of AS of the 24 false-negative cases in VCACS-3mm was 2.3 (range 1.1-21.1). The false-negative rate for detecting AS {>=} 10 on LDCT-3mm was 1.9 %. VCACS-3mm had higher concordance with AS than VCACS-5mm (k = 0.813 versus k = 0.685). An extended test of VCACS-3mm for four junior observers showed high inter-observer reliability (intra-class correlation = 0.90) and good concordance with AS (k = 0.662-0.747). This study validated the reliability of VCACS on LDCT for lung cancer screening and showed that LDCT-3mm was more feasible than LDCT-5mm for CAD risk stratification. (orig.)

  1. External beam radiation therapy and a low-dose-rate brachytherapy boost without or with androgen deprivation therapy for prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To assess outcomes with external beam radiation therapy (EBRT) and a low-dose-rate (LDR) brachytherapy boost without or with androgen deprivation therapy (ADT) for prostate cancer. Materials and Methods: From January 2001 through August 2011, 120 intermediate-risk or high-risk prostate cancer patients were treated with EBRT to a total dose of 4,500 cGy in 25 daily fractions and a palladium-103 LDR brachytherapy boost of 10,000 cGy (n = 90) or an iodine-125 LDR brachytherapy boost of 11,000 cGy (n = 30). ADT, consisting of a gonadotropin-releasing hormone agonist ± an anti-androgen, was administered to 29/92 (32%) intermediate-risk patients for a median duration of 4 months and 26/28 (93%) high-risk patients for a median duration of 28 months. Results: Median follow-up was 5.2 years (range, 1.1-12.8 years). There was no statistically-significant difference in biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), or overall survival (OS) without or with ADT. Also, there was no statistically-significant difference in bDFS, DMFS, or OS with a palladium-103 vs. an iodine-125 LDR brachytherapy boost. Conclusions: There was no statistically-significant difference in outcomes with the addition of ADT, though the power of the current study was limited. The Radiation Therapy Oncology Group 0815 and 0924 phase III trials, which have accrual targets of more than 1,500 men, will help to clarify the role ADT in locally-advanced prostate cancer patients treated with EBRT and a brachytherapy boost. Palladium-103 and iodine-125 provide similar bDFS, DMFS, and OS. (author)

  2. External beam radiation therapy and a low-dose-rate brachytherapy boost without or with androgen deprivation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Tobin J.; Hutchinson, Sean Z.; Shrinath, Kushagra; Cruz, Alex A.; Figura, Nicholas B.; Nethers, Kevin; Biagioli, Matthew C.; Fernandez, Daniel C.; Heysek, Randy V.; Wilder, Richard B., E-mail: richard.wilder@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

    2014-07-15

    Purpose: To assess outcomes with external beam radiation therapy (EBRT) and a low-dose-rate (LDR) brachytherapy boost without or with androgen deprivation therapy (ADT) for prostate cancer. Materials and Methods: From January 2001 through August 2011, 120 intermediate-risk or high-risk prostate cancer patients were treated with EBRT to a total dose of 4,500 cGy in 25 daily fractions and a palladium-103 LDR brachytherapy boost of 10,000 cGy (n = 90) or an iodine-125 LDR brachytherapy boost of 11,000 cGy (n = 30). ADT, consisting of a gonadotropin-releasing hormone agonist ± an anti-androgen, was administered to 29/92 (32%) intermediate-risk patients for a median duration of 4 months and 26/28 (93%) high-risk patients for a median duration of 28 months. Results: Median follow-up was 5.2 years (range, 1.1-12.8 years). There was no statistically-significant difference in biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), or overall survival (OS) without or with ADT. Also, there was no statistically-significant difference in bDFS, DMFS, or OS with a palladium-103 vs. an iodine-125 LDR brachytherapy boost. Conclusions: There was no statistically-significant difference in outcomes with the addition of ADT, though the power of the current study was limited. The Radiation Therapy Oncology Group 0815 and 0924 phase III trials, which have accrual targets of more than 1,500 men, will help to clarify the role ADT in locally-advanced prostate cancer patients treated with EBRT and a brachytherapy boost. Palladium-103 and iodine-125 provide similar bDFS, DMFS, and OS. (author)

  3. A study of the prognostic role of serum fucose and fucosyl transferase in cancer of the uterine cervix.

    Directory of Open Access Journals (Sweden)

    Sen,Urmi

    1985-04-01

    Full Text Available Serum fucose levels and fucosyl transferase activities have been designated as nonspecific markers of malignancy, and play an important role in the diagnosis of different types of malignancies. In the present study, attempts were made to determine the prognostic significance of these markers in patients with cancer of the uterine cervix after therapy. It was found that both serum fucose and fucosyl transferase, which were elevated in untreated patients declined significantly in patients responsive to therapy at different follow-up intervals, but not in patients unresponsive to therapy.

  4. Biological effects of low doses of radiation at low dose rate

    International Nuclear Information System (INIS)

    The purpose of this report was to examine available scientific data and models relevant to the hypothesis that induction of genetic changes and cancers by low doses of ionizing radiation at low dose rate is a stochastic process with no threshold or apparent threshold. Assessment of the effects of higher doses of radiation is based on a wealth of data from both humans and other organisms. 234 refs., 26 figs., 14 tabs

  5. PREGNANCY WITH CARCINOMA CERVIX

    Directory of Open Access Journals (Sweden)

    Sunita

    2014-05-01

    Full Text Available : Invasive cervical cancer during pregnancy is rare, but is a dilemma for women and their physicians. Pregnancy provides a good opportunity to the obstetrician to screen the patient for cervical neoplasia. We report a case of pregnancy with carcinoma cervix. A 40 years old lady G5P3+1 presented in casualty at 38 weeks 2 days with bleeding per vaginum. On examination she was stage III b Carcinoma Cervix with term pregnancy. She underwent classical cesarean section followed by EBRT and brachytherapy. The main objective of this case report is to highlight the need of doing cervical screening routinely in pregnancy in a low resource setting also to decrease the burden of carcinoma cervix in society

  6. A novel method to quantify and compare anatomical shape: application in cervix cancer radiotherapy

    Science.gov (United States)

    Oh, Seungjong; Jaffray, David; Cho, Young-Bin

    2014-06-01

    Adaptive radiation therapy (ART) had been proposed to restore dosimetric deficiencies during treatment delivery. In this paper, we developed a technique of Geometric reLocation for analyzing anatomical OBjects' Evolution (GLOBE) for a numerical model of tumor evolution under radiation therapy and characterized geometric changes of the target using GLOBE. A total of 174 clinical target volumes (CTVs) obtained from 32 cervical cancer patients were analyzed. GLOBE consists of three main steps; step (1) deforming a 3D surface object to a sphere by parametric active contour (PAC), step (2) sampling a deformed PAC on 642 nodes of icosahedron geodesic dome for reference frame, and step (3) unfolding 3D data to 2D plane for convenient visualization and analysis. The performance was evaluated with respect to (1) convergence of deformation (iteration number and computation time) and (2) accuracy of deformation (residual deformation). Based on deformation vectors from planning CTV to weekly CTVs, target specific (TS) margins were calculated on each sampled node of GLOBE and the systematic (Σ) and random (σ) variations of the vectors were calculated. Population based anisotropic (PBA) margins were generated using van Herk's margin recipe. GLOBE successfully modeled 152 CTVs from 28 patients. Fast convergence was observed for most cases (137/152) with the iteration number of 65 ± 74 (average ± STD) and the computation time of 13.7 ± 18.6 min. Residual deformation of PAC was 0.9 ± 0.7 mm and more than 97% was less than 3 mm. Margin analysis showed random nature of TS-margin. As a consequence, PBA-margins perform similarly to ISO-margins. For example, PBA-margins for 90% patients' coverage with 95% dose level is close to 13 mm ISO-margins in the aspect of target coverage and OAR sparing. GLOBE demonstrates a systematic analysis of tumor motion and deformation of patients with cervix cancer during radiation therapy and numerical modeling of PBA-margin on 642 locations of CTV

  7. Naltrexone at low doses upregulates a unique gene expression not seen with normal doses: Implications for its use in cancer therapy.

    Science.gov (United States)

    Liu, Wai M; Scott, Katherine A; Dennis, Jayne L; Kaminska, Elwira; Levett, Alan J; Dalgleish, Angus G

    2016-08-01

    It has been reported that lower doses of the opioid antagonist naltrexone are able to reduce tumour growth by interfering with cell signalling as well as by modifying the immune system. We have evaluated the gene expression profile of a cancer cell line after treatment with low-dose naltrexone (LDN), and assessed the effect that adapting treatment schedules with LDN may have on enhancing efficacy. LDN had a selective impact on genes involved with cell cycle regulation and immune modulation. Similarly, the pro-apoptotic genes BAD and BIK1 were increased only after LDN. Continuous treatment with LDN had little effect on growth in different cell lines; however, altering the treatment schedule to include a phase of culture in the absence of drug following an initial round of LDN treatment, resulted in enhanced cell killing. Furthermore, cells pre-treated with LDN were more sensitive to the cytotoxic effects of a number of common chemotherapy agents. For example, priming HCT116 with LDN before treatment with oxaliplatin significantly increased cell killing to 49±7.0 vs. 14±2.4% in cultures where priming was not used. Interestingly, priming with NTX before oxaliplatin resulted in just 32±1.8% cell killing. Our data support further the idea that LDN possesses anticancer activity, which can be improved by modifying the treatment schedule. PMID:27279602

  8. Bystander Effects Induced by Continuous Low-Dose-Rate 125I Seeds Potentiate the Killing Action of Irradiation on Human Lung Cancer Cells In Vitro

    International Nuclear Information System (INIS)

    Purpose: To investigate bystander effects of low-dose-rate (LDR) 125I seed irradiation on human lung cancer cells in vitro. Methods and Materials: A549 and NCI-H446 cell lines of differing radiosensitivity were directly exposed to LDR 125I seeds irradiation for 2 or 4 Gy and then cocultured with nonirradiated cells for 24 hours. Induction of micronucleus (MN), γH2AX foci, and apoptosis were assayed. Results: After 2 and 4 Gy irradiation, micronucleus formation rate (MFR) and apoptotic rate of A549 and NCI-H446 cells were increased, and the MFR and apoptotic rate of NCI-H446 cells was 2.1-2.8 times higher than that of A549 cells. After coculturing nonirradiated bystander cells with 125I seed irradiated cells for 24 hours, MFR and the mean number of γH2AX foci/cells of bystander A549 and NCI-H446 cells were similar and significantly higher than those of control (p 125I seeds could induce bystander effects, which potentiate the killing action on tumor cells and compensate for the influence of nonuniform distribution of radiation dosage on therapeutic outcomes

  9. Radiation biology of low doses

    International Nuclear Information System (INIS)

    Present risk assessments and standards in radiation protection are based on the so-called linear no-threshold (LNT) dose - effect hypothesis, i.e., on a linear, proportional relationship between radiation doses and their effects on biological systems. This concept presupposes that any dose, irrespective of its level and time of occurrence, carries the same risk coefficient and, moreover, that no individual biological effects are taken into account. This contribution presents studies of low energy transfer (LET) radiation which deal with the risk of cancer to individual cells. According to the LNT hypothesis, the relationship for the occurrence of these potential effects should be constant over the dose range: successful repair, cell death, mutation with potential carcinogenesis. The results of the studies presented here indicate more differentiated effects as a function of dose application as far as damage to cellular DNA by ionizing radiation is concerned. At the same overall dose level, multiple exposures to low doses sometimes give rise to much smaller effects than those arising from one single exposure to the total dose. These adaptive effects of cells are known from other studies. The results of the study allow the conclusion to be drawn that non-linear relationships must be assumed to exist for the LET radiation considered. Correspondingly, the linear no-threshold hypothesis model should at least be reconsidered with respect to the low dose range in the light of recent biological findings. The inclusion of other topical research findings also could give rise to a new, revised, risk-oriented approach in radiological protection. (orig.)

  10. USE OF A COMBINATION OF АVASTIN AND LOW-DOSE INTERFERON- α IN THE FIRST-LINE TREATMENT OF METASTATIC RENAL-CELL CANCER

    Directory of Open Access Journals (Sweden)

    A. S. Kalpinsky

    2014-07-01

    Full Text Available Background. The registered AVOREN Phase III trial demonstrated the efficacy of a combination of bevacizumab and interferon-α (IFN-α as first-line targeted therapy in patients with metastatic renal-cell cancer (mRCC. The median progression-free survival (PFS was significantly higher in the bevacizumab + IFN-α group, amounting to 10.2 months versus 5.4 months in the IFN-α group (p < 0.0001. The most common grade 3 and 4 side effects in the AVOREN study included the adverse events due to IFN-α use; this initiated a prospective multicenter BEVLiN (Bevacizumab and Low-Dose Interferon Phase II trial in 2008 to evaluate the efficacy and tolerability of a combination of bevacizumab and low-dose IFN-α in patients with mRCC to diminish the toxicity of treatment.Subjects and methods. The trial enrolled 146 patients having good and moderate prognosis according to the MSKCC scale. The patients received Avastin 10 mg/kg every 2 weeks and IFN-α 3,000,000 IU thrice weekly. The historical control group was taken from the AVOREN trial as a control group. The main purposes of the trial were to evaluate the tolerability of treatment (the frequency of adverse events due to IFN-α use, grade 3 or more toxicity and PFS. The additional goals were to estimate overall survival (OS, objective response rates, and the incidence of any adverse events of grade 3–4 toxicity.Results. The median follow-up was 29.4 months (range 1.5–35.4 months. The rate of objective responses was 28.8 % (95 % confidence interval (CI 21.4–37.1. The median PFS was 15.3 months (95 % CI 11.7–18.0 and PFS was 58.2 and 28.9 % at 12 and 24 months of treatment, respectively. The median OS was 30.7 months (95 % CI 25.7 was unachieved. In the IFN-α group, all grades of adverse reactions and their grade 3 or more were recorded in 53.4 and 10.3 % of the patients, respectively. The adverse events that were a reason for IFN-α discontinuation were recorded in 24.0 % of the patients

  11. Low doses effects and gamma radiations low dose rates

    International Nuclear Information System (INIS)

    This expose wishes for bringing some definitions and base facts relative to the problematics of low doses effects and low dose rates effects. It shows some already used methods and some actual experimental approaches by focusing on the effects of ionizing radiations with a low linear energy transfer. (N.C.)

  12. Hepatic intra-arterial chemotherapy (HIAC) of high dose mitomycin and epirubicin combined with caval chemofiltration versus prolonged low doses in liver metastases from colorectal cancer: a prospective randomized clinical study.

    Science.gov (United States)

    Fiorentini, G; Poddie, D B; Cantore, M; Rossi, S; Tumolo, S; Dentico, P; Bernardeschi, P; Guadagni, S; Rossi, G; Valori, V M; De Simone, M

    2004-11-01

    A multicenter randomized study comparing high dose of mitomycin and epirubicin given as hepatic intra-arterial chemotherapy (HIAC) combined with caval chemofiltration (CF) versus low doses of the same drugs in unresectable liver metastases from colorectal cancer showed a significant improvement in the survival rate of the 20 patients treated with high dose compared to the 22 patients treated with low doses with a 1 year survival of 69% vs 39%. The median survival was 17 vs 11 months and the responses were 65% vs 33%. Toxicity was colangitis in 50% of patients considered. The extrahepatic progression was similar in the two groups (7/20 vs 8/22). PMID:15675479

  13. Health benefits from low-dose irradiation

    International Nuclear Information System (INIS)

    Whole-body exposures of mice and humans show no harm from low doses of ionizing radiation. Forty reports show statistically significant, p < 0.01, beneficial effects when cancer and total mortality rates were examined in mice. In vitro experiments indicate that radiogenic metabolism, adaptive repair mechanisms, such as DNA repair enzymes, and the essential nature of ionizing radiation are responsible for part of this activity. However, overwhelming evidence shows that low-dose irradiation increases immune competence. Such data negate the linear concept, which has no reliable whole-animal data to support it in the low-dose range. Cell culture data are not pertinent; such cells do not have a complete immune system

  14. Radiochemotherapy with short daily infusion of low-dose oxaliplatin, leucovorin, and 5-FU in T3-T4 unresectable rectal cancer: a phase II IATTGI study

    International Nuclear Information System (INIS)

    survival was 19.5 months (CI 95%, 18.0, 21). Conclusions: Outpatient treatment with low-dose, 30-min daily OXA infusion was feasible and very active, with acceptable toxicity

  15. Radiation Leukemogenesis at Low Dose Rates

    International Nuclear Information System (INIS)

    The major goals of this program were to study the efficacy of low dose rate radiation exposures for the induction of acute myeloid leukemia (AML) and to characterize the leukemias that are caused by radiation exposures at low dose rate. An irradiator facility was designed and constructed that allows large numbers of mice to be irradiated at low dose rates for protracted periods (up to their life span). To the best of our knowledge this facility is unique in the US and it was subsequently used to study radioprotectors being developed for radiological defense (PLoS One. 7(3), e33044, 2012) and is currently being used to study the role of genetic background in susceptibility to radiation-induced lung cancer. One result of the irradiation was expected; low dose rate exposures are ineffective in inducing AML. However, another result was completely unexpected; the irradiated mice had a very high incidence of hepatocellular carcinoma (HCC), approximately 50%. It was unexpected because acute exposures are ineffective in increasing HCC incidence above background. This is a potential important finding for setting exposure limits because it supports the concept of an 'inverse dose rate effect' for some tumor types. That is, for the development of some tumor types low dose rate exposures carry greater risks than acute exposures

  16. Radiation Leukemogenesis at Low Dose Rates

    Energy Technology Data Exchange (ETDEWEB)

    Weil, Michael; Ullrich, Robert

    2013-09-25

    The major goals of this program were to study the efficacy of low dose rate radiation exposures for the induction of acute myeloid leukemia (AML) and to characterize the leukemias that are caused by radiation exposures at low dose rate. An irradiator facility was designed and constructed that allows large numbers of mice to be irradiated at low dose rates for protracted periods (up to their life span). To the best of our knowledge this facility is unique in the US and it was subsequently used to study radioprotectors being developed for radiological defense (PLoS One. 7(3), e33044, 2012) and is currently being used to study the role of genetic background in susceptibility to radiation-induced lung cancer. One result of the irradiation was expected; low dose rate exposures are ineffective in inducing AML. However, another result was completely unexpected; the irradiated mice had a very high incidence of hepatocellular carcinoma (HCC), approximately 50%. It was unexpected because acute exposures are ineffective in increasing HCC incidence above background. This is a potential important finding for setting exposure limits because it supports the concept of an 'inverse dose rate effect' for some tumor types. That is, for the development of some tumor types low dose rate exposures carry greater risks than acute exposures.

  17. MRI-assisted cervix cancer brachytherapy pre-planning, based on application in paracervical anaesthesia: final report

    International Nuclear Information System (INIS)

    Optimal applicator insertion is a precondition for the success of cervix cancer brachytherapy (BT). We aimed to assess feasibility and efficacy of MRI-assisted pre-planning, based on applicator insertion in para-cervical anaesthesia (PCA). Five days prior to BT, the pre-planning procedure was performed in 18 cervix cancer patients: tandem-ring applicator was inserted under PCA, pelvic MRI obtained and applicator removed. Procedure tolerability was assessed. High risk clinical target volume (HR CTV) and organs at risk were delineated on the pre-planning MRI, virtual needles placed at optimal positions, and dose planning performed. At BT, insertion was carried out in subarachnoidal anaesthesia according to pre-planned geometry. Pre-planned and actual treatment parameters were compared. Pre-planning procedure was well tolerated. Median difference between the pre-planned and actual needle insertion depth and position were 2 (0–10) mm and 4 (0–30) degrees, respectively. The differences between the pre-planned and actual geometric and dosimetric parameters were statistically non-significant. All actual needles were positioned inside the HR CTV and outside the organs at risk (OAR). Our pre-planning approach is well tolerated and effective. Pre-planned geometry and dose distribution can be reproduced at BT

  18. Uncertainties of target volume delineation in MRI guided adaptive brachytherapy of cervix cancer: A multi-institutional study

    International Nuclear Information System (INIS)

    Background and aim: We aimed to quantify target volume delineation uncertainties in cervix cancer image guided adaptive brachytherapy (IGABT). Materials and methods: Ten radiation oncologists delineated gross tumour volume (GTV), high- and intermediate-risk clinical target volume (HR CTV, IR CTV) in six patients. Their contours were compared with two reference delineations (STAPLE-Simultaneous Truth and Performance Level Estimation and EC- expert consensus) by calculating volumetric and planar conformity index (VCI and PCI) and inter-delineation distances (IDD). Results: VCISTAPLE and VCIEC were 0.76 and 0.72 for HR CTV, 0.77 and 0.68 for IR CTV and 0.59 and 0.58 for GTV. Variation was most prominent caudally and cranially in all target volumes and posterolaterally in IR CTV. IDDSTAPLE and IDDEC for HR CTV (3.6 ± 3.5 and 3.8 ± 3.4 mm) were significantly lower than for GTV (4.8 ± 4.2 and 4.2 ± 3.5 mm) and IR CTV (4.7 ± 5.2 and 5.2 ± 5.6 mm) (p < 0.05). Conclusions: Due to lower delineation uncertainties when compared to GTV and IR CTV, HR CTV may be considered most robust volume for dose prescription and optimization in cervix cancer IGABT. Adequate imaging, training and use of contouring recommendations are main strategies to minimize delineation uncertainties

  19. Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAseff.; 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population. (orig.)

  20. Long-Term Efficacy and Toxicity of Low-Dose-Rate {sup 125}I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kittel, Jeffrey A.; Reddy, Chandana A.; Smith, Kristin L.; Stephans, Kevin L.; Tendulkar, Rahul D. [Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio (United States); Ulchaker, James; Angermeier, Kenneth; Campbell, Steven; Stephenson, Andrew; Klein, Eric A. [Department of Urology, Cleveland Clinic Glickman Urological and Kidney Institute, Cleveland, Ohio (United States); Wilkinson, D. Allan [Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio (United States); Ciezki, Jay P., E-mail: ciezkij@ccf.org [Department of Radiation Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio (United States)

    2015-07-15

    Purpose/Objectives: To report long-term efficacy and toxicity for a single-institution cohort of patients treated with low-dose-rate prostate brachytherapy permanent implant (PI) monotherapy. Methods and Materials: From 1996 to 2007, 1989 patients with low-risk (61.3%), intermediate-risk (29.8%), high-intermediate-risk (4.5%), and high-risk prostate cancer (4.4%) were treated with PI and followed up prospectively in a registry. All patients were treated with {sup 125}I monotherapy to 144 Gy. Late toxicity was coded retrospectively according to a modified Common Terminology Criteria for Adverse Events 4.0 scale. The rates of biochemical relapse-free survival (bRFS), distant metastasis-free survival (DMFS), overall survival (OS), and prostate cancer–specific mortality (PCSM) were calculated. We identified factors associated with late grade ≥3 genitourinary (GU) and gastrointestinal (GI) toxicity, bRFS, DMFS, OS, PCSM, and incontinence. Results: The median age of the patients was 67 years, and the median overall and prostate-specific antigen follow-up times were 6.8 years and 5.8 years, respectively. The overall 5-year rates for bRFS, DMFS, OS, and PCSM were 91.9%, 97.8%, 93.7%, and 0.71%, respectively. The 10-year rates were 81.5%, 91.5%, 76.1%, and 2.5%, respectively. The overall rates of late grade ≥3 GU and GI toxicity were 7.6% and 0.8%, respectively. On multivariable analysis, age and prostate length were significantly associated with increased risk of late grade ≥3 GU toxicity. The risk of incontinence was highly correlated with both pre-PI and post-PI transurethral resection of the prostate. Conclusions: Prostate brachytherapy as monotherapy is an effective treatment for low-risk and low-intermediate-risk prostate cancer and appears promising as a treatment for high-intermediate-risk and high-risk prostate cancer. Significant long-term toxicities are rare when brachytherapy is performed as monotherapy.

  1. Low-dose non-enhanced CT versus full-dose contrast-enhanced CT in integrated PET/CT studies for the diagnosis of uterine cancer recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro [Institute of Biomedical Research and Innovation, Department of PET Diagnosis, Kobe (Japan); Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Suzuki, Kayo [Institute of Biomedical Research and Innovation, Department of PET Diagnosis, Kobe (Japan); Nakamoto, Yuji [Kyoto University Hospital, Department of Diagnostic Radiology, Kyoto (Japan); Onishi, Yumiko; Sakamoto, Setsu; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Senda, Michio [Institute of Biomedical Research and Innovation, Department of Molecular Imaging, Kobe (Japan); Kita, Masato [Kobe City Medical Center General Hospital, Department of Obstetrics and Gynecology, Kobe (Japan)

    2010-08-15

    To evaluate low-dose non-enhanced CT (ldCT) and full-dose contrast-enhanced CT (ceCT) in integrated {sup 18}F-fluorodeoxyglucose (FDG) PET/CT studies for restaging of uterine cancer. A group of 100 women who had undergone treatment for uterine cervical (n=55) or endometrial cancer (n=45) underwent a conventional PET/CT scans with ldCT, and then a ceCT scan. Two observers retrospectively reviewed and interpreted the PET/ldCT and PET/ceCT images in consensus using a three-point grading scale (negative, equivocal, or positive) per patient and per lesion. Final diagnoses were obtained by histopathological examination, or clinical follow-up for at least 6 months. Patient-based analysis showed that the sensitivity, specificity and accuracy of PET/ceCT were 90% (27/30), 97% (68/70) and 95% (95/100), respectively, whereas those of PET/ldCT were 83% (25/30), 94% (66/70) and 91% (91/100), respectively. Sensitivity, specificity and accuracy did not significantly differ between two methods (McNemar test, p=0.48, p=0.48, and p=0.13, respectively). There were 52 sites of lesion recurrence: 12 pelvic lymph node (LN), 11 local recurrence, 8 peritoneum, 7 abdominal LN, 5 lung, 3 supraclavicular LN, 3 liver, 2 mediastinal LN, and 1 muscle and bone. The grading results for the 52 sites of recurrence were: negative 5, equivocal 0 and positive 47 for PET/ceCT, and negative 5, equivocal 4 and positive 43 for PET/ldCT, respectively. Four equivocal regions by PET/ldCT (local recurrence, pelvic LN metastasis, liver metastasis and muscle metastasis) were correctly interpreted as positive by PET/ceCT. PET/ceCT is an accurate imaging modality for the assessment of uterine cancer recurrence. Its use reduces the frequency of equivocal interpretations. (orig.)

  2. Long-Term Efficacy and Toxicity of Low-Dose-Rate 125I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

    International Nuclear Information System (INIS)

    Purpose/Objectives: To report long-term efficacy and toxicity for a single-institution cohort of patients treated with low-dose-rate prostate brachytherapy permanent implant (PI) monotherapy. Methods and Materials: From 1996 to 2007, 1989 patients with low-risk (61.3%), intermediate-risk (29.8%), high-intermediate-risk (4.5%), and high-risk prostate cancer (4.4%) were treated with PI and followed up prospectively in a registry. All patients were treated with 125I monotherapy to 144 Gy. Late toxicity was coded retrospectively according to a modified Common Terminology Criteria for Adverse Events 4.0 scale. The rates of biochemical relapse-free survival (bRFS), distant metastasis-free survival (DMFS), overall survival (OS), and prostate cancer–specific mortality (PCSM) were calculated. We identified factors associated with late grade ≥3 genitourinary (GU) and gastrointestinal (GI) toxicity, bRFS, DMFS, OS, PCSM, and incontinence. Results: The median age of the patients was 67 years, and the median overall and prostate-specific antigen follow-up times were 6.8 years and 5.8 years, respectively. The overall 5-year rates for bRFS, DMFS, OS, and PCSM were 91.9%, 97.8%, 93.7%, and 0.71%, respectively. The 10-year rates were 81.5%, 91.5%, 76.1%, and 2.5%, respectively. The overall rates of late grade ≥3 GU and GI toxicity were 7.6% and 0.8%, respectively. On multivariable analysis, age and prostate length were significantly associated with increased risk of late grade ≥3 GU toxicity. The risk of incontinence was highly correlated with both pre-PI and post-PI transurethral resection of the prostate. Conclusions: Prostate brachytherapy as monotherapy is an effective treatment for low-risk and low-intermediate-risk prostate cancer and appears promising as a treatment for high-intermediate-risk and high-risk prostate cancer. Significant long-term toxicities are rare when brachytherapy is performed as monotherapy

  3. The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

    Institute of Scientific and Technical Information of China (English)

    Rui-Yi Wu; Guo-Min Wang; Lei Xu; Bo-Heng Zhang; Ye-Qing Xu; Zhao-Chong Zeng; Bing Chen

    2011-01-01

    The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (+) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU+LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU+LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU+LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P=0.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU+LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU+LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU+LRT and CRT were independently associated with DSS (P=0.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU+LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade ≥II. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU+LRT showed good efficacy and better safety.

  4. Normal tissue response to low doses of radiotherapy assessed by molecular markers - A study of skin in patients treated for prostate cancer

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate normal tissue response by molecular markers to multi fraction low doses of ionizing radiation, with the focus on changes in repopulation, estimated using Ki-67 as the proliferation marker, and on expressions of the p53 and p21 proteins, identified as key proteins in the DNA damage checkpoint. Repeated skin biopsies were taken from patients treated for prostate cancer with radiotherapy. The expressions of Ki-67, p53 and p21 of the keratinocytes in the basal cell layer of the epidermis were quantified immunohistochemically. The dose to the basal layer was 1.1 Gy per fraction, given five times per week for seven weeks. The indices of the three markers were determined over the whole period. A significant suppression of the Ki-67 index was observed during the first weeks, followed by a significant gradual increase in the Ki-67 index over the last weeks. The p53 and p21 protein levels were almost zero in the unirradiated skin. Upon irradiation, both the p53 and p21 index increased in a pattern very congruent to the Ki-67 index. In conclusion, daily fractions of about 1 Gy to the skin resulted in, for the keratinocytes in the basal layer, a cell growth arrest for a couple of weeks and a subsequent acceleration in repopulation during the following weeks of irradiation. The present findings also provided novel insights into the role of the p53/p21 pathway in the response of a normal epithelium to ionizing radiation as it is applied in radiotherapy

  5. Therapeutic and diagnostic procedures in preinvasive disease of the cervix and cervical cancer in pregnant women

    International Nuclear Information System (INIS)

    154 pregnant women with displasis and cervical carcinoma of the uterus treated in the Institute in years 1953-1990 underwent investigation. Authors noticed that only 50 pathologies were diagnosed in 1st trimester of pregnancy and 85% constituted precancerous and early forms of carcinoma of the uterine cervix. Authors presented the model of management and care of pregnancy, labour and puerperium in these patients. Due to this procedure we obtained 90% comparability of preliminary and final diagnosis. (author)

  6. Investigation of rectal complication after RALS-therapy for uterine cervix cancer using multivariate analysis

    International Nuclear Information System (INIS)

    Rectal injury is one of the major side effects after radiation therapy for carcinoma of the uterine cervix. According to our previous reports, the cases of rectal complication were mainly related to the measured rectal dose in half of patients, and the other causes were related to the following factors; such as diabetes mellitus, hemorrhagic tendency, syphilis and so on. Concerning to rectal complication, these factors were investigated by means of the discriminant analysis, one of the multivariate analyses, in this paper. Twenty-eight factors as to radiation dose, laboratory tests and physical condition of patients were analyzed. From August 1978 through January 1980, 52 cases of previously untreated carcinoma of the uterine cervix were treated using RALS, remotely controlled high dose rate intracavitary radiotherapy, at our department. The data from 49 out of 52 cases were available for the discriminant analysis. By m eans of this analysis, it was found that these factors, such as the dose of whole pelvic irradiation, Point A dose of RALS, measured rectal dose by RALS, WGC-Z and TPHA were important factors for occurence of rectal complication. According to the discriminant score, 46 out of 49 cases (94 %) could be correctly discriminated. There were two cases of false positive and one false negative. Form February 1980 through July 1980, 27 cases of previously untreated carcinoma of the uterine cervix were treated at our department. The obtained discriminant function was applied to these 27 cases, and 24 out of 27 cases (89 %) were correctly predicted. There were two cases of false positive, and one of false negative. Discriminant analysis is useful for the prediction of rectal complication after radiation therapy for carcinoma of the uterine cervix. (J.P.N.)

  7. Catheter-based ultrasound hyperthermia with HDR brachytherapy for treatment of locally advanced cancer of the prostate and cervix

    Science.gov (United States)

    Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I. C.

    2011-03-01

    A clinical treatment delivery platform has been developed and is being evaluated in a clinical pilot study for providing 3D controlled hyperthermia with catheter-based ultrasound applicators in conjunction with high dose rate (HDR) brachytherapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within HDR brachytherapy implants during radiation therapy in the treatment of cervix and prostate. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm length × 180 deg and 3-4 cm × 360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers × dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and six prostate implants. 100 % of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target

  8. Role of low-dose spiral CT scan in early lung cancer screeing of high risk population: a systematic review of the literature with a Meta-analysis

    International Nuclear Information System (INIS)

    Objective: To assess the overall diagnostic value of low-dose spiral computed tomography (LDSCT) screening trials for early lung cancer of high risk population. Methods: A search in PubMed, Cancerlit, Embase bank, Cochrane Library, CBMdisc and CNKI was performed to identify relevant English and Chinese-language articles from January 1, 1995 to June 1,2005. Quality evaluation and heterogeneity test were performed to the included researches. Consistency analysis was executed. Pooled weighted sensitivity and specificity were calculated. Receiver operating characteristic (ROC) curve was performed and area under the curve (AUC) was calculated. Test of odds ratio(OR)was performed to these results of base screening and annual follow-up screening at least two years. Finally, sensitivity analysis was performed. Results: Fifteen articles were included, with 9 independent researches and a total of 8168 subjects. Heterogeneity existed. Base screening was undertaken in high risk population in the grade of BO (discovering nodule), B5 (discovering nodule of diameter more than 5 mm), B10 (discovering nodule of diameter more than 10 mm) and corresponding Kappa value was 0.061, 0.134 and 0.460, pooled weighted sensitivity was 0.686, 0.721 and 0.640, pooled weighted specificity was 0.708, 0.815 and 0.959. Area under the ROC was 0.778, 0.949 and 0.539 respectively. Statistically significant difference did not exist between the AUC of BO and B5 (P>0.05), but existed between B0 and B10, B5 and B10 (P<0.05). With the fixed effect model, the pooled OR in the grade of B5 and B10 were 1.11 and 1.66 respectively. Conclusion: The articles entered into this Meta-analysis were of high quality. The pooled weighted sensitivity and specificity of LDSCT screening for early lung cancer of high risk population was moderate. The method was affected by chance factors easily. It was relatively reasonable to define the positive standard as the discovered nodule's diameter was more than 5 mm. Close flow

  9. To study the role of visual inspection of cervix with acetic acid (VIA in cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Sunita Goyal

    2014-06-01

    Full Text Available Background: Objectives of current study were to evaluate visual inspection of cervix with acetic acid in picking up abnormal cervix and to correlate the findings of VIA with Pap smear, colposcopy and cervical biopsy. Methods: Study was conducted on 300 sexually active women attending the gynaecological OPD at Dayanand medical college and hospital, Ludhiana. All patients underwent VIA and Pap smear screening and if either of the two was abnormal, colposcopy was done and colposcopic guided cervical biopsy was taken if indicated. Total 105 colposcopies were done. Cervical biopsy was taken in 87 cases and the results were compared and statistically analysed. Results: The sensitivity of VIA was 86% and specificity 40.50%. No case was missed by VIA when cut off was taken as moderate dysplasia or higher lesions on biopsy. Conclusions: VIA is a sensitive, practical and a low cost affair in cervical cancer screening. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 684-687

  10. Effectiveness of cervical conization versus simple total hysterectomy, patients with in situ cervix cancer, Instituto Oncologico Nacional Dr. Juan Tanca Marengo Guayaquil 1996-1998

    International Nuclear Information System (INIS)

    The cancer in the cervix is the main cause of oncologic disease in the women in Ecuador. This investigation tries to find out the more adequate surgical treatment used in the patients with early cervix cancer, in agreed with the cost benefit relationship. This work has not been before done in the ION SOLCA, because of that, there is only information reports of other countries. We make a bibliographic review of previous reports about the surgical treatments of the cancer in situ of the cervix, that is the cervical conization and the simple total hysterectomy, likewise, we analyse the results of the efficacy of both treatments in the patients attended during three years in the National Oncologic Institute SOLCA, by means of a 5 years follow up. In this retrospective study, it was compared the efficacy between the cervical conization and the simple total hysterectomy in the treatment of patients with in situ cancer of cervix who went to the service of surgery of the Oncologic National Institute SOLCA Guayaquil during 1996, 1997 and 1998 and whom were followed up during 5 years. This is a bibliographic documental investigation, in which, we got information about the object of study from the department of statistics in the ION SOLCA; the techniques used were the analysis and the documental statistic collection. We revised 246 clinical histories of patients with cancer in situ of cervix, of which, 128 were included and 118 were excluded. The reasons for exclusion were the lack of posttreatment controls and data record. The data collection was accomplished by formularies. The 128 clinical histories were classified in three groups: the group in which it was done only the conization. The group in which it was done only the simple total hysterectomy. The group in which it was done both treatment. (The author)

  11. Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer

    International Nuclear Information System (INIS)

    Background: To investigate the clinical impact of MRI based cervix cancer brachytherapy combined with external beam radiochemotherapy applying dose volume adaptation and dose escalation in a consecutive group of patients with locally advanced cervix cancer. Methods: In the period 1998-2003, 145 patients with cervix cancer stages IB-IVA were treated with definitive radiotherapy +/- cisplatin chemotherapy. Median age was 60 years. In 67 patients, the tumour size was 2-5 cm, in 78 patients it was >5 cm. In 29 cases the standard intracavitary technique was combined with interstitial brachytherapy. Total prescribed dose was 80-85 Gy (total biologically equivalent dose in 2 Gy fractions). Since 2001, MRI based treatment planning integrated systematic concepts for High Risk Clinical Target Volume (HR CTV) and organs at risk (OAR), biological modelling, Dose-Volume-Histogram analysis, dose-volume-adaptation (D90, D 2 cm3), and dose escalation, if appropriate and feasible. Findings: Dose volume adaptation was performed in 130/145 patients. The mean D90 during the whole period was 86 Gy, with a mean D90 of 81 Gy and 90 Gy during the first and second period, respectively (p 5 cm it was 71% in 1998-2000 and 90% in 2001-2003 (p = 0.05). Progression free survival (PFS) for true pelvis (local control) was 85%, PFS for distant metastases was 80%, both at 3 years. Local control for tumours >5 cm was 64% in 1998-2000 and 82% in 2001-2003 (p = 0.09) and 100% and 96%, respectively, for tumours 2-5 cm. PFS for distant metastases remained the same during the two treatment periods with 79% and 80%. Overall survival (OS) was 58%, and cancer-specific survival (CSS) was 68% at 3 years. In the two different periods improvement in OS was from 53% to 64% (p = 0.03) and in CSS from 62% to 74% (p = 0.13). Improvement occurred only in tumours >5 cm: OS 28% versus 58% (p = 0.003); CSS 40% versus 62% (p = 0.07). Actuarial late morbidity rate (LENT SOMA, grades 3 and 4) at 3 years was

  12. New risk estimates at low doses

    International Nuclear Information System (INIS)

    The age of molecular radiation epidemiology may be at hand. The techniques are available to establish with the degree of precision required to determine whether agent-specific mutations can be identified consistently. A concerted effort to examine radiation-induced changes in as many relevant genes as possible appears to be justified. Cancers in those exposed to low doses of ionizing radiation should be chosen for the investigation. Parallel studies of radiation-induced cancers in experimental animals would not only complement the human studies, but perhaps reveal approaches to extrapolation of risk estimates across species. A caveat should be added to this optimistic view of what molecular studies might contribute to the knotty problem of risk estimates at low doses. The suggestions are made by one with no expertise in the field of molecular biology

  13. Mammography-oncogenecity at low doses

    International Nuclear Information System (INIS)

    Controversy exists regarding the biological effectiveness of low energy x-rays used for mammography breast screening. Recent radiobiology studies have provided compelling evidence that these low energy x-rays may be 4.42 ± 2.02 times more effective in causing mutational damage than higher energy x-rays. These data include a study involving in vitro irradiation of a human cell line using a mammography x-ray source and a high energy source which matches the spectrum of radiation observed in survivors from the Hiroshima atomic bomb. Current radiation risk estimates rely heavily on data from the atomic bomb survivors, and a direct comparison between the diagnostic energies used in the UK breast screening programme and those used for risk estimates can now be made. Evidence highlighting the increase in relative biological effectiveness (RBE) of mammography x-rays to a range of x-ray energies implies that the risks of radiation-induced breast cancers for mammography x-rays are potentially underestimated by a factor of four. A pooled analysis of three measurements gives a maximal RBE (for malignant transformation of human cells in vitro) of 4.02 ± 0.72 for 29 kVp (peak accelerating voltage) x-rays compared to high energy electrons and higher energy x-rays. For the majority of women in the UK NHS breast screening programme, it is shown that the benefit safely exceeds the risk of possible cancer induction even when this higher biological effectiveness factor is applied. The risk/benefit analysis, however, implies the need for caution for women screened under the age of 50, and particularly for those with a family history (and therefore a likely genetic susceptibility) of breast cancer. In vitro radiobiological data are generally acquired at high doses, and there are different extrapolation mechanisms to the low doses seen clinically. Recent low dose in vitro data have indicated a potential suppressive effect at very low dose rates and doses. Whilst mammography is a low

  14. The OER at low-dose rates

    International Nuclear Information System (INIS)

    There is increasing interest in the treatment of human cancers with multifraction beam therapy at low dose-rates, on the assumption that the OER at low dose-rates is smaller than that at high dose-rates. A comparison has therefore been made of various published values of OER as a function of γ dose-rate for Vicia faba, HeLa cells, P388 cells, hamster cells and chromosome aberrations. The mean value of the OER at low dose-rate was about 20% lower than the mean OER obtained at high dose-rate, although two OER values at low dose-rates were significantly lower than the other reported values. There are technical difficulties associated with maintaining the test systems under hypoxic conditions for long periods of time and the observed decrease in cloning efficiency of hypoxic control cells indicates that cells can be damaged by this treatment alone. It is therefore possible that the high dose-rate OER values would have been reduced if the cells irradiated at high dose-rates under oxic and anoxic conditions had had a pre-treatment period of storage under anoxic conditions. (U.K.)

  15. The 20th L H Gray Conference - Radiation Cancer Analysis and Low Dose Risk Assessment: New Developments and Perspectives (Ede, the Netherlands, February 2002)

    International Nuclear Information System (INIS)

    There are few international venues where scientists in vastly different fields working on a common problem, or on a number of closely related problems, can get together in an intimate setting to present the results of their research and to discuss their approaches and views in a collegial atmosphere, and without the trappings of a huge convention with its conflicting parallel sessions and distracting events. Over the years, the L H Gray Conferences have provided an ideal setting for such intimate gatherings. This year the 20th L H Gray Conference, held in Ede, the Netherlands, was no exception. Convened for the first time outside the United Kingdom and hosted by the Dutch National Institute for Public Health and the Environment (RIVM). Paramount in all the participants' minds was the emerging information from molecular radiation biology on the recently recognised 'new' processes such as genomic instability, bystander effects, hypersensitivity, and the adaptive response. A novel aspect this year was the introduction of the opportunity, both at the beginning and at the end of the meeting, to participate in a 'vote' on controversial subjects by answering electronically such questions as: 'does radiation hormesis occur at low doses?' and 'should an age-dependence of radiological risk be incorporated into recommendations for radiation protectionThere appears to be no evidence for radiation-induced genomic instability, at least in this tumour. If this model holds for other tumour types, it would suggest that there is no 'radiation fingerprint' and that no special mechanism lies behind radiation-induced cancer. The major social event of the meeting was an afternoon devoted to a delightful excursion to the renowned Kroeller-Mueller Museum in the nearby national park (De Hoge Veluwe). Our Dutch hosts were even able to order up some sunshine for the day. After an afternoon of strolling through the museum and surrounding park, we were bussed to a hotel on the precipitous

  16. Dosimetric characterization of the GammaClip™169Yb low dose rate permanent implant brachytherapy source for the treatment of nonsmall cell lung cancer postwedge resection

    International Nuclear Information System (INIS)

    Purpose: A novel 169Yb low dose rate permanent implant brachytherapy source, the GammaClip™, was developed by Source Production and Equipment Co. (New Orleans, LA) which is designed similar to a surgical staple while delivering therapeutic radiation. In this report, the brachytherapy source was characterized in terms of “Dose calculation for photon-emitting brachytherapy sources with average energy higher than 50 keV: Report of the AAPM and ESTRO” by Perez-Calatayud et al. [Med. Phys. 39, 2904–2929 (2012)] using the updated AAPM Task Group Report No. 43 formalism.Methods: Monte Carlo calculations were performed using Monte Carlo N-Particle 5, version 1.6 in water and air, the in-air photon spectrum filtered to remove photon energies below 10 keV in accordance with TG-43U1 recommendations and previously reviewed 169Yb energy cutoff levels [D. C. Medich, M. A. Tries, and J. M. Munro, “Monte Carlo characterization of an Ytterbium-169 high dose rate brachytherapy source with analysis of statistical uncertainty,” Med. Phys. 33, 163–172 (2006)]. TG-43U1 dosimetric data, including SK, D-dot (r,θ), Λ, gL(r), F(r, θ), φan(r), and φan were calculated along with their statistical uncertainties. Since the source is not axially symmetric, an additional set of calculations were performed to assess the resulting axial anisotropy.Results: The brachytherapy source's dose rate constant was calculated to be (1.22 ± 0.03) cGy h−1 U−1. The uncertainty in the dose to water calculations, D-dot (r,θ), was determined to be 2.5%, dominated by the uncertainties in the cross sections. The anisotropy constant, φan, was calculated to be 0.960 ± 0.011 and was obtained by integrating the anisotropy factor between 1 and 10 cm using a weighting factor proportional to r−2. The radial dose function was calculated at distances between 0.5 and 12 cm, with a maximum value of 1.20 at 5.15 ± 0.03 cm. Radial dose values were fit to a fifth order polynomial and dual exponential

  17. High dose rate 60Co remote afterloading irradiation in cancer of the cervix in Haiti, 1977-1984

    International Nuclear Information System (INIS)

    From 1977 through 1984, 293 previously untreated patients with biopsy proven carcinoma of the uterine cervix were treated by whole pelvis irradiation and high intensity 60Co remote afterloading (RAL) intrauterine tandem techniques in Haiti. The treatment results were analyzed retrospectively to evaluate the therapeutic results and prognostic factors of a strict protocol involving 40 Gy to the whole pelvis (2 Gy/day, 5 days/week). In addition, on the 5th day of the 3rd week, the first outpatient 60Co remote afterloading intracavitary insertion, delivering 7.5 Gy to point A with each insertion, repeated 3 times by a week separation for a total of 4 times. The total TDF for external beam plus RAL was 158 and 175 for early and late effects respectively. One hundred-four patients were evaluable after 1 year or more follow-up, with a median of 26.5 months. No evidence of disease (NED) by Stage at 1 year was: Stage I of 100% (3/3), Stage II of 82% (9/11), Stage III of 80% (47/59), and Stage IV of 58% (18/31). The post-therapeutic complication rate was 7.7%, with no fistulas or requirement of surgical intervention. Those with documented follow-up of at least 2 years (74 patients) had comparable survival to other high dose rate and low dose rate studies. This study shows that outpatient brachytherapy can be carried out without sophisticated and expensive equipment with minimal staff trained in radiation therapy. A detailed description of this outpatient RAL technique and results are described so that this method can be adapted to other developing and industrialized nations where cost containment is becoming a key issue

  18. AB139. Low-dose versus standard dose of bacillus Calmette-Guerin in the treatment of non-muscle invasive bladder cancer

    Science.gov (United States)

    Xu, Chuanliang

    2016-01-01

    Objective To investigate whether low-dose BCG treatment can reduce the side effects while maintaining efficacy for patients with NMIBC when compared with standard dose BCG treatment. Methods A comprehensive literature search of PubMed, EMBASE, CINAHL, LILACS and CENTRAL databases was conducted to identify relevant randomized controlled trials (RCT) or quasi-randomized controlled trials (qRCT) that have assessed the efficacy of low and standard dose BCG therapy for patients with NMIBC. Systematic review and meta-analysis were performed according to preferred reporting items for systematic reviews and meta-analysis criteria. Results Six RCTs and two qRCTs were eligible for meta-analysis. Low-dose BCG instillation was not inferior to reduce the risk of bladder tumor recurrence [hazard ratio (HR), 1.15; 95% confidence interval (CI), 1.00–1.31; P=0.05], meanwhile no difference was found regarding tumor progression (HR =1.08; 95% CI, 0.83–1.42; P=0.57). However, low-dose BCG provided a significantly lower incidence of overall side effects (RR =0.75; 95% CI, 0.60–0.94; P=0.01), systemic side effects (RR =0.57; 95% CI, 0.34–0.97; P=0.04), severe side effects (RR =0.52; 95% CI, 0.36–0.74; P=0.0003) and withdrawal due to BCG toxicity (RR =0.49; 95% CI, 0.26–0.91; P=0.02). In contrast, local side effects were comparable between low-dose and standard dose arms (RR =0.89; 95% CI, 0.73–1.08; P=0.24). Conclusions Low-dose BCG instillation significantly reduces the incidence of overall side effects, especially severe and systemic symptoms in patients with NMIBC, while the oncological control efficacy of low-dose BCG is not inferior to standard dose BCG. Further studies with stratification using different risk factors at randomization are required to assess whether the efficacy of low-dose BCG is comparable to standard dose BCG for different risk of patients.

  19. Comparison of two different treatment regimens for cancer of uterine cervix as practised in our institute: a retrospective analysis

    International Nuclear Information System (INIS)

    Starting from the early days of radiotherapy practice till today, cancer of female uterine cervix is the most common malignant disease in India. A number of treatment modalities are being used for the treatment of this disease. Earlier, Wertheim's hysterectomy was the primary line of treatment. But due to poor cosmetic results and other complications, nowadays radiotherapy is the most preferred modality for the radical treatment of this commonest malignancy. Due to the lack of any universally accepted radiotherapy treatment regime, different oncology therapists within the same institute are practising different regimens derived from their own clinical practice experience. Majority of the patients are treated with two parallel opposed (AP-PA) portals up to 40 Gy, then 10 Gy dose is delivered using central shield to avoid overdose to bladder and rectum and to get dose uniformity caused by I/C application. External irradiation was delivered by a 60Co photon beam

  20. Comparison of 3D MRI with high sampling efficiency and 2D multiplanar MRI for contouring in cervix cancer brachytherapy

    International Nuclear Information System (INIS)

    MRI sequences with short scanning times may improve accessibility of image guided adaptive brachytherapy (IGABT) of cervix cancer. We assessed the value of 3D MRI for contouring by comparing it to 2D multi-planar MRI. In 14 patients, 2D and 3D pelvic MRI were obtained at IGABT. High risk clinical target volume (HR CTV) was delineated by 2 experienced radiation oncologists, using the conventional (2D MRI-based) and test (3D MRI-based) approach. The value of 3D MRI for contouring was evaluated by using the inter-approach and inter-observer analysis of volumetric and topographic contouring uncertainties. To assess the magnitude of deviation from the conventional approach when using the test approach, the inter-approach analysis of contouring uncertainties was carried out for both observers. In addition, to assess reliability of 3D MRI for contouring, the impact of contouring approach on the magnitude of inter-observer delineation uncertainties was analysed. No approach- or observer - specific differences in HR CTV sizes, volume overlap, or distances between contours were identified. When averaged over all delineated slices, the distances between contours in the inter-approach analysis were 2.6 (Standard deviation (SD) 0.4) mm and 2.8 (0.7) mm for observers 1 and 2, respectively. The magnitude of topographic and volumetric inter-observer contouring uncertainties, as obtained on the conventional approach, was maintained on the test approach. This variation was comparable to the inter-approach uncertainties with distances between contours of 3.1 (SD 0.8) and 3.0 (SD 0.7) mm on conventional and test approach, respectively. Variation was most pronounced at caudal HR CTV levels in both approaches and observers. 3D MRI could potentially replace multiplanar 2D MRI in cervix cancer IGABT, shortening the overall MRI scanning time and facilitating the contouring process, thus making this treatment method more widely employed

  1. Plasma osteopontin levels in patients with head and neck cancer and cervix cancer are critically dependent on the choice of ELISA system

    International Nuclear Information System (INIS)

    The tumor-associated glycoprotein osteopontin (OPN) is discussed as a plasma surrogate marker of tumor hypoxia and as an indicator of the presence of pleural mesothelioma in asbestos-exposed individuals. The clinical introduction of plasma OPN measurements requires the availability of a reliable enzyme-linked immunosorbence assay (ELISA). We compared previously described and currently available ELISA systems on 88 archival plasma samples obtained from patients with head and neck or cervix cancer between 20 days before and 171 after the start of radiotherapy. Median (range) plasma OPN levels were 667 (148.8–2095) ng/ml and 9.8 (3.5–189.5) ng/ml for a previously described and a newly marketed assay, respectively. Although results for different assays were significantly correlated (r = 0.38, p < 0.05, Spearman rank test), between-assay factors ranged from 2.0 to 217.9 (median 74.6) in individual patients. OPN levels in cervix cancer patients were comparable to those of head and neck cancer patients. Commercially available OPN ELISA systems produce different absolute plasma OPN levels, compromising a comparison of individual patient data with published results. However, different assays appear to have a similar capacity to rank patients according to plasma OPN level. A review of literature data suggests that plasma OPN levels measured even with identical ELISA systems can only be compared with caution

  2. Estimation of radiation risks at low dose

    International Nuclear Information System (INIS)

    The report presents a review of the effects caused by radiation in low doses, or at low dose rates. For the inheritable (or ''genetic''), as well as for the cancer producing effects of radiation, present evidence is consistent with: (a) a non-linear relationship between the frequency of at least some forms of these effects, with comparing frequencies caused by doses many times those received annually from natural sources, with those caused by lower doses; (b) a probably linear relationship, however, between dose and frequency of effects for dose rates in the region of that received from natural sources, or at several times this rate; (c) no evidence to indicate the existence of a threshold dose below which such effects are not produced, and a strong inference from the mode of action of radiation on cells at low dose rates that no such thresholds are likely to apply to the detrimental, cancer-producing or inheritable, effects resulting from unrepaired damage to single cells. 19 refs

  3. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities; Comparacion dosimetrica en un cancer de Cervix con distintas modalidades terapeuticas

    Energy Technology Data Exchange (ETDEWEB)

    Alonso Iracheta, L.; Casa de Julian, M. A. de la; Samper Ots, P.; Penas Cabrera, M. D. de las; Jimenez Gonzalez, J. M.

    2013-07-01

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  4. Radiotherapy results of uterine cervix cancer stape IIB : overall survival, prognostic facters, patterns of failure and late complications

    International Nuclear Information System (INIS)

    Treatment of choice for uterine cervix cancer stage IIB is radiotherapy. We analyzed survivals, prognostic factors, patterns of failure and complications. This is a retrospective analysis of 167 patients with stage IIB carcinoma of uterine cervix treated with curative external pelvic and high dose rate intracavitary radiotherapy at the Department of Therapeutic Radiology, Soonchunhyang University Hospital from August 1985 to August 1994. All the patients followed up from 3 to 141 months(mean 60 months) and age of patients ranged from 31 to 78 years at presentation(mean : 55 years). Overall complete response rate was 84%. The response rate for squamous cell carcimoma and adenocarcinoma were 86% and 60%, respectively. Overall 5-years survival rate and disease free survival rate was 62 and 59%, respectively. Mass size and treatment response were significant prognostic factors for survival. Pathologic type and parametrial involvement were marginally significants prognostic factors. Local failure was 43 cases, distant metastasis was 14 cases and local failure plus distant metastasis was 3 cases, and most of local failures occurred within 24 months, distant metastasis within 12 months after treatment. Twenty eight(16.8%) patients developed late rectal and urinary complications There were tendency to increasing severity and frequency according to increased fractional dose and total(rectal and bladder) dose. Survival rate was significantly related to tumor size and radiotherapy response. Tumor size should be considered in the clinical staging. To increased survival and local control, clinical trials such as decreasing duration of radiotherapy or addition of chemotherapy is needed. To detect early recurrence, regular follow up after RT is important. Because total rectal and bladder dose affected late complications, meticulous vaginal packing is needed to optimize dose of normal tissues and to decrease late complications

  5. Indications of postoperative irradiation and prognosis in cancer of the uterine cervix; Reevaluation of its indications from prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Shiromizu, Kenji; Ishimoto, Kazuya; Kobayashi, Kouichi; Onda, Takashi; Nishimura, Toshinobu; Takahashi, Michiko; Matsuzawa, Masumi; Sakura, Mizuyoshi (Saitama Prefectural Cancer Center, Ina (Japan))

    1993-09-01

    This study reevaluated indications of postoperative radiotherapy for cancer of the uterine cervix from the viewpoint of prognosis and side effects. The subjects were 441 patients treated for clinical stage Ib or more from 1976 through 1987. According to the degree of cancer involvement, the patients were classified as cancer involvement to one third of the uterine cervix (group A), two thirds (group B), more than two thirds (group C), and the parauterine tissue (group D). Postoperative total pelvic irradiation of 40-50 Gy was given to patients with vascular involvement in groups A and B, all patients in groups C and D, and patients with lymph node (LN) metastases. Histology revealed squamous cell carcinoma (SCC) in 354 patients and adenocarcinoma or adenomatous SCC in the other 87. In LN negative SCC patients (n=268), the recurrence rate for irradiated patients was 16.7% in group A, 13.6% in group B, and 21.0% in group C; the corresponding figures for non-irradiated patients were 9.6%, 8.3%, and 50.0%, respectively. In all LN positive SCC patients treated with irradiation (n=86), it was 0% in group A, 37.5% in group B, 45.7% in group C, and 54.8% in group D. The more cancer was involved, the higher the recurrence rate was in both negative and positive SCC patients. The 5-year survival rate in LN negative SCC patients was 100% and 97.2% for irradiated and non-irradiated patients, respectively, in group A, 100% and 97.0% in group B, and 89.7% and 50.0% in group C. Postoperative irradiation seemed to be unnecessary for LN negative patients in groups A and B. In SCC patients with either musculi iliacus involvement or primary LN metastases, prognosis was independent of the presence or absence of irradiation. The incidence of edema in the lower extremities and vulva was 0% for irradiation without LN dissection, 10.2% for LN dissection without irradiation, and 51.3% for both irradiation and LN dissection. (N.K.).

  6. Evaluation of the effect of routine packed red blood cell transfusion in anemic cervix cancer patients treated with radical radiotherapy

    International Nuclear Information System (INIS)

    Purpose: It is well established that anemia predicts diminished radiocurability in cervix cancer. However, the therapeutic benefit of measures to correct the anemia remains controversial. The objective of this study was to determine the impact of routine transfusion in patients with hemoglobin level (hb-l) ≤11 g/dl. Methods and Materials: Since 1985, it has been departmental policy to attempt to correct hb-l ≤11 g/dl before and/or during radiotherapy by red blood cell transfusion (RBCT) in patients undergoing radical radiotherapy for primary cervix cancer. To assess the benefit of RBCT, the charts of 204 patients (FIGO: IB-IV) treated until 1997 were reviewed. Parameters analyzed for their impact on disease-specific survival (DSS), pelvic control (PC), and metastases-free survival (MFS) included pretreatment hb-l, treatment hb-l, stage, tumor size, and lymph node status. To determine any differences in outcome according to type of anemia, a separate analysis was performed, grouping patients by cause of anemia (tumor vs. other medical illness related). Results: Each of the parameters tested was significantly correlated with the end points studied in univariate analysis. Patients whose hb-l were corrected (18.5%) had an outcome that did not differ significantly from that of nontransfused patients, whereas DSS, PC, and MFS (all: p<0.001) were significantly decreased in nonresponders to RBCT. Subgroup analysis showed no impact of hb-l in patients with other medical illness-related anemia (n=12). In multivariate analysis treatment, but not pretreatment, hb-l remained predictive for DSS, PC, and MFS. Persistent anemia was associated with a significantly increased risk of death (relative risk: 2.1) and pelvic failure (relative risk: 2.4) compared with nontransfused patients. If only patients with tumor anemia were considered, the respective risks increased (2.7; 3.6). None of the patients with other causes of anemia recurred, whether or not their hb-l was maintained

  7. Treatment of cancer of cervix stages IB1 and IB2 in the Hospital Calderon Guardia (2000-2003)

    International Nuclear Information System (INIS)

    The types of treatment applied in patients with stages of cancer of cervix IB1 and IB2, your evolution and prognosis were determined. Different methods of treatment were compared. It was a prospective descriptive and observational study of the patients of Servicio de Ginecologia Oncologica of the Hospital Calderon Guardia, San Jose, Costa Rica. It was carried out from August 2000 to November 2002. The study included all female patients with proved histological diagnosis of cervical cancer IB1 and IB2. All of them had pre-operative studies: plate of thorax, abdomen ultrasound, computerized axial tomography of pelvis and abdomen, at least received primary treatment (surgery) and the following monitoring. The statistical analysis was realized with chi-square evidences, through epi-info software. Of 24 patients only 19 got complete information. It was found a 22% of patients with positives adenopatias to level of histological study with a ganglionic compromise of 32% in general form, a 36% in the stages IB1 and a 25% in stages IB2. Of all the patients that presented ganglionic metastasis illness, did not get to show with the computerized axial tomography and it is concluded that TAC is a bad method for detection of the microscopic metastasis illness, or at least to 2 cm. None of the patients in stages IB1 presented relapse data in the observed period, founding a 100% of survival to 24 months. The patients in stages IB2 presented relapses, with a 75% of survival

  8. The body’s immune response in the induction and progression of cancer of the cervix uteri: possible mechanisms

    Directory of Open Access Journals (Sweden)

    O. V. Kurmyshkina

    2014-08-01

    Full Text Available Human papillomavirus (HPV that is a main cause of cancer of the cervix uteri (CCU has immunogenic properties, i.e. an abilityto activate antiviral immunity responses as adaptive HPV-specific and innate ones. For this reason, despite multiple mechanisms generated by HPV to avoid immunity responses, the human body can eliminate the infection in most cases. At the same time, CCU results from the combined influence of many factors of different nature, among which the factors that impair the normal course of an immune response are of vital importance.This review describes the major factors and mechanisms, which promote the establishment of persistent HPV infection and the progression of dysplasia to cancer, on the one hand, and allow the tumor cells in CCU to restrict the body’s immune reactions, on the other Immune disorders induced by the virus and/or tumor cells are considered at both local and systemic levels. Particular emphasis is placed on the molecular mechanisms that can change the population composition and functional activity of leukocytes and the cytokine profile of cells and can form the tumor suppressor microenvironment.

  9. Early diffusion weighted magnetic resonance imaging can predict survival in women with locally advanced cancer of the cervix treated with combined chemo-radiation

    Energy Technology Data Exchange (ETDEWEB)

    Somoye, Gbolahan; Parkin, David [Ward 42, Aberdeen Royal Infirmary, Aberdeen (United Kingdom); Harry, Vanessa [Royal Marsden NHS Foundation Trust, London (United Kingdom); Semple, Scott [Queen' s Medical Research Institute, Centre for Cardiovascular Science, Clinical Research Imaging Centre, Edinburgh (United Kingdom); Plataniotis, George [Musgrove Park Hospital, Taunton and Somerset NHS Foundation, Taunton (United Kingdom); Scott, Neil [University of Aberdeen, Section of Population Health, Aberdeen (United Kingdom); Gilbert, Fiona J. [University of Cambridge, Radiology Department, Box 218, Cambridge (United Kingdom)

    2012-11-15

    To assess the predictive value of diffusion weighted imaging (DWI) for survival in women treated for advanced cancer of the cervix with concurrent chemo-radiotherapy. Twenty women treated for advanced cancer of the cervix were recruited and followed up for a median of 26 (range <1 to 43) months. They each had DWI performed before treatment, 2 weeks after beginning therapy (midtreatment) and at the end of treatment. Apparent diffusion coefficient (ADC) values were calculated from regions of interest (ROI). All participants were reviewed for follow-up data. ADC values were compared with mortality status (Mann-Whitney test). Time to progression and overall survival were assessed (Kaplan-Meier survival graphs). There were 14 survivors. The median midtreatment ADC was statistically significantly higher in those alive compared to the non-survivors, 1.55 and 1.36 (x 10{sup -3}/mm{sup 2}/s), respectively, P = 0.02. The median change in ADC 14 days after treatment commencement was significantly higher in the alive group compared to non-survivors, 0.28 and 0.14 (x 10{sup -3}/mm{sup 2}/s), respectively, P = 0.02. There was no evidence of a difference between survivors and non-survivors for pretreatment baseline or post-therapy ADC values. Functional DWI early in the treatment of advanced cancer of the cervix may provide useful information in predicting survival. (orig.)

  10. Comparison of molecular signatures in large scale protein interaction networks in normal and cancer conditions of brain, cervix, lung, ovary and prostate

    Directory of Open Access Journals (Sweden)

    Rajat Suvra Banik

    2016-04-01

    Full Text Available Background Cancer, the disease of intricateness, has remained beyond our complete perception so far. Network systems biology (termed NSB is one of the most recent approaches to understand the unsolved problems of cancer development. From this perspective, differential protein networks (PINs have been developed based on the expression and interaction data of brain, cervix, lung, ovary and prostate for normal and cancer conditions. Methods Differential expression database GeneHub-GEPIS and interaction database STRING were applied for primary data retrieval. Cytoscape platform and related plugins named network analyzer; MCODE and ModuLand were used for visualization of complex networks and subsequent analysis. Results Significant differences were observedamong different common network parameters between normal and cancer states. Moreover, molecular complex numbers and overlapping modularization found to be varying significantly between normal and cancerous tissues. The number of the ranked molecular complex and the nodes involved in the overlapping modules were meaningfully higher in cancer condition.We identified79 commonly up regulated and 6 down regulated proteins in all five tissues. Number of nodes, edges; multi edge node pair, and average number of neighbor are found with significant fluctuations in case of cervix and ovarian tissues.Cluster analysis showed that the association of Myc and Cdk4 proteins is very close with other proteins within the network.Cervix and ovarian tissue showed higher increment of the molecular complex number and overlapping module network during cancer in comparison to normal state. Conclusions The differential molecular signatures identified from the work can be studied further to understand the cancer signaling process, and potential therapeutic and detection approach. [Biomed Res Ther 2016; 3(4.000: 605-615

  11. 低剂量螺旋CT扫描在周围型肺癌诊断中的临床应用价值%Low Dose Spiral CT Scanning in the Diagnosis of Peripheral Lung Cancer Clinical Application Value

    Institute of Scientific and Technical Information of China (English)

    何揆

    2014-01-01

    目的探讨低剂量螺旋CT扫描在周围型肺癌诊断中临床应用价值。方法回顾性分析我院自2008年12月~2013年12月收治的30例经手术和病理证实周围型肺癌患者,在同一时间段内分别给予常规剂量螺旋CT扫描和低剂量螺旋CT扫描,比较两种检查方法对周围型肺癌征象的显示情况。结果肿瘤径线10 mm低剂量螺旋CT扫描显示的数量分别为8例、12例、5例,合计25例,常规剂量螺旋CT扫描显示的数量分别为9例、14例及6例,合计29例,两组相比较差异无统计学差异(>0.05);低剂量螺旋CT扫描与常规剂量螺旋CT扫描相比,低剂量螺旋CT扫描对坏死、钙化、细短毛刺、分叶征、血管集束征、胸膜凹陷征及阻塞性肺炎或肺不张等周围型肺癌征象的显示率无显著降低,其差异不具有统计学意义(>0.05)。结论低剂量螺旋CT扫描在降低辐射剂量的同时,也可以清楚显示周围型肺癌的各种征象,在诊断周围型肺癌中具有较高的临床应用价值。%Objective Explore the low-dose spiral CT scanning in peripheral lung cancer diagnosis in the clinical application value. Methods Retrospective analysis since December 2008 to December 2013 were 30 cases confirmed by surgery and pathology of peripheral lung cancer patients, at the same time period were given routine dose spiral CT scanning and low-dose spiral CT scanning, compare two methods of checking to show signs of peripheral lung cancer. Results Tumor diameter line 10 mm low-dose spiral CT scan revealed a number of 8 cases, 12 cases, 5 cases respectively, total 25 cases, conventional dose spiral CT scan showed the number of 9 cases, 14 cases and 6 cases respectively, total 29 cases, no statistical y significant dif erence compared with the two groups ( >0.05);Low-dose spiral CT scanning compared with conventional dose spiral CT scanning, low-dose spiral CT scanning of necrosis and calcification and fine short bur

  12. High-dose-rate brachytherapy in the treatment of uterine cervix cancer. Analysis of dose effectiveness and late complications

    International Nuclear Information System (INIS)

    Purpose: This retrospective analysis aims to report results of patients with cervix cancer treated by external beam radiotherapy (EBR) and high-dose-rate (HDR) brachytherapy. Methods and Materials: From September 1992 to December 1996, 138 patients with FIGO Stages II and III and mean age of 56 years were treated. Median EBR to the whole pelvis was 45 Gy in 25 fractions. Parametrial boost was performed in 93% of patients, with a median dose of 14.4 Gy. Brachytherapy with HDR was performed during EBR or following its completion with a dose of 24 Gy in four weekly fractions of 6 Gy to point A. Median overall treatment time was of 60 days. Patient age, tumor stage, and overall treatment time were variables analyzed for survival and local control. Cumulative biologic effective dose (BED) at rectal and bladder reference points were correlated with late complications in these organs and dose of EBR at parametrium was correlated with small bowel complications. Results: Median follow-up time was 38 months. Overall survival, disease-free survival, and local control at 5 years was 53.7%, 52.7%, and 62%, respectively. By multivariate and univariate analysis, overall treatment time up to 50 days was the only statistically significant adverse variable for overall survival (p=0.003) and actuarial local control (p=0.008). The 5-year actuarial incidence of rectal, bladder, and small bowel late complications was 16%, 11%, and 14%, respectively. Patients treated with cumulative BED at rectum points above 110 Gy3 and at bladder point above 125 Gy3 had a higher but not statistically significant 5-year actuarial rate of complications at these organs (18% vs. 12%, p=0.49 and 17% vs. 9%, p=0.20, respectively). Patients who received parametrial doses larger than 59 Gy had a higher 5-year actuarial rate of complications in the small bowel; however, this was not statistically significant (19% vs. 10%, p=0.260). Conclusion: This series suggests that 45 Gy to the whole pelvis combined with

  13. The influence of bone density on the radiotherapy of cervix cancer

    International Nuclear Information System (INIS)

    Until the 1970s the irradiated region of a patient undergoing external beam radiotherapy was considered a homogeneous volume and a regular surface, with physical characteristics similar to water. With the improvement of medical imaging equipment, it has become possible to conduct planning in radiotherapy treatment that considers the heterogeneities and irregularities of a patient's anatomy. Consequently, such technological resources have brought greater accuracy to radiotherapy. In this study, we determined the variation in the average amount of absorbed dose on the target volume and at the point of prescription treatment by comparing the doses which were calculated in a planning system considering the patient both as a homogeneous, and as a heterogeneous medium. The results showed that when we take into account the volume of the upper vagina and cervix, and consider the pelvis as a heterogeneous medium, the calculated dose was under-estimated at some points in the studied volume with respect to the dose when this region was considered homogeneous.

  14. The influence of bone density on the radiotherapy of cervix cancer

    Energy Technology Data Exchange (ETDEWEB)

    Soares, M.R. [Departamento de Fisica, Universidade Federal de Sergipe, Av. Marechal Rondon s/n, 49.100-000, Rosa Elze, Sao Cristovao, SE (Brazil); Souza, D.N., E-mail: divanizi@ufs.br [Departamento de Fisica, Universidade Federal de Sergipe, Av. Marechal Rondon s/n, 49.100-000, Rosa Elze, Sao Cristovao, SE (Brazil)

    2011-10-01

    Until the 1970s the irradiated region of a patient undergoing external beam radiotherapy was considered a homogeneous volume and a regular surface, with physical characteristics similar to water. With the improvement of medical imaging equipment, it has become possible to conduct planning in radiotherapy treatment that considers the heterogeneities and irregularities of a patient's anatomy. Consequently, such technological resources have brought greater accuracy to radiotherapy. In this study, we determined the variation in the average amount of absorbed dose on the target volume and at the point of prescription treatment by comparing the doses which were calculated in a planning system considering the patient both as a homogeneous, and as a heterogeneous medium. The results showed that when we take into account the volume of the upper vagina and cervix, and consider the pelvis as a heterogeneous medium, the calculated dose was under-estimated at some points in the studied volume with respect to the dose when this region was considered homogeneous.

  15. Treatment and outcome in cancer cervix patients treated between 1979 and 1994: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Shyamkishore Shrivastava

    2013-01-01

    Materials and Methods: This is a retrospective study of 6234 patients with carcinoma of the cervix treated with radical intent between 1979 and 1994. All the work-up, staging investigations, treatment details, radiation protocols, outcomes, and toxicities were noted, compiled, and analyzed. Results: With a mean age of 46 years (range: 18-90 years; median: 45 years, 669 (11% patients were in stage Ib, 284 (5% were in stage IIa, 1891 (30% were in stage IIb, 69 (1% were in stage IIIa, and 3321 (53% were in stage IIIb. With a median follow-up of 68 months (57-79 months for the entire group, there was no significant difference in the outcome of 953 patients with international federation of gynecology and obstetrics (FIGO Ib-IIa treated after radical surgery, pre-operative radiation therapy (pre-op RT + Sx or after radical radiation; their disease-free survival (DFS was 60-62% at 8 years. In our series of 1891 patients with stage IIb and 3321 with stage IIIb, a respective DFS of 56% and 40% was achieved at 8 years. Conclusion: Over the last two decades, with the acquisition of newer facilities and inception of Joint Clinics, there has been a significant refinement in the treatment protocols and outcome. Improving radiation strategies to improve therapeutic ratio is the key to success.

  16. The influence of bone density on the radiotherapy of cervix cancer

    Science.gov (United States)

    Soares, M. R.; Souza, D. N.

    2011-10-01

    Until the 1970s the irradiated region of a patient undergoing external beam radiotherapy was considered a homogeneous volume and a regular surface, with physical characteristics similar to water. With the improvement of medical imaging equipment, it has become possible to conduct planning in radiotherapy treatment that considers the heterogeneities and irregularities of a patient's anatomy. Consequently, such technological resources have brought greater accuracy to radiotherapy. In this study, we determined the variation in the average amount of absorbed dose on the target volume and at the point of prescription treatment by comparing the doses which were calculated in a planning system considering the patient both as a homogeneous, and as a heterogeneous medium. The results showed that when we take into account the volume of the upper vagina and cervix, and consider the pelvis as a heterogeneous medium, the calculated dose was under-estimated at some points in the studied volume with respect to the dose when this region was considered homogeneous.

  17. Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis

    OpenAIRE

    Chen, Jinmei; Hong, Jinsheng; Zou, Xi; Lv, Wenlong; Guo, Feibao; Hong, Hualan; Zhang, Weijian

    2015-01-01

    The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5–30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5–30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of...

  18. Biology responses to low dose radiation

    International Nuclear Information System (INIS)

    Biology responses to low dose radiation is the most important problem of medical radiation and radiation protection. The especial mechanism of low dose or low dose rate induced cell responses, has been found independent with linear no-threshold model. This article emphasize to introduce low dose or low dose rate induced biology responses of adaptive response, by-effect, super-sensitivity and genomic instability. (authors)

  19. Alterations in p53-specific T cells and other lymphocyte subsets in breast cancer patients during vaccination with p53-peptide loaded dendritic cells and low-dose interleukin-2

    DEFF Research Database (Denmark)

    Svane, Inge Marie; Pedersen, Anders E; Nikolajsen, Kirsten;

    2008-01-01

    We have previously established a cancer vaccine using autologous DCs, generated by in vitro stimulation with IL-4 and GM-CSF, and pulsed with six HLA-A*0201 binding wild-type p53 derived peptides. This vaccine was used in combination with low-dose interleukin-2 in a recently published clinical...... Phase II trial where 26 HLA-A2+ patients with progressive late-stage metastatic breast cancer (BC) were included. Almost 1/3rd of the patients obtained stable disease or minor regression during treatment with a positive correlation to tumour over-expression of p53. In the present study, we performed a...... (CD44high, CCR-7low and CD62Llow). Furthermore, fresh blood from 18 cancer patients included in the vaccination trial were prospectively examined for more general treatment associated quantitative and qualitative changes in T cell subpopulations. We found that the frequency of CD4+ CD25high regulatory...

  20. Adenosquamous cell carcinoma of the cervix — clinical and prognostic characteristics of the disease

    Directory of Open Access Journals (Sweden)

    E. K. Tanriverdieva

    2012-01-01

    Full Text Available Adenosquamous cell carcinoma of the cervix is a rare form of cancer of the cervix. Because of the small number of observations adenosquamous cell carcinoma of the cervix remains poorly understood disease, although the first mention of it dates back to 1956, when A. Glucksmann, and C.D. Cherry first described of mixed carcinoma (adenoacanthoma of the uterine cervix.

  1. Interobserver variation in rectal and bladder doses in orthogonal film-based treatment planning of cancer of the uterine cervix

    Directory of Open Access Journals (Sweden)

    Raghukumar P

    2008-01-01

    Full Text Available Orthogonal film-based treatment planning is the most commonly adopted standard practice of treatment planning for cancer of the uterine cervix using high dose rate brachytherapy (HDR. This study aims at examining the variation in rectal and bladder doses when the same set of orthogonal films was given to different observers. Five physicists were given 35 pairs of orthogonal films obtained from patients who had undergone HDR brachytherapy. They were given the same instructions and asked to plan the case assuming the tumor was centrally placed, using the treatment-planning system, PLATO BPS V13.2. A statistically significant difference was observed in the average rectal (F = 3.407, P = 0.01 and bladder (F = 3.284, P = 0.013 doses and the volumes enclosed by the 100% isodose curve ( P < 0.01 obtained by each observer. These variations may be attributed to the differences in the reconstruction of applicators, the selection of source positions in ovoids and the intrauterine (IU tube, and the differences in the selection of points especially for the rectum, from lateral radiographs. These variations in planning seen within a department can be avoided if a particular source pattern is followed in the intrauterine tube, unless a specific situation demands a change. Variations in the selection of rectal points can be ruled out if the posterior vaginal surface is clearly seen.

  2. Prognostic factors in patients with cervix cancer treated by radiation therapy: results of a multiple regression analysis

    International Nuclear Information System (INIS)

    A retrospective analysis of 965 patients with invasive cervix cancer treated by radiation therapy between 1976 and 1981 was performed in order to evaluate prognostic factors for disease-free survival (DFS) and pelvic control. FIGO stage was the most powerful prognostic factor followed by radiation dose and treatment duration (P values = 0.0001). If the analysis was limited to patients treated with radical doses of 75 Gy or more, dose was no longer significant. Young age at diagnosis, non-squamous histology and transfusion during treatment were also adverse prognostic factors for survival and control. Para-aortic nodal involvement on lymphogram was associated with a reduction in DFS (P = 0.0027), whereas pelvic lymph node involvement alone was not. In patients with Stage I and IIA disease, tumour size was the most powerful prognostic factor for survival (P = 0.0001) and the extent of pelvic sidewall involvement was significant in patients with Stage III tumours (P = 0.007). Histological grade appeared to be a predictive factor but was only recorded in 712 patients. These features should be considered in the staging of patients and in the design of clinical trials

  3. Dissection of the sentry ganglion by laparoscopic boarding in patients with cervix uterine cancer clinical stages IA2 at IIB; Diseccion de ganglio centinela por abordaje laparoscopico en pacientes con cancer cervicouterino etapas clinicas IA2 a IIB

    Energy Technology Data Exchange (ETDEWEB)

    Valdez U, J.J.; Pichardo M, P.A.; Cortes M, G.; Escudero de los Rios, P. [Hospital de Oncologia. Centro Medico Nacional Siglo XXI. IMSS, Mexico D.F. (Mexico)

    2005-07-01

    The obtained results in presently study demonstrate that the feasibility of the detection of the sentry ganglion in cervix uterine cancer using a boarding by laparoscopic via, being necessary the use of twice labelled as much with patent blue and radioisotope (colloid of labelled rhenium with {sup 99m}Tc, total dose of 3 MCi) to achieve the identification of the ganglion. (Author)

  4. Statistical and low dose response

    International Nuclear Information System (INIS)

    The low dose response and the lower limit of detection of the Hanford dosimeter depend upon may factors, including the energy of the radiation, whether the exposure is to be a single radiation or mixed fields, annealing cycles, environmental factors, and how well various batches of TLD materials are matched in the system. A careful statistical study and sensitivity analysis were performed to determine how these factors influence the response of the dosimeter system. Estimates have been included in this study of the standard deviation of calculated dose for various mixed field exposures from 0 to 1000 mrem

  5. Simple DVH parameter addition as compared to deformable registration for bladder dose accumulation in cervix cancer brachytherapy

    International Nuclear Information System (INIS)

    Background and purpose: Variations in organ position, shape, and volume cause uncertainties in dose assessment for brachytherapy (BT) in cervix cancer. The purpose of this study was to evaluate uncertainties associated with bladder dose accumulation based on DVH parameter addition (previously called “the worst case assumption”) in fractionated BT. Materials and methods: Forty-seven patients treated for locally advanced cervical cancer were included. All patients received EBRT combined with two individually planned 3D image-guided adaptive BT fractions. D2cm3 and D0.1cm3were estimated by DVH parameter addition and compared to dose accumulations based on an in-house developed biomechanical deformable image registration (DIR) algorithm. Results: DIR-based DVH analysis was possible in 42/47 patients. DVH parameter addition resulted in mean dose deviations relative to DIR of 0.4 ± 0.3 Gyαβ3 (1.5 ± 1.8%) and 1.9 ± 1.6 Gyαβ3 (5.2 ± 4.2%) for D2cm3 and D0.1cm3, respectively. Dose deviations greater than 5% occurred in 2% and 38% of the patients for D2cm3 and D0.1cm3, respectively. Visual inspection of the dose distributions showed that hotspots were located in the same region of the bladder during both BT fractions for the majority of patients. Conclusion: DVH parameter addition provides a good estimate for D2cm3, whereas D0.1cm3 is less robust to this approximation

  6. Second cancers after squamous cell carcinoma and adenocarcinoma of the cervix

    DEFF Research Database (Denmark)

    Chaturvedi, Anil K; Kleinerman, Ruth A; Hildesheim, Allan;

    2008-01-01

    METHODS: We assessed second cancer risk among 85,109 cervical SCC and 10,280 AC survivors reported to population-based cancer registries in Denmark, Finland, Norway, Sweden, and the United States. Risks compared to the general population were assessed using standardized incidence ratios (SIR). RESULTS......: Overall cancer risk was significantly increased among both cervical SCC survivors (n = 10,559 second cancers; SIR, 1.31; 95% CI, 1.29 to 1.34) and AC survivors (n = 920 second cancers; SIR, 1.29; 95% CI, 1.22 to 1.38). Risks of HPV-related and radiation-related cancers were increased to a similar extent...... among cervical SCC and AC survivors. Although significantly increased in both groups when compared with the general population, risk of smoking-related cancers was significantly higher among cervical SCC than AC survivors (P = .015; SIR for cervical SCC = 2.07 v AC = 1.78). This difference was limited...

  7. Carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: To discuss a variety of technical and clinical issues concerning the management of carcinoma of the uterine cervix. Radiation therapy plays a central role in the management of patients with invasive carcinoma of the uterine cervix. Although survival rates are high for patients with small volume disease, clinicians continue to search for approaches that might improve treatment results for patients who have bulky central disease, evidence of regional dissemination or other factors associated with a high rate of disease recurrence. New technical approaches have contributed to controversy about the best means of optimizing therapeutic ratio. This course will review current approaches to the management of cervical cancer. Technical aspects of intracavitary and external beam treatment will be emphasized. Problems with brachytherapy dose specification will be discussed as will technical factors that may influence the incidence of treatment-related complications. Current understanding of the natural history of disease and of clinical factors that influence the rate of disease recurrence will be reviewed, including the importance of tumor volume, lymph node involvement, and histologic type on natural history and prognosis. The possible role of controversial methods of clinical evaluation such as lymphangiography and surgical staging will be discussed. Some of the more controversial aspects of treatment including the indications of radiation therapy vs. surgical therapy for stage IB disease, the role of extended field therapy, postoperative therapy, adjuvant hysterectomy, and neoadjuvant or concurrent chemotherapy will be discussed. Conclusions from the recent NCI consensus conference on cervical cancer will be reviewed

  8. Assessment of the expected harm from prenatal irradiation with low doses and low dose rates

    International Nuclear Information System (INIS)

    The validity of the coefficients, suggested by ICRP (Publication 45) for assessment of the risk from prenatal irradiation with low doses and low dose rates is discussed. This includes: development of lethal and curable cancer, severe genetic defects, death before implantation and retarded mental development. Summarizing the individual assessment, the total harm from prenatal irradiation with 1 mvSv have been estimated at 4,9.104 lost years. The expected harm from the additional irradiation of the Bulgarian population during the first year after the Chernobyl accident is evaluated on that basis, taking into account the number of expected pregnancies among Bulgarian women in reproductive age and the individual effective equivalent doses. 15 refs

  9. Pre-irradiation with low-dose 12C6+ beam significantly enhances the efficacy of AdCMV-p53 gene therapy in human non-small lung cancer

    Science.gov (United States)

    Liu, Bing; Zhang, Hong; Li, Wenjian; Li, Qiang; Zhou, Guangming; Xie, Yi; Hao, Jifang; Min, Fengling; Zhou, Qingming; Duan, Xin

    2007-04-01

    The combination of ionizing radiation and gene therapy has been investigated. However, there are very few reports about the combination of heavy-ion irradiation and gene therapy. To determine if the pre-exposure to low-dose heavy ion beam enhances the suppression of AdCMV-p53 on non-small lung cancer (NSLC), the cells pre-irradiated or non-irradiated were infected with 20, 40 MOI of AdCMV-p53. Survival fraction and the relative biology effect (RBE) were determined by clonogenic assay. The results showed that the proportions of p53 positive cells in 12C6+ beam induced AdCMV-p53 infected cells were more than 90%, which were significantly more than those in γ-ray induced AdCMV-p53 infected cells. The pre-exposure to low-dose 12C6+ beam significantly prevented the G0/G1 arrest and activated G2/M checkpoints. The pre-exposure to 12C6+ beam significantly improved cell to apoptosis. RBEs for the 12C6+ + AdCMV-p53 infection groups were 30% 60%, 20% 130% and 30% 70% more than those for the 12C6+-irradiated only, AdCMV-p53 infected only, and γ-irradiation induced AdCMVp53 infected groups, respectively. The data suggested that the pre-exposure to low-dose 12C6+ beam significantly promotes exogenous p53 expression in NSLC, and the suppression of AdCMV-p53 gene therapy on NSLC.

  10. Pre-irradiation with low-dose 12C6+beam significantly enhances the efficacy of AdCMV-p53 gene therapy in human non-small lung cancer

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The combination of ionizing radiation and gene therapy has been investigated. However, there are very few reports about the combination of heavy-ion irradiation and gene therapy. To determine if the pre-exposure to low-dose heavy ion beam enhances the suppression of AdCMV-p53 on non-small lung cancer (NSLC), the cells pre-irradiated or non-irradiated were infected with 20, 40 MOI of AdCMV-p53. Survival fraction and the relative biology effect (RBE) were determined by clonogenic assay. The results showed that the proportions of p53 positive cells in 12C6+ beam induced AdCMV-p53 infected cells were more than 90%, which were signifi-cantly more than those in γ-ray induced AdCMV-p53 infected cells. The pre-exposure to low-dose 12C6+ beam significantly prevented the G0/G1 arrest and activated G2/M checkpoints. The pre-exposure to 12C6+ beam significantly improved cell to apoptosis. RBEs for the 12C6+ + AdCMV-p53 infection groups were 30%-60%, 20%-130% and 30%-70% more than those for the 12C6+-irradiated only, AdCMV-p53 infected only, and γ-irradiation induced AdCMVp53 infected groups, respectively. The data suggested that the pre-exposure to low-dose 12C6+ beam significantly promotes exogenous p53 expression in NSLC, and the suppression of AdCMV-p53 gene therapy on NSLC.

  11. Advanced Computational Approaches for Characterizing Stochastic Cellular Responses to Low Dose, Low Dose Rate Exposures

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Bobby, R., Ph.D.

    2003-06-27

    OAK - B135 This project final report summarizes modeling research conducted in the U.S. Department of Energy (DOE), Low Dose Radiation Research Program at the Lovelace Respiratory Research Institute from October 1998 through June 2003. The modeling research described involves critically evaluating the validity of the linear nonthreshold (LNT) risk model as it relates to stochastic effects induced in cells by low doses of ionizing radiation and genotoxic chemicals. The LNT model plays a central role in low-dose risk assessment for humans. With the LNT model, any radiation (or genotoxic chemical) exposure is assumed to increase one¡¯s risk of cancer. Based on the LNT model, others have predicted tens of thousands of cancer deaths related to environmental exposure to radioactive material from nuclear accidents (e.g., Chernobyl) and fallout from nuclear weapons testing. Our research has focused on developing biologically based models that explain the shape of dose-response curves for low-dose radiation and genotoxic chemical-induced stochastic effects in cells. Understanding the shape of the dose-response curve for radiation and genotoxic chemical-induced stochastic effects in cells helps to better understand the shape of the dose-response curve for cancer induction in humans. We have used a modeling approach that facilitated model revisions over time, allowing for timely incorporation of new knowledge gained related to the biological basis for low-dose-induced stochastic effects in cells. Both deleterious (e.g., genomic instability, mutations, and neoplastic transformation) and protective (e.g., DNA repair and apoptosis) effects have been included in our modeling. Our most advanced model, NEOTRANS2, involves differing levels of genomic instability. Persistent genomic instability is presumed to be associated with nonspecific, nonlethal mutations and to increase both the risk for neoplastic transformation and for cancer occurrence. Our research results, based on

  12. Assessment of the knowledge, attitude and practice of rural women of northeast Nigeria on risk factors associated with cancer of the Cervix

    Directory of Open Access Journals (Sweden)

    John S. Bimba

    2013-08-01

    Full Text Available Cervical cancer is the leading cancer-related cause of death among women in Nigeria. An estimated 70,700 new cases occur each year, representing one quarter of all female cancers in sub Saharan Africa. The magnitude of the problem has been under recognised and under prioritised compared with the competing health priorities of infectious diseases such as HIV/ AIDS, tuberculosis and malaria. Studies in the United States and Nigeria have indicated that the disease has the highest incidence among the lowest socio-economic groups especially residing in rural areas. The peak age for the disease has been shown to be within 35-45 years age group. Knowledge of the risk factors of the disease is deemed important in its early detection and prevention. The objective of this study was to assess the knowledge, attitude and practice of rural women with cancer of the cervix. A cross sectional descriptive study was conducted among 1600 rural women aged 15-55 years (randomly selected from 28 villages who were interviewed using a structured questionnaire between April and June, 2010. The majority (82.2% were married before the age of 20 years and 19.3% before 15 years, 40% in polygamous union, 22.6% have had 2 or more sexual partners, 71.3% were primi and grand multiparous, 7.5% have had previous treatment for STIs and 10.1% were on various types of contraceptive. 454 (28.4% have heard of Ca cervix, 358 (22.4% knew the location of the cervix. 2.3% had Pap smear test of which 72.6% were within 2 years. The majority (89.9% will avail themselves for screening.

  13. Low dose effects. Adaptive response

    International Nuclear Information System (INIS)

    The purpose of this work was to evaluate if there are disturbancies in adaptive response when lymphocytes of people living on the polluted with radionuclides area after Chernobyl disaster and liquidators suffered from accident have been investigated. The level of lymphocytes with micronuclei have been scored in Moscow donors and people living in Bryansk region with the degree of contamination 15 - 40 Ci/km. The doses that liquidators have been obtained were not higher then 25 cGy. The mean spontaneous level of MN in control people and people from Chernobyl zones does't differ significantly but the individual variability in the mean value between two populations does not differ significantly too. And in this case it seems that persons of exposed areas. Then another important fact in lymphocytes of people living on polluted areas the chronic low dose irradiation does not induce the adaptive response. In Moscow people in most cases (≅ 59 %) the adaptive response is observed and in some cases the demonstration of adaptive response is not significant (≅1%). In Chernobyl population exposed to chronic low level, low dose rate irradiation there are fewer people here with distinct adaptive response (≅38%). And there appear beings with increased radiosensitivity after conditioned dose. Such population with enhanced radiosensitivity have not observed in Moscow. In liquidators the same types of effects have been registered. These results have been obtained on adults. Adaptive response in children 8 - 14 old population living in Moscow and in Chernobyl zone have been investigated too. In this case the spontaneous level of MN is higher in children living in polluted areas, after the 1.0 Gy irradiation the individual variability is very large. Only 5 % of children have distinct is very large. Only 5 % of children have distinct adaptive response, the enhancement of radiosensitivity after conditioned dose is observed. (authors)

  14. Enhancement of the Immunostimulatory Functions of Ex Vivo–Generated Dendritic Cells from Early-Stage Colon Cancer Patients by Consecutive Exposure to Low Doses of Sequential-Kinetic-Activated IL-4 and IL-12. A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Elisabetta Radice

    2015-08-01

    Full Text Available Dendritic cells (DCs, specialized antigen-presenting cells bridging innate and adaptive immunity, play a crucial role in determining specific immune response to tumors. Because of their potent immunoregulatory capacities, DCs have been exploited in anticancer vaccination, with limited success thus far. This pilot study compared low-dose interleukin (IL-4 and IL-12 prepared by sequential kinetic activation (SKA with standard doses of the same recombinant human cytokines on functional activity of ex vivo–generated monocyte-derived (Mo DCs from colon carcinoma patients and normal subjects. MoDCs were exposed to medium alone, SKA-IL-4 (0.5 fg/ml, or SKA-IL-12 (2 fg/ml, alone or consecutively combined, in parallel with rhIL-4 (50 ng/ml and rhIL-12 (1 ng/ml. Primary allogeneic one-way mixed lymphocyte reaction (MLR was the end point to assess in vitro T-lymphocyte proliferation in response to MoDCs, and secreted IL-12p70 and interferon-γ in MLR supernatants measured by ELISA to assay for T-helper 1–promoting MoDC phenotype. No single agent enhanced the compromised allostimulatory activity of MoDCs from colon cancer patients, unlike healthy donors. However, MoDCs from nonmetastatic colon cancer patients, after sequential exposure to SKA-IL-4 (48 hours and SKA-IL-12 (24 hours, displayed increased T-cell stimulatory capacity by MLR and acquired driving T-helper 1 polarization activity, although less markedly than the effects induced by recombinant human cytokines or found in normal subjects. These results point to an immunomodulatory capacity of low-dose SKA-IL-4 and SKA-IL-12 and encourage further investigation to provide clues for the rational development of new and more effective immunotherapeutic strategies against cancer.

  15. A Community Based Study On The Prevalence Of Risk Factors OF Cancer Cervix In Married Women Of A Rural Area Of West Bengal

    Directory of Open Access Journals (Sweden)

    Dasgupta Aparajita

    2002-01-01

    Full Text Available Research question: What is the prevalence of the established risk factors associated with cancer cervix? Objective: To assess the presence of some determinants of cancer cervix among married, rural women of reproductive age group. Study design: Community based, cross â€" sectional, observational study. Setting: Rural: Village East Gobindopur is Singur block in Hooghly district of West Bengal. Study population : All the married women of reproductive age group (103 of the village were included in the study. Results: More than two â€" third (72.8% of the study population belonged to the vulnerable age group (25-45 years for this disease while 59.3% were married before they attained 18 years of age. Again 50% (approx of the married women gave birth to their first child before they were 18 years of age. One â€" third of the study population had parity higher than three. Two â€" third of the women studied were using one or more methods of family planning and one â€" third of the same population were permanently sterilized, 20% were using oral contraceptive pills and only 7.7% were using barrier methods of contraception. Only 31% of the women had satisfactory genital hygiene practice and 36.9% had symptoms of reproductive tract infection. Conclusion: There was a high prevalence of some important risk factors associated with cancer cervix like age, age of marriage, age of first child birth, parity ,family planning practices, genital hygiene and reproductive tract infections in the study population. Therefore screening and early detection efforts can be directed specifically to the group at risk.

  16. Prognostic value of response to external radiation in stage IIIB cancer cervix in predicting clinical outcomes: A retrospective analysis of 556 patients from India

    International Nuclear Information System (INIS)

    Background and purpose: To evaluate the prognostic significance of response to external beam radiation (EBRT) in predicting the clinical outcomes in stage IIIB cancer cervix and to find out factors affecting response to EBRT. Patients and methods: This retrospective study included 556 patients of cancer cervix stage IIIB treated between 1996 and 2001 with EBRT (46 Gy/23fx/4.5 weeks) followed by intracavitary radiotherapy (ICRT). At the end of EBRT, response to EBRT was grouped as 'no gross residual tumor'(NRT) or 'gross residual tumor'(GRT). Results: Follow up ranged from 2 to 93 months with a median of 36 months. Median dose to point A was 81 Gy. At the end of EBRT, 393 patients (70.7%) attained NRT response. NRT responders had significantly better 5 year pelvic control, disease free survival (DFS) and overall survival (OS) than those who had a GRT response (75.6 vs. 54.6%; 60.6 vs. 31.9% and 62.6 vs. 33.7%, respectively; all P values <0.0001). Apart from response to EBRT, overall treatment time also has emerged as an independent factor to affect all clinical outcomes in multivariate analysis but age had significant impact on pelvic control only. Age was the only factor, which significantly influenced the response to EBRT in univariate as well as multivariate analysis (P=<0.001, OR=1.973, 95% C.I. 1.357-2.868). Patients with age more than 50 years had more NRT response (77%) than patients with age less than 50 years (63.8%). Conclusions: Patients who attain NRT response to EBRT will have an impressive long term pelvic control, DFS and OS in stage IIIB cancer cervix. Older patients (≥50 years) attain significantly higher NRT rates than younger patients

  17. Effects of Fermented Mushroom of Cordyceps sinensis, Rich in Selenium, on Uterine Cervix Cancer.

    Science.gov (United States)

    Ji, Jing; Liu, Juan; Liu, Haijuan; Wang, Yueling

    2014-01-01

    The purpose of this study was to investigate the effect of fermented mushroom of Cordyceps sinensis (CS), rich in selenium (Se-CS), on uterine cervical cancer in mice. The methylcholanthrene- (MCA-) induced tumor model was used in this paper. After the mice were administered Se-CS, the animals showed 40% tumor incidence (P < 0.05). Se-CS also enhanced the immune functions. Se-CS treatment showed significant (P < 0.05-0.01) restoration in the level of glutathione content, lipid peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na(+)/K(+)-ATPase activity, and glutathione S transferase activity. This finding suggested that the concomitant use of Se and CS could be a potential therapeutic approach to improve the efficacy of therapy for uterine cervical cancer. PMID:24971145

  18. PREVENTION OF CANCER OF THE CERVIX UTERI AT AN ANTENATAL CLINIC

    Directory of Open Access Journals (Sweden)

    I. E. Bakhlaev

    2009-01-01

    Full Text Available Cervical cancer (CC morbidity is analyzed on the basis of the data of the Karelian cancer register over the period 1998-2007. During this period, 816 cases of CC were registered and 126 were found at an antenatal clinic (AC. Its early detection rate was ascertained to be 96% during screening at the AC. A comprehensive examination was made in 1742 women with various cervical diseases, of them 37.5% were infected with human papillomavirus (HPV. High-grade dysplasia and carcinoma in situ were diagnosed in 6.6% of the HPV-infected patients. Large-scale screening for HPV infection and pretumor disorders with their further treatment will aid in reduc- ing CC morbidity and mortality rates.

  19. Effects of Fermented Mushroom of Cordyceps sinensis, Rich in Selenium, on Uterine Cervix Cancer

    Directory of Open Access Journals (Sweden)

    Jing Ji

    2014-01-01

    Full Text Available The purpose of this study was to investigate the effect of fermented mushroom of Cordyceps sinensis (CS, rich in selenium (Se-CS, on uterine cervical cancer in mice. The methylcholanthrene- (MCA- induced tumor model was used in this paper. After the mice were administered Se-CS, the animals showed 40% tumor incidence (P<0.05. Se-CS also enhanced the immune functions. Se-CS treatment showed significant (P<0.05–0.01 restoration in the level of glutathione content, lipid peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na+/K+-ATPase activity, and glutathione S transferase activity. This finding suggested that the concomitant use of Se and CS could be a potential therapeutic approach to improve the efficacy of therapy for uterine cervical cancer.

  20. Dosimetric comparison in a cancer of the Cervix with different therapeutic modalities

    International Nuclear Information System (INIS)

    Cervical cancer is usually treated with radiotherapy composed of 3D (RC3D) and supine position, and is usually not usually outline the small intestine in cases of exclusively pelvic irradiation. In our Center we wanted to check what dose receives the small intestine in these cases and if the positioning of the patient or used irradiation technique influence the distribution of the histogram dose-volume. (Author)

  1. Breast cancer risk from low-dose exposures to ionizing radiation: results of parallel analysis of three exposed populations of women

    International Nuclear Information System (INIS)

    Breast cancer incidence data were analyzed from three populations of women exposed to ionizing radiation: survivors of the Hiroshima and Nagasaki atomic bombs, patients in Massachusetts tuberculosis sanitoria who were exposed to multiple chest fluoroscopies, and patients treated by X-rays for acute postpartum mastitis in Rochester, New York. Parallel analyses by radiation dose, age at exposure, and time after exposure suggested that risk of radiation-induced cancer increased approximately linearly with increasing dose and was heavily dependent on age at exposure; however, the risk was otherwise remarkably similar among the three populations, at least for ages 10 to 40 years at exposure, and followed the same temporal pattern of occurrence as did breast cancer incidence in nonexposed women of similar ages

  2. Carcinoma of the cervix

    International Nuclear Information System (INIS)

    Purpose: To discuss a variety of technical and clinical issues concerning the management of carcinoma of the uterine cervix. Radiation therapy plays a central role in the management of patients with invasive carcinoma of the uterine cervix. Although survival rates are high for patients with small volume disease, clinicians continue to search for approaches that might improve treatment results for patients who have bulky central disease, evidence of regional dissemination or other factors associated with a high rate of disease recurrence. New technical approaches have contributed to controversy about the best means of optimizing therapeutic ratio. This course will review current approaches to the management of cervical cancer. Technical aspects of intracavitary and external beam treatment will be emphasized. Problems with brachytherapy dose specification will be discussed as will technical factors that may influence the incidence of treatment-related complications. Current understanding of the natural history of disease and of clinical factors that influence the rate of disease recurrence will be reviewed, including the importance of tumor volume, lymph node involvement, and histologic type on natural history and prognosis. The possible role of controversial methods of clinical evaluation such as lymphangiography and surgical staging will be discussed. Some of the more controversial aspects of treatment such as the indications for radiation therapy vs. surgical therapy for stage IB disease, the role of extended field therapy, postoperative therapy, adjuvant hysterectomy and neoadjuvant or concurrent chemotherapy will be reviewed

  3. How to understand low dose risks

    International Nuclear Information System (INIS)

    It is well established that those who were exposed to ionizing radiation have increased risks of developing malignancies. The magnitude of the risk varies depending on not only the dose but also age at the time of exposure, gender, background incidence rate etc. In the case of atomic bomb survivors, the relative risk of cancer is linearly related to the dose, and the sex averaged relative risk (exposure age is 30, risk calculation is when they reached age 70) is 1.5 at 1 Gy. Because the increased risks below 100 to 200 mGy are too small and not statistically significant, there are arguments in interpreting the risks at the low dose range. (author)

  4. Effects of Fermented Mushroom of Cordyceps sinensis, Rich in Selenium, on Uterine Cervix Cancer

    OpenAIRE

    Jing Ji; Juan Liu; Haijuan Liu; Yueling Wang

    2014-01-01

    The purpose of this study was to investigate the effect of fermented mushroom of Cordyceps sinensis (CS), rich in selenium (Se-CS), on uterine cervical cancer in mice. The methylcholanthrene- (MCA-) induced tumor model was used in this paper. After the mice were administered Se-CS, the animals showed 40% tumor incidence (P < 0.05). Se-CS also enhanced the immune functions. Se-CS treatment showed significant (P < 0.05–0.01) restoration in the level of glutathione content, lipid peroxidation, g...

  5. An Optimization-Driven Analysis Pipeline to Uncover Biomarkers and Signaling Paths: Cervix Cancer

    Directory of Open Access Journals (Sweden)

    Enery Lorenzo

    2015-05-01

    Full Text Available Establishing how a series of potentially important genes might relate to each other is relevant to understand the origin and evolution of illnesses, such as cancer. High‑throughput biological experiments have played a critical role in providing information in this regard. A special challenge, however, is that of trying to conciliate information from separate microarray experiments to build a potential genetic signaling path. This work proposes a two-step analysis pipeline, based on optimization, to approach meta-analysis aiming to build a proxy for a genetic signaling path.

  6. Expedience of conventional radiotherapy in locally advanced cervix cancer: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Prakash Bhagat

    2015-02-01

    Full Text Available Objective: Analysis was done to assess the implications of total radiation treatment duration towards locally advanced cervical cancer. Methods: A comparative study was conducted in CNCI, Kolkata. A total of 38 patients were studied with interdigited brachyttherapy during the course of conventional teleradiotherapy and they were compared to a total of 39 patients with conventional sequential teletherapy and brachytherapy. Results: In the experimental arm all the patients had complete response to treatment whereas, 24 patients (85.7% in the conventional arm had complete response [ P = 0.08]. At the last follow up 28 patients (73.68% in the study arm and 17 patients (43.58% in the control arm were free of disease. The failure rate in the conventional control arm was significantly higher [ P = 0.035]. Test of proportion derived from data also showed that the proportion of patients with no evidence of disease at the time of last follow-up was significantly higher in the study arm compared to the control arm [ P < 0.05] and the proportion of patients with persistent disease was significantly less in the stuwdy arm compared to the control arm [ P < 0.05]. The probability of disease-free survival in percentage according to the curve at the time of median follow-up was approximately 70% for study arm and 60% for control arm [log-rank test, P = 0.2463]. Conclusion: we should hence minimize treatment time and avoid any planned or unplanned interruptions or delays by timely integration of external beam and intra-cavitary irradiation that may yield a better local control in locally advanced cervical cancer

  7. Pelvic exenteration for cervix cancer: would additional intraoperative interstitial brachytherapy improve survival?

    International Nuclear Information System (INIS)

    Objective: Improved local control with the addition of brachytherapy to pelvic exenteration for recurrent cervical cancer has been reported to improve survival. We examined the sites of recurrence after pelvic exenteration to determine if these patients might have been salvaged by the improved local control promised by interstitial brachytherapy. We sought to identify risk factors available intraoperatively or perioperatively which might predict decreased local control. Methods: A retrospective review of 26 patients with recurrent cervical cancer who underwent total pelvic exenteration since 1988 at our institution was performed. Results: Overall, the mean follow-up was 29.5 months (range 6.1-81.6). Of the 26 patients, 14 had no evidence of disease (NED), 1 was alive with disease (AWD), 9 were dead of disease (DOD), and 2 died of unrelated causes (DOC). Seven of 26 patients (27%) had margins ≤ 5 mm, of whom 2 were NED, 4 DOD, and 1 AWD. Seven of 26 (27%) patients had lymphovascular involvement (LVI) or perineural invasion (PNI) with clear margins. Three of the seven with LVI or PNI and clear margins were NED, and four DOD. Of the 10 failures, 9 (90%) had close margins, PNI, or LVI. Conclusion: Our data reveal that 9 of 14 (64%) patients with close margins, LVI, or PNI were DOD or AWD, and 6 of 9 of those patients suffered local regional failure alone. Brachytherapy has the potential to cure 6 of 14 (43%) patients with these risk factors. Further study of brachytherapy at the time of pelvic extenteration is warranted

  8. Sustained platelet-sparing effect of weekly low dose paclitaxel allows effective, tolerable delivery of extended dose dense weekly carboplatin in platinum resistant/refractory epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Blagden Sarah

    2011-07-01

    Full Text Available Abstract Background Platinum agents have shown demonstrable activity in the treatment of patients with platinum resistant, recurrent ovarian cancer when delivered in a "dose-dense" fashion. However, the development of thrombocytopenia limits the weekly administration of carboplatin to no greater than AUC 2. Paclitaxel has a well-described platelet sparing effect however its use to explicitly provide thromboprotection in the context of dose dense carboplatin has not been explored. Methods We treated seven patients with platinum resistant ovarian cancer who had previously received paclitaxel or who had developed significant peripheral neuropathy precluding the use of further full dose weekly paclitaxel. Results We were able to deliver carboplatin AUC 3 and paclitaxel 20 mg/m2 with no thrombocytopenia or worsening of neuropathic side-effects, and with good activity. Conclusions We conclude that this regimen may be feasible and active, and could be formally developed as a "platinum-focussed dose-dense scaffold" into which targeted therapies that reverse platinum resistance can be incorporated, and merits further evaluation.

  9. Ameliorative effects of low dose/low dose-rate irradiation on reactive oxygen species-related diseases model mice

    International Nuclear Information System (INIS)

    β-cells against superoxide generated by glycation reaction evoked by high glucose environment. Continuous irradiation at 0.63 mGy/hr from 28 days of age elongates life span, and recovers splenic inflammatory response in Klotho-mice bearing ageing syndrome. The radiation increases anti-oxidants in liver, implicating the prevention of ageing through the suppression of cellular oxidative damages. Our results suggest that low dose/low dose-rate radiation effectively ameliorates diseases related to reactive oxygen species, and elongates life span of animals, at least in part through the stimulation of protective responses against oxidative stress. These findings are important not only for clinical use of low dose/low dose-rate radiation for human diseases, but also for non-cancerous risk estimation at dose and dose rate range argued in legal restrictions. (author)

  10. ROLE OF COLPOSCOPY USING MODIFIED REID’S INDEX IN SCREENING OF CERVICAL CANCER IN WOMEN WITH ABNORMAL CERVIX ON NAKED EYE EXAMINATION

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    Deshpande

    2014-01-01

    Full Text Available OBJECTIVE: To assess the validity of Colposcopy using Modified Reid's Index as a screening tool in cervical cancer in women with abnormal cervix on naked eye examination . METHODS: This observational study was carried out in Government medical college, Aurangabad from June 2011 to May 2013 . Total 392 women with abnormal cervix on naked eye examination of underwent colposcopy and diagnosis was made on the basis of Modified R eid’s Index. Colposcope directed biopsies were obtained from the abnormal areas. In women with normal colposcopic findings four quadrant biopsies from squamo - columnar junction were taken .Eight women were excluded from analysis owing to unsatisfactory colp oscopy. Results of colposcopy were validated by calculating sensitivity, specificity, positive predictive value, negative predictive value in diagnosing histopathologically confirmed lesions which served as gold standard. RESULTS: Overall sensitivity of colposcopy in all grades of lesions is around 90% or more, touching 100% in high order of histological lesions.Overall specificity is also high.It does have an excellent negative predictive value but comparatively lower positive predictive value especially in high order lesions with fair degree of accuracy in all grades of lesions in the hands of an experienced operator. CONCLUSION: Colposcopy using Modified Reid’s Index with high sensitivity and specificity is a good screening tool for cervical cancer

  11. Intra-patient semi-automated segmentation of the cervix-uterus in CT-images for adaptive radiotherapy of cervical cancer

    Science.gov (United States)

    Luiza Bondar, M.; Hoogeman, Mischa; Schillemans, Wilco; Heijmen, Ben

    2013-08-01

    For online adaptive radiotherapy of cervical cancer, fast and accurate image segmentation is required to facilitate daily treatment adaptation. Our aim was twofold: (1) to test and compare three intra-patient automated segmentation methods for the cervix-uterus structure in CT-images and (2) to improve the segmentation accuracy by including prior knowledge on the daily bladder volume or on the daily coordinates of implanted fiducial markers. The tested methods were: shape deformation (SD) and atlas-based segmentation (ABAS) using two non-rigid registration methods: demons and a hierarchical algorithm. Tests on 102 CT-scans of 13 patients demonstrated that the segmentation accuracy significantly increased by including the bladder volume predicted with a simple 1D model based on a manually defined bladder top. Moreover, manually identified implanted fiducial markers significantly improved the accuracy of the SD method. For patients with large cervix-uterus volume regression, the use of CT-data acquired toward the end of the treatment was required to improve segmentation accuracy. Including prior knowledge, the segmentation results of SD (Dice similarity coefficient 85 ± 6%, error margin 2.2 ± 2.3 mm, average time around 1 min) and of ABAS using hierarchical non-rigid registration (Dice 82 ± 10%, error margin 3.1 ± 2.3 mm, average time around 30 s) support their use for image guided online adaptive radiotherapy of cervical cancer.

  12. Low-dose cyclophosphamide-induced acute hepatotoxicity

    OpenAIRE

    Subramaniam, S. Ravih; Cader, Rizna Abdul; Mohd, Rozita; Yen, Kong Wei; Ghafor, Halim Abdul

    2013-01-01

    Patient: Male, 48 Final Diagnosis: Low dose cyclophosphamide-induced acute hepatotoxicity Symptoms: Epigastric pain Medication: Withdrawal of cyclophosphamide Clinical Procedure: — Specialty: Nephrology • Hepatology • Gastroenterology • Toxicology Objective: Unexpected drug reaction Background: Cyclophosphamide is commonly used to treat cancers, systemic vasculitides, and kidney diseases (e.g., lupus nephritis and focal segmental glomerulosclerosis). Acute adverse effects include bone marrow ...

  13. Transcriptome profiling of mice testes following low dose irradiation

    DEFF Research Database (Denmark)

    Belling, Kirstine C.; Tanaka, Masami; Dalgaard, Marlene Danner; Nielsen, John Erik; Nielsen, Henrik Bjørn; Brunak, Søren; Almstrup, Kristian; Leffers, Henrik

    2013-01-01

    ABSTRACT: BACKGROUND: Radiotherapy is used routinely to treat testicular cancer. Testicular cells vary in radio-sensitivity and the aim of this study was to investigate cellular and molecular changes caused by low dose irradiation of mice testis and to identify transcripts from different cell types...

  14. Comparative analysis of cisplatin-induced nephrotoxicity in head and neck cancer and carcinoma cervix during concurrent chemoradiotherapy

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    Puneet Kumar Bagri

    2014-01-01

    Full Text Available Background: Cisplatin is widely used as radio sensitizer in head and neck cancer (HNC and carcinoma cervix (CaCx. This study aims to see comparative nephrotoxicity of cisplatin in HNC and in CaCx without obstructive uropathy treated by concurrent chemoradiotherapy (CCRT. Materials and Methods: Fifty patients of HNC and 50 patients of CaCx stage II/III without obstructive uropathy were included in this study. Cisplatin 50 mg intravenous weekly was given before EBRT with adequate hydration and premedication in both groups. Before chemotherapy; blood urea, serum creatinine, and glomerular filtration rate (GFR were measured. GFR was measured using 99m Tc diethylene triamine pentacaetic acid (DTPA renogram study. Results: At the end of 4 th week, blood urea level 41-45 mg% was in 40 and 4% in HNC and CaCx, respectively (P = 0.018. At the end of 3 rd and 4 th week, blood urea level >45 mg% was 10 and 6% in HNC cases, respectively. At the end of 4 th week, serum creatinine level 1.1-1.5 mg% was 50 and 8% in HNC and CaCx, respectively (P = 0.047. Serum creatinine level >1.5 mg% was 6, 8, and 22% in HNC at the end of 2 nd , 3 rd , and 4 th week, respectively. GFR <80 ml/min at the end of 4 th week was 14% in HNC and only 2% in CaCx. GFR <100ml/min was significant at the end of 4 th week (P = 0.04. Univariate analysis showed significant relation between reduced oral fluid intake and reduced GFR (P < 0.001. Conclusion: In HNC, during concurrent chemoradiation, as the 3 rd -4 th week is reached, oral mucosal reactions increase and affect oral intake which further add to the cisplatin-induced nephrotoxicity. In CaCx without obstructive uropathy, renal function impairment is less severe as oral intake of water and liquid is not much impaired.

  15. Fludarabine Phosphate, Low-Dose Total Body Irradiation, and Donor Stem Cell Transplant in Treating Patients With Hematologic Malignancies or Kidney Cancer

    Science.gov (United States)

    2015-10-13

    Accelerated Phase Chronic Myelogenous Leukemia; Adult Acute Lymphoblastic Leukemia in Remission; Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); B-cell Chronic Lymphocytic Leukemia; Childhood Acute Lymphoblastic Leukemia in Remission; Childhood Acute Myeloid Leukemia in Remission; Childhood Chronic Myelogenous Leukemia; Childhood Myelodysplastic Syndromes; Childhood Renal Cell Carcinoma; Chronic Phase Chronic Myelogenous Leukemia; Clear Cell Renal Cell Carcinoma; de Novo Myelodysplastic Syndromes; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Previously Treated Myelodysplastic Syndromes; Recurrent Adult Acute Lymphoblastic Leukemia; Recurrent Adult Acute Myeloid Leukemia; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Hodgkin Lymphoma; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Relapsing Chronic Myelogenous Leukemia; Splenic Marginal Zone Lymphoma; Stage III Renal Cell Cancer; Stage IV Renal Cell Cancer; T-cell Large Granular Lymphocyte Leukemia; Type 1 Papillary Renal Cell Carcinoma; Type 2 Papillary Renal Cell Carcinoma; Waldenström Macroglobulinemia

  16. Low-dose radiation epidemiology studies: status and issues.

    Science.gov (United States)

    Shore, Roy E

    2009-11-01

    Although the Japanese atomic bomb study and radiotherapy studies have clearly documented cancer risks from high-dose radiation exposures, radiation risk assessment groups have long recognized that protracted or low exposures to low-linear energy transfer radiations are key radiation protection concerns because these are far more common than high-exposure scenarios. Epidemiologic studies of human populations with low-dose or low dose-rate exposures are one approach to addressing those concerns. A number of large studies of radiation workers (Chernobyl clean-up workers, U.S. and Chinese radiological technologists, and the 15-country worker study) or of persons exposed to environmental radiation at moderate to low levels (residents near Techa River, Semipalatinsk, Chernobyl, or nuclear facilities) have been conducted. A variety of studies of medical radiation exposures (multiple-fluoroscopy, diagnostic (131)I, scatter radiation doses from radiotherapy, etc.) also are of interest. Key results from these studies are summarized and compared with risk estimates from the Japanese atomic bomb study. Ideally, one would like the low-dose and low dose-rate studies to guide radiation risk estimation regarding the shape of the dose-response curve, DDREF (dose and dose-rate effectiveness factor), and risk at low doses. However, the degree to which low-dose studies can do so is subject to various limitations, especially those pertaining to dosimetric uncertainties and limited statistical power. The identification of individuals who are particularly susceptible to radiation cancer induction also is of high interest in terms of occupational and medical radiation protection. Several examples of studies of radiation-related cancer susceptibility are discussed, but none thus far have clearly identified radiation-susceptible genotypes. PMID:19820457

  17. Biological dose estimation of partial body exposures in cervix cancer patients

    International Nuclear Information System (INIS)

    fraction. Cells containing aberrations will have been in the irradiated part of the body. Normal undamaged cells will comprise two subpopulations; those from the unexposed fraction and irradiated cells representing the first term (e-γ) of the Poisson series. From the degree of the deviation from Poisson, the fraction of irradiated lymphocytes of the body and its mean dose can be obtained. The alternative Qdr method considers the yield of dicentrics and rings only from those cells that contain unstable aberrations and assumes that these cells were irradiated in situ. The Qdr value represents the expected frequency of dicentrics and rings among first division damaged cells (containing dicentrics, rings and excess acentric fragments). It is dose dependent, but independent of dose homogeneity and of a dilution of damaged cells by undamaged cells. Qdr assumes that the excess acentric fragments follow the Poisson distribution, but this is not borne out by data from in vitro experiments. It also assumes that cells containing excess acentric fragments will have been in the irradiated fraction of the body. However, their induction is not radiation specific, showing a variable spontaneous frequency, As these limitations are thought to be important, they were avoided by considering the yield of dicentrics + rings in those damaged cells which contain just dicentrics + rings (Qdr reduced equations). This simplified equation produces a dose estimate identical to that obtained by Dolphin method. Therefore, we apply Qdr reduced equation for data analysis. After inhomogeneous exposures, information on the absorbed dose and its distribution in the body is of great importance for an early assessment of irradiation consequences in the exposed individuals. As cancer patients undergoing partial-body fractionated radiotherapy may provide a model for in vivo irradiation, the objective of this work has been to assess the possibilities and limitations of Qdr method to determine reliable dose

  18. DVH parameters and outcome for patients with early-stage cervical cancer treated with preoperative MRI-based low dose rate brachytherapy followed by surgery

    International Nuclear Information System (INIS)

    Background: To our knowledge no DVH data have so far been reported for MRI-guided BT in the preoperative setting of early-stage cervical cancer. We assessed DVH parameters and clinical outcome using 3D MRI-guided preoperative intracavitary LDR BT. Patients and methods: Thirty-nine patients with primary early cervical carcinoma (IB1 37, IIA 1 and IIB 1) were treated with preoperative MRI-based LDR BT, consisting of uterovaginal BT to a total dose of 60 Gy to the intermediate-risk CTV, followed 6 weeks later by bilateral salpingo-oophorectomy and extrafascial hysterectomy plus pelvic node dissection. Adjuvant chemoradiation was delivered to patients with pelvic lymph node involvement. Results: With a median follow-up of 4.4 years (range 2.6-6.6 years), local recurrence occurred in 1 patient (a lateropelvic relapse) (2.6%). The 4-year actuarial overall survival and disease-free survival were 94% (95% CI, 82-98), and 86% (95% CI, 67-95), respectively. The 2- and 4-year actuarial local relapse-free survival were 94 (95% CI, 86-100) and 91% (95% CI, 81-100), respectively. For intermediate-risk CTV, median D100 and D90 were 43 Gyα/β10 (range 2-74 Gyα/β10) and 75 Gyα/β10, respectively (range 29-129 Gyα/β10). For high-risk CTV, the median D100 and D90 were 69 Gyα/β10 (range 24-137 Gyα/β10) and 109 Gyα/β10 (range 37-198 Gyα/β10), respectively. Twenty grade 1-2 late complications were observed in 13 patients (33.3%): 10 bladder, 3 ureteral, 1 rectal, 1 small bowel, 1 vaginal, 1 pelvic fibrosis, 1 peripheral nerve, and 2 others. No grade 3 or 4 complication occurred. Conclusion: MRI-guided brachytherapy with adaptation of the time duration and/or the length of each radioactive source allows both high local control and low toxicity in the preoperative settings of early-stage cervical cancers.

  19. Second-line treatment of non small cell lung cancer by biweekly gemcitabine and docetaxel +/- granulocyte-macrophage colony stimulating factor and low dose aldesleukine.

    Science.gov (United States)

    Correale, Pierpaolo; Tindara Miano, Salvatora; Remondo, Cinzia; Migali, Cristina; Rotundo, Maria Saveria; Macrì, Paolo; Tagliaferri, Pierosandro; Caraglia, Michele; Gotti, Giuseppe; Francini, Guido

    2009-03-15

    Background. The antitumor activity of a novel biweekly gemcitabine (G) + docetaxel (D) regimen +/- granulocyte-macrophage colony stimulating factor (GM-CSF) and aldesleukine (IL-2) has been evaluated in a phase II trial in advanced pretreated non-small-cell lung cancer (NSCLC). Results. The treatment was well tolerated. The 42.3% response rate exceeded the predefined target activity, while time to progression (TTP) and overall survival (OS) were 7 and 11.2 months, respectively. A greater objective response rate (58.3% vs 28.6%) and an increased number of eosinophils, basophils and activated mononuclear blood cells were observed in those patients who also received cytokine administration. Methods. Twenty-six NSCLC patients received second line G (1000 mg/m2) and D (75 mg/m2) every 15 days. 12/26 patients also received s.c. GM-CSF (100µg, days 2-6) and s.c. IL-2 (0.5MIU/ twice daily, days 7-14 and 16-29) by random selection. Conclusion. The biweekly GD regimen is a safe and active second-line treatment in NSCLC. Addition of immune-adjuvant cytokines' may enhance the activity of this therapeutic combination. PMID:19242101

  20. A Pilot Study of Catheter-Based Ultrasound Hyperthermia with HDR Brachytherapy for Treatment of Locally Advanced Cancer of the Prostate and Cervix

    Science.gov (United States)

    Diederich, Chris J.; Wootton, Jeff; Prakash, Punit; Salgaonkar, Vasant; Juang, Titania; Scott, Serena; Chen, Xin; Cunha, Adam; Pouliot, Jean; Hsu, I. C.

    2011-09-01

    Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within temporary HDR brachytherapy implants during radiation therapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm length×180 deg and 3-4 cm×360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers x dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and four prostate implants. 100% of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target volume (HTV) and clinical target volume (CTV) are reported. Catheter-based ultrasound hyperthermia with HDR appears feasible with therapeutic temperature coverage of the target volume within the prostate or cervix while sparing surrounding more sensitive regions.

  1. A Pilot Study of Catheter-Based Ultrasound Hyperthermia with HDR Brachytherapy for Treatment of Locally Advanced Cancer of the Prostate and Cervix

    International Nuclear Information System (INIS)

    Interstitial and endocavity ultrasound devices have been developed specifically for applying hyperthermia within temporary HDR brachytherapy implants during radiation therapy. Catheter-based ultrasound applicators are capable of 3D spatial control of heating in both angle and length of the devices, with enhanced radial penetration of heating compared to other hyperthermia technologies. A pilot study of the combination of catheter based ultrasound with HDR brachytherapy for locally advanced prostate and cervical cancer has been initiated, and preliminary results of the performance and heating distributions are reported herein. The treatment delivery platform consists of a 32 channel RF amplifier and a 48 channel thermocouple monitoring system. Controlling software can monitor and regulate frequency and power to each transducer section as required during the procedure. Interstitial applicators consist of multiple transducer sections of 2-4 cm lengthx180 deg and 3-4 cmx360 deg. heating patterns to be inserted in specific placed 13g implant catheters. The endocavity device, designed to be inserted within a 6 mm OD plastic tandem catheter within the cervix, consists of 2-3 transducers x dual 180 or 360 deg sectors. 3D temperature based treatment planning and optimization is dovetailed to the HDR optimization based planning to best configure and position the applicators within the catheters, and to determine optimal base power levels to each transducer section. To date we have treated eight cervix implants and four prostate implants. 100% of treatments achieved a goal of >60 min duration, with therapeutic temperatures achieved in all cases. Thermal dosimetry within the hyperthermia target volume (HTV) and clinical target volume (CTV) are reported. Catheter-based ultrasound hyperthermia with HDR appears feasible with therapeutic temperature coverage of the target volume within the prostate or cervix while sparing surrounding more sensitive regions.

  2. Fludarabine Phosphate, Low-Dose Total-Body Irradiation, and Donor Stem Cell Transplant Followed by Cyclosporine, Mycophenolate Mofetil, Donor Lymphocyte Infusion in Treating Patients With Hematopoietic Cancer

    Science.gov (United States)

    2016-08-01

    ; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Renal Cell Cancer; Recurrent Small Lymphocytic Lymphoma; Recurrent/Refractory Childhood Hodgkin Lymphoma; Refractory Chronic Lymphocytic Leukemia; Refractory Hairy Cell Leukemia; Refractory Multiple Myeloma; Small Intestine Lymphoma; Splenic Marginal Zone Lymphoma; Stage II Multiple Myeloma; Stage III Multiple Myeloma; T-cell Large Granular Lymphocyte Leukemia; Testicular Lymphoma; Waldenström Macroglobulinemia

  3. Use of alpha-1 adrenoceptor antagonists in patients who underwent low-dose-rate brachytherapy for prostate cancer - a randomized controlled trial of silodosin versus naftopidil -

    International Nuclear Information System (INIS)

    To evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy. A total of 141 patients who had been clinically diagnosed with localized prostate cancer and underwent LDR-brachytherapy were enrolled. Patients were randomized and allocated to two groups (silodosin 8 mg vs. naftopidil 75 mg). The primary endpoint was a change in the international prostate symptom score (IPSS) at 3 months after seed implantation. Secondary endpoints included the recovery rate of IPSS at 12 months after seed implantation, the change in IPSS and overactive bladder symptom score, uroflowmetric parameters, and frequency volume chart (FVC). To determine independent variables that can predict IPSS recovery, logistic regression analysis was carried out. The mean change in the IPSS at 3 months after seed implantation in both groups was ⊿10.6 (naftopidil) and ⊿10.4 (silodosin), respectively. There was not a significant difference between the two groups (p=0.728). An increase in urinary frequency and a decrease in total urinated volume and mean voided volume were observed in FVC for 12 months after seed implantation. Multivariate analysis revealed that the urethral dose (UD30) was an independent predictive parameter of IPSS recovery. Patients with UD30 < 200Gy showed a higher recovery rate of IPSS at 12 months after seed implantation. There was no significant difference of serial change in IPSS between silodosin and naftopidil during the first year after seed implantation. A lower dose on the urethra was an independent predictor of IPSS recovery at 12 months after seed implantation

  4. Low doses of arsenic, via perturbing p53, promotes tumorigenesis.

    Science.gov (United States)

    Ganapathy, Suthakar; Li, Ping; Fagman, Johan; Yu, Tianqi; Lafontant, Jean; Zhang, Guojun; Chen, Changyan

    2016-09-01

    In drinking water and in workplace or living environments, low doses of arsenic can exist and operate as a potent carcinogen. Due to insufficient understanding and information on the pervasiveness of environmental exposures to arsenic, there is an urgent need to elucidate the underlying molecular mechanisms of arsenic regarding its carcinogenic effect on human health. In this study, we demonstrate that low doses of arsenic exposure mitigate or mask p53 function and further perturb intracellular redox state, which triggers persistent endoplasmic reticulum (ER) stress and activates UPR (unfolded protein response), leading to transformation or tumorigenesis. Thus, the results suggest that low doses of arsenic exposure, through attenuating p53-regulated tumor suppressive function, change the state of intracellular redox and create a microenvironment for tumorigenesis. Our study also provides the information for designing more effective strategies to prevent or treat human cancers initiated by arsenic exposure. PMID:27425828

  5. Low Dose Risk, Decisions, and Risk Communication

    International Nuclear Information System (INIS)

    The overall research objective was to establish new levels of information about how people, groups, and communities respond to low dose radiation exposure. This is basic research into the social psychology of individual, group, and community responses to radiation exposures. The results of this research are directed to improving risk communication and public participation in management of environmental problems resulting from low dose radiation

  6. Biologically based analysis of lung cancer incidence in a large Canadian occupational cohort with low-LET low-dose radiation exposure, and comparison with Japanese atomic bomb survivors

    International Nuclear Information System (INIS)

    Lung cancer incidence is analyzed in a large Canadian National Dose Registry (CNDR) cohort with individual annual dosimetry for low-dose occupational exposure to gamma and tritium radiation using several types of multistage models. The primary analysis utilizes the two-stage clonal expansion model (TSCE), with sensitivity analyses using extensions of this model incorporating additional stages. Characteristic and distinct temporal patterns of risk are found for dose-response affecting early, middle, or late stages of carcinogenesis, e.g. initiation with one or more stages, clonal expansion, or malignant conversion. Fixed lag or lag distributions are used to model time from first malignant cell to incidence. Background rates are analyzed by gender, job classification and birth cohort. Lacking individual smoking data, surrogate doses based on US annual per capita cigarette consumption appear to account for much of the birth cohort effect. Males, with mean cumulative exposure for gamma and tritium of 11.5 mSv and 322 incident lung cancer cases have a significant dose-response with 33 cases attributable to radiation. Female dose-response, with mean cumulative exposure of 1.7 mSv and 78 incident cases, appears similar but is not statistically significant. Findings for males include an inverse-dose-rate effect (increased risk with protraction of a given dose) and dose-response effects on initiation, promotion and malignant conversion, although the effect on initiation is not statistically significant. The excess relative risk (ERR) and excess absolute risk (EAR) depend on age at exposure, duration, dose, and age at follow-up. The ERR increases with dose, tapering off at higher doses, making a plot of ERR against dose concave-downward, similar to apparent low-dose results seen below 1 Sv for solid tumor mortality of atomic bomb survivors. The concave-downward trend of ERR and the inverse-dose-rate effect are both counter to prevailing beliefs about effects of low

  7. Effects of low doses of ionizing radiation

    International Nuclear Information System (INIS)

    Several groups of human have been irradiated by accidental or medical exposure, if no gene defect has been associated to these exposures, some radioinduced cancers interesting several organs are observed among persons exposed over 100 to 200 mSv delivered at high dose rate. Numerous steps are now identified between the initial energy deposit in tissue and the aberrations of cell that lead to tumors but the sequence of events and the specific character of some of them are the subject of controversy. The stake of this controversy is the risk assessment. From the hypothesis called linear relationship without threshold is developed an approach that leads to predict cancers at any tiny dose without real scientific foundation. The nature and the intensity of biological effects depend on the quantity of energy absorbed in tissue and the modality of its distribution in space and time. The probability to reach a target (a gene) associated to the cancerating of tissue is directly proportional to the dose without any other threshold than the quantity of energy necessary to the effect, its probability of effect can be a more complex function and depends on the quality of the damage produced as well as the ability of the cell to repair the damage. These two parameters are influenced by the concentration of initial injuries in the target so by the quality of radiation and by the dose rate. The mechanisms of defence explain the low efficiency of radiation as carcinogen and then the linearity of effects in the area of low doses is certainly the least defensible scientific hypothesis for the prediction of the risks. (N.C.)

  8. Micronucleus test in cytokinesis-blocked lymphocytes of cervix cancer patients as a predictive assay of individual radiosensitivity

    International Nuclear Information System (INIS)

    The ability to control a tumor by radiation therapy is limited by the tolerance of normal tissues within the treatment field, particularly by the occurrence of severe late normal tissue reactions (NTR), developed month to years after treatment. Patients receiving identical radiation treatments have different impacts on normal tissues, varying from undetectable to sever. Cellular and molecular mechanisms of these reactions are not yet understood. It has been suggested that the extent of late NTR may depend on the individual cellular radiosensitivity, associated with defects in DNA repair capacity. There is some evidence in favor of the hypothesis that in vitro radiosensitivity tests, in normal or neoplastic cells, are predictive of clinical expression of late normal tissue complications after radiotherapy. Intrinsic radiosensitivity testing is considered more feasible and promising in normal than tumor tissues because normal cell populations are less heterogeneous than tumor cell populations, and clinical studies on radiosensitivity are easier to implement. Peripheral blood lymphocytes are considered the cells of choice because they are easy to obtain, with minimal trauma to donors, and to use for in vitro tests, giving quick results. The cytokinesis-blocked micronucleus assay is an established cytogenetic technique to evaluate intrinsic cell radiosensitivity in tumor cells and lymphocytes. The objective of our study was to assess, prospectively, the individual cytogenetic response to radiotherapy applying the cytokinesis blocked micronucleus (MN) assay to peripheral blood lymphocytes from cervix cancer patients undergoing radiation therapy as part of their treatment, in comparison with the observed clinical response. Blood samples were collected just before treatment, mid-way during treatment and/or on completion of treatment. Cytogenetic data were analyzed using a mathematical model to evaluate the attenuation of the cytogenetic effect as a function of the time

  9. Low dose irradiation and biological defense mechanisms

    International Nuclear Information System (INIS)

    It has been generally accepted in the context of radiation protection that ionizing radiation has some adverse effect even at low doses. However, epidemiological studies of human populations cannot definitively show its existence or absence. Furthermore, recent studies of populations living in areas of different background radiation levels reported some decrease in adverse health effects at high background levels. Genetic studies of atomic bomb survivors failed to produce statistically significant findings on the mutagenic effects of ionizing radiation. A British study however, suggests that a father's exposure to low dose radiation on the job may increase his children's risk of leukemia. On the other hand, many experimental studies have raised the possibility that low doses of ionizing radiation may not be harmful or may even produce stimulating or adaptive responses. The term 'hormesis' has come to be used to describe these phenomena produced by low doses of ionizing radiation when they were beneficial for the organisms studied. At the end of the International Conference on Low Dose Irradiation one conclusion appeared to be justified: radiation produces an adaptive response, though it is not universally detected yet. The conference failed to obtain any consensus on risk assessment at low doses, but raised many problems to be dealt with by future studies. The editors therefore believe that the Proceedings will be useful for all scientists and people concerned with radiation protection and the biological effects of low-dose irradiation

  10. Detection of organ movement in cervix cancer patients using a fluoroscopic electronic portal imaging device and radiopaque markers

    International Nuclear Information System (INIS)

    Purpose: To investigate the use of a fluoroscopic electronic portal imaging device (EPID) and radiopaque markers to detect internal cervix movement. Methods and Materials: For 10 patients with radiopaque markers clamped to the cervix, electronic portal images were made during external beam irradiation. Bony structures and markers in the portal images were registered with the same structures in the corresponding digitally reconstructed radiographs of the planning computed tomogram. Results: The visibility of the markers in the portal images was good, but their fixation should be improved. Generally, the correlation between bony structure displacements and marker movement was poor, the latter being substantially larger. The standard deviations describing the systematic and random bony anatomy displacements were 1.2 and 2.6 mm, 1.7 and 2.9 mm, and 1.6 and 2.7 mm in the lateral, cranial-caudal, and dorsal-ventral directions, respectively. For the marker movement those values were 3.4 and 3.4 mm, 4.3 and 5.2 mm, 3.2 and 5.2 mm, respectively. Estimated clinical target volume to planning target volume (CTV-PTV) planning margins (∼11 mm) based on the observed overall marker displacements (bony anatomy + internal cervix movement) are only marginally larger than the margins required to account for internal marker movement alone. Conclusions: With our current patient setup techniques and methods of setup verification and correction, the required CTV-PTV margins are almost fully determined by internal organ motion. Setup verification and correction using radiopaque markers might allow decreasing those margins, but technical improvements are needed

  11. Design and construction of a holder to the safety handling of Cs-137 to be used in cervix cancer treatments using intracavitary brachytherapy by afterloading

    International Nuclear Information System (INIS)

    In venezuelan public hospitals where cervix cancer treatments are performed by means of Cs-137 manual afterloading systems, the handling of the sources is done with two type of holders, metallic and plastic, the plastic holders are pieces of induced serious radio-sanitary problem such as loser of the Cs-137 source and radioactive contamination in the treatment area, this has caused the interruption of the treatments in many hospitals. This interruption had a high social cost because of the thousands women waiting for intracavitary therapy. To start again with the treatments, the metallic holders were required but there were not enough funds in the budget, because of this problem in a short time IVIS'S health physics drew and made a low price source holder. (authors). 2 figs., 2 tabs

  12. Abnormal cervical smears in the unchanged uterine cervix: difficulties in the screening, diagnosis, and treatment of cervical intraepithelial neoplasias and microinvasive cancer

    Directory of Open Access Journals (Sweden)

    L. I. Korolenkova

    2011-01-01

    Full Text Available The author analyzes an algorithm for identifying and treating w omen with cervical intraepithelial neoplasias (CIN and microinv asive cancer of the cervix uteri in cases of the hidden area of transformation and in the absence of visible cervical changes. There are excep- tional difficulties of making the diagnosis of epithelial damages due to the incomplete reproducibility of cytological abnormal ities and the low informative value of a histological study of scrapes from the cervical canal. To avoid hypodiagnosis, it is justifiable to prefer human papillomavirus testing (Hybrid Capture 2 (HC2 to repeat smears for the choice of a management tactic. Conization is recommend ed as a diagnostic and/or therapeutic procedure when the viral load is high in over 35-year-old patients with abnormal smears anda hidden transformation area.

  13. Inappropriate cervical injection of radiotracer for sentinel node mapping in a uterine cervix cancer patient: importance of lymphoscintigraphy and blue dye injection

    Directory of Open Access Journals (Sweden)

    Sima Kadkhodayan

    2014-10-01

    Full Text Available Herein, we report a case of sentinel lymph node mapping in a uterine cervix cancer patient, referring to the nuclear medicine department of our institute. Lymphoscintigraphy images showed inappropriate intra‐cervical injection of radiotracer. Blue dye technique was applied for sentinel lymph node mapping, using intra‐cervical injection of methylene blue. Two blue/cold sentinel lymph nodes, with no pathological involvement, were intra‐operatively identified, and the patient was spared pelvic lymph node dissection. The present case underscores the importance of lymphoscintigraphy imaging in sentinel lymph node mapping and demonstrates the added value of blue dye injection in selected patients. It is suggested that preoperative lymphoscintigraphy imaging be considered as an integral part of sentinel lymph node mapping in surgical oncology. Detailed results of lymphoscintigraphy images should be provided for surgeons prior to surgery, and in case the sentinel lymph nodes are not visualized, use of blue dye for sentinel node mapping should be encouraged.

  14. Genetic factors affecting radiosensitivity and cancer predisposition: application of a continuous low dose-rate irradiation colony formation assay to select radiosensitive retinoblastoma family members for correction with a cDNA library

    International Nuclear Information System (INIS)

    Full text: The aim of this study is to identify new or undescribed functions of radiosensitivity and genomic instability genes using a continuous low dose-rate colony formation assay. This assay expands on the standard colony formation assay, whereby colony formation ability (retention of proliferative capacity) is measured during continuous low dose-rate irradiation rather than 10-14 days following the completion of such exposures. This approach has previously employed by the Bedford laboratory to identify a Prkdc (DNA-PKcs) mutant of CHO cells, irs-20. In this study we examine the growth response of fibroblasts derived from recently identified radiosensitive retinoblastoma family members, both affected probands and their unaffected parents, and various apparently normal fibroblast lines obtained from the NIGMS Human Genetic Cell Repository (Coriell Medical Institute, Camden, NJ). Colony formation was assayed by plating single cells, exposing them at 37 deg C to continuous Cs-137 gamma irradiation at dose rates of 0.5-8.5 cGy/h, and scoring survivors as colonies with >100 viable cells. The retinoblastoma family members display severely limited growth (survival less than 10E-3) at dose rates greater than 2-2.5 cGy/h, while the apparently normal cell lines do not display such inhibited growth until 6-7 cGy/h. Two of the retinoblastoma family cell lines, MF-6F and MF-15F (both unaffected but radiosensitive parents), were selected as targets of transfection with a viral cDNA library (ViraPort human cDNA library, Stratagene Cloning Systems, La Jolla, CA) and subjected to a ∼3 cGy/h selection dose rate, where uncorrected survival relative to normal cells is lower by a factor of 50-150. Colonies recovered will provide valuable information regarding the genetic nature of their radiosensitivity (possibly involving chromosome stability, DNA repair, and/or cell cycle regulatory pathways), that may influence risks for cancer and heritable effects for a previously

  15. Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis.

    Science.gov (United States)

    Chen, Jinmei; Hong, Jinsheng; Zou, Xi; Lv, Wenlong; Guo, Feibao; Hong, Hualan; Zhang, Weijian

    2015-11-01

    The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5-30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5-30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of clinical factors and dose-volume parameters with Grade ≥2 RILI was analyzed. The median follow-up was 12.3 months; 18 (21.7%) cases of Grade 2 RILI, seven (8.4%) of Grade 3 and two (2.4%) of Grade 4 were observed. Univariate analysis revealed the located lobe of the primary tumor. V5, V10, V20, MLD of the ipsilateral lung, V5, V10, V20, V30 and MLD of the bilateral lung, and AVS5 and AVS10 of the ipsilateral lung were associated with Grade ≥2 RILI (P lung was prognostic for Grade ≥2 RILI (P = 0.010, OR = 0.272, 95% CI: 0.102-0.729). Receiver operating characteristic curves indicated Grade ≥2 RILI could be predicted using AVS5 of the ipsilateral lung (area under curve, 0.668; cutoff value, 564.9 cm(3); sensitivity, 60.7%; specificity, 70.4%). The incidence of Grade ≥2 RILI was significantly lower with AVS5 of the ipsilateral lung ≥564.9 cm(3) than with AVS5 lung were associated with Grade ≥2 RILI, and AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI for lung cancer after IMRT. PMID:26454068

  16. Pathogenic effects of low dose irradiation: dose-effect relationships

    International Nuclear Information System (INIS)

    There is no evidence of pathogenic effects in human groups exposed to less than 100 mSv at low dose-rate. The attributed effects are therefore the result of extrapolations from higher doses. The validity of such extrapolations is discussed from the point of view of epidemiology as well as cellular and molecular biology. The Chernobyl accident resulted in large excess of thyroid cancers in children; it also raised the point that some actual sanitary effects among distressed populations might be a direct consequence of low doses. Studies under the control of UN have not confirmed this point identifying no dose-effect relationship and 'severe socio-economic and psychological pressures... poverty, poor diet and living conditions, and lifestyle factors' as the main cause for depressed health. Some hypothesis are considered for explaining the dose-dependence and high prevalence of non-cancer causes of death among human groups exposed to more than 300 mSv. (author)

  17. Descriptive study of breast and cervix cancer, in patients treated with linear accelerator, at the Centro Medico de Radioterapia Irazu, between 2000 and 2001, and proposed a database

    International Nuclear Information System (INIS)

    A descriptive study of breast and cervix cancer was performed in patients who have received treatment linear accelerator, during the period 2000 - 2001 in the Centro Medico de Radioterapia Irazu. The survival of the patients was assessed to five years (2006). One proposal called database is the product of analysis performed and consistent with the objectives set. The idea to develop the database of these features in the medical center, arises because the Centre was at that time with the only linear accelerator in the country and also all the necessary information of patients was easily accessible. A population of 438 records, with a common pathology was analyzed under the following variables: type of cancer, identification of anatomic region, province, age, sex, type of radiation, number of sessions, referral hospital, physician, physician referral. This work is relevant, because breast and cervical cancers have been a major cause of mortality, ranked among the five most common malignancies in women. From there to have adequate information systems, has led policy makers and health professionals to have a better outlook for their level of management. (author)

  18. Impact of post-implant dosimetric parameters on the quality of life of patients treated with low-dose rate brachytherapy for localised prostate cancer: results of a single-institution study

    International Nuclear Information System (INIS)

    To assess the relationship between dosimetric parameters and the quality of life (QL) outcomes of patients with low-intermediate-risk localised prostate cancer (LPC) treated with low-dose-rate brachytherapy (LDR-BT). We evaluated the participants in two consecutive prospective studies of the QL of patients treated with LDR-BT for LPC. QL was evaluated by means of a patient-completed questionnaire assessing non functional [physical (PHY) and psychological (PSY) well-being, physical autonomy (POW), social relationships (REL)] and functional scales [urinary (URI), rectal (REC), and sexual (SEX) function]; a scale for erectile function (ERE) was included in the second study. Urethra (D10 ≤ 210 Gy) and rectal wall constraints (V100 ≤ 0.5 cc) were used for pre-planning dosimetry and were assessed with post planning computerized tomography one month later for each patient. QL was assessed in 251 LPC patients. Dosimetry did not influence the non-functional scales. As expected, a progressive impairment in sexual and erectile function was reported one month after LDR-BT, and became statistically significant after the third year. Rectal function significantly worsened after LDR-BT, but the differences progressively decreased after the 1-year assessment. Overall urinary function significantly worsened immediately after LDR-BT and then gradually improved over the next three years. Better outcomes were reported for V100 rectal wall volumes of ≤ 0.5 cc and D10 urethra values of ≤ 210 Gy. The findings of this study show that dosimetric parameters influence only functional QL outcomes while non-functional outcomes are only marginally influenced

  19. LOW DOSE MAGNESIUM SULPHATE REGIME FOR ECLAMPSIA

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    Bangal V

    2009-09-01

    Full Text Available Pre- eclampsia is one of the commonest medical complications seen during pregnancy. It contributes significantly to maternal and perinatal morbidity and mortality. Dr.J.A.Pritchard in 1955, introduced magnesium sulphate for control of convulsions in eclampsia and is used worldwide. Considering the low body mass index of indian women, a low dose magnesium sulphate regime has been introduced by some authors. Present study was carried out at tertiary care centre in rural area. Fifty cases of eclampsia were randomly selected to find out the efficacy of low dose magnesium sulphate regime to control eclamptic convulsions. Maternal and perinatal outcome and magnesium toxicity were analyzed. It was observed that 86% cases responded to initial intravenous dose of 4 grams of 20% magnesium sulphate . Eight percent cases, who got recurrence of convulsion, were controlled by additional 2 grams of 20% magnesium sulphate. Six percent cases required shifting to standard Pritchard regime, as they did not respond to low dose magnesium sulphate regime. The average total dose of magnesium sulphate required for control of convulsions was 20 grams ie. 54.4% less than that of standard Pritchard regime. The maternal and perinatal morbidity and mortality in the present study werecomparable to those of standard Pritchard regime. The study did not find a single case of magnesium related toxicity with low dose magnesium sulphate regime. Low dose magnesium sulphate regime was found to be safe and effective in eclampsia.

  20. Low dose rapamycin exacerbates autoimmune experimental uveitis.

    Directory of Open Access Journals (Sweden)

    Zili Zhang

    Full Text Available BACKGROUND: Rapamycin, a potent immune modulator, is used to treat transplant rejection and some autoimmune diseases. Uveitis is a potentially severe inflammatory eye disease, and 2 clinical trials of treating uveitis with rapamycin are under way. Unexpectedly, recent research has demonstrated that low dose rapamycin enhances the memory T cell population and function. However, it is unclear how low dose rapamycin influences the immune response in the setting of uveitis. DESIGN AND METHODS: B10.RIII mice were immunized to induce experimental autoimmune uveitis (EAU. Ocular inflammation of control and rapamycin-treated mice was compared based on histological change. ELISPOT and T cell proliferation assays were performed to assess splenocyte response to ocular antigen. In addition, we examined the effect of rapamycin on activation-induced cell death (AICD using the MitoCapture assay and Annexin V staining. RESULTS: Administration of low dose rapamycin exacerbated EAU, whereas treating mice with high dose rapamycin attenuated ocular inflammation. The progression of EAU by low dose rapamycin coincided with the increased frequency of antigen-reactive lymphocytes. Lastly, fewer rapamycin-treated T cells underwent AICD, which might contribute to exaggerated ocular inflammation and the uveitogenic immune response. CONCLUSION: These data reveal a paradoxical role for rapamycin in uveitis in a dose-dependent manner. This study has a potentially important clinical implication as rapamycin might cause unwanted consequences dependent on dosing and pharmacokinetics. Thus, more research is needed to further define the mechanism by which low dose rapamycin augments the immune response.

  1. Low-dose-rate brachytherapy as the sole radiation modality in the management of patients with early-stage breast cancer treated with breast-conserving therapy: preliminary results of a pilot trial

    International Nuclear Information System (INIS)

    Purpose: We present the preliminary findings of our in-house protocol treating the tumor bed alone after lumpectomy with low-dose-rate (LDR) interstitial brachytherapy in selected patients with early-stage breast cancer treated with breast-conserving therapy (BCT). Methods and Materials: Since March 1, 1993, 60 women with early-stage breast cancer were entered into a protocol of tumor bed irradiation only using an interstitial LDR implant with iodine-125. Patients were eligible if the tumor was ≤3 cm, margins were ≥2 mm, there was no extensive intraductal component, the axilla was surgically staged, and a postoperative mammogram was performed. Implants were placed using a standardized template either at the time of reexcision or shortly after lumpectomy. A total of 50 Gy was delivered at 0.52 Gy/h over a period of 96 h to the lumpectomy bed plus a 2-cm margin. Perioperative complications, cosmetic outcome, and local control were assessed. Results: The median follow-up for all patients is 20 months. Three patients experienced minimal perioperative pain that required temporary nonnarcotic analgesics. There have been four postoperative infections which resolved with oral antibiotics. No significant skin reactions related to the implant were noted and no patient experienced impaired would healing. Early cosmetic results reveal minimal changes consisting of transient hyperpigmentation of the skin at the puncture sites and temporary induration in the tumor bed. Good to excellent cosmetic results were noted in all 19 patients followed up a minimum of 24 months posttherapy. To date, 51 women have obtained 6-12-month follow-up mammograms and no recurrences have been noted. All patients currently have no physical signs of recurrence, and no patient has failed regionally or distantly. Conclusion: Treatment of the tumor bed alone with LDR interstitial brachytherapy appears to be well tolerated, and early results are promising. Long-term follow-up of these patients is

  2. Effect of ultra-low-dose estriol and lactobacilli vaginal tablets (Gynoflor®) on inflammatory and infectious markers of the vaginal ecosystem in postmenopausal women with breast cancer on aromatase inhibitors.

    Science.gov (United States)

    Donders, G; Bellen, G; Neven, P; Grob, P; Prasauskas, V; Buchholz, S; Ortmann, O

    2015-10-01

    This study was a detailed microscopic analysis of the changes of vaginal microflora characteristics after application of 0.03 mg estriol-lactobacilli combination on the vaginal ecosystem in postmenopausal breast cancer (BC) survivors on aromatase inhibitors (AI) with severe atrophic vaginitis. A total of 16 BC women on AI applied daily one vaginal tablet of Gynoflor® for 28 days followed by a maintenance therapy of three tablets weekly for 8 weeks. During four follow up visits a smear from the upper lateral vaginal wall was analysed by phase contrast microscopy at 400 times magnification in order to classify the lactobacillary grades(LBG), bacterial vaginosis (BV), aerobic vaginitis (AV), vulvovaginal candidosis (VVC), proportional number of leukocytes and evidence of parabasal cells and epitheliolysis. LBG improved from 81% LBG-III at entry to 88% LBG-I&IIa after 2 weeks of initial therapy, which further improved upon follow up (p treatment (p < 0.01). While at entry most patients had moderate or severe AV, after maintenance therapy no patient except one had AV. The number of leukocytes dropped dramatically from a score of 1.78 ± 0.70 to 1.06 ± 0.25 which was consistent till the end of the study (p < 0.01). Parabasal cells dropped from a score of 3.4 ± 0.64 at entry to 1.3 ± 0.60 at the final visit (p trend < 0.01). Starting from a low rate of Candida colonisation of 2/14 (14%), a sudden rise to 7/16 (44%) occurred after 2 weeks, to return back to base levels at subsequent visits. The vaginal use of ultra-low dose estriol and lactobacilli results in rapid and enduring improvement of all markers of the vaginal microflora and epithelial vaginal cell quality in women with breast cancer on AI with dyspareunia. Candida may develop soon after its use, but rapidly disappears again upon their prolonged use. Due to its excellent safety profiles and clinical efficacy we recommend this product as first choice in women on AI with severe dyspareunia. PMID:26223323

  3. LOW DOSE RISK, DECISIONS, and RISK COMMUNICATION

    International Nuclear Information System (INIS)

    The objective of this project is to conduct basic research on how people receive, evaluate, and form positions on scientific information and its relationship to low-dose radiation exposure. There are three major areas of study in our research program. First is the development of theories, frameworks and concepts essential to guiding data collection and analysis. The second area is a program of experimental studies on risk perception, evaluation of science information, and the structure of individual positions regarding low-dose exposures. Third is the community-level studies to examine and record how the social conditions, under which science communications take place, influence the development of attitudes and opinions about: low-dose exposures, the available management options, control of radiation risks, and preferences for program and policy goals

  4. [Cervix cancer and pregnancy. Experience of 5 years at the Gynecology-Obstetrics Hospital No. 3, C. M. La Raza from the Mexican Institute of Social Security].

    Science.gov (United States)

    Novoa Vargas, A; Padilla Cortez, M E; Bacelis Castaño, C

    1999-12-01

    Of the 300 clinical files of pregnant women, 22 were associated with cancer plus pregnancy in 5 years. Of them 7 were excluded in the work. 15 patients with CaCu and pregnancy were studied in the Gineco-Obstetric Hospital No. 3 C.M. La Raza of the IMSS México City in a period since 1st of January 1988 to 31st December of 1992. Early menarchia and sexual life, take an important roll in the mexican women as predisponent factors, multideliver and tobacco too. The colposcopy with manage cervix biopsy is the election method of diagnosis, with 99.5% of confiability. In the 15 patients, the estirpe was epidermoid cancer in all of them. The diagnosis of pregnancy age made in the first and third trimester of gestation. Only in 3 patients (20%) were founded visible lesion, this rename the necessity of make detection of CaCu during the pregnancy, because we will can found the cases in preinvader stages or early invader, that cure highly, like the cases seen in this work. Stages preinvader and early invaders during the pregnancy are highly curatives. We concluded that they have worst prognosis of survival, aggressivity and early relapse in patients with pregnancy stage by stage. The last because in the Historical Literature review about this topic, there was statistical relevance about pregnancy in the women with CaCu, using our work for reference. CaCu does change his prognosis associated with the pregnancy. PMID:10692806

  5. Analysis of the expression of genes involved in proliferation and apoptosis in cervical intraepithelial neoplasias and cancer of the cervix uteri

    Directory of Open Access Journals (Sweden)

    V. K. Bozhenko

    2014-08-01

    Full Text Available The viral nature of many female genital cancers is now beyond question. By taking into account this fact, the problem of qualitative assessment ofthenatureofcervicalintraepithelialneoplasia(CINanditsfocusonprogressiontoinvasivecarcinomabecomesquitenatu ral.Studiesof a number of biological markers of carcinogenesis have recently provided a possibility for prospective prediction. The paper con siders the as- pects of importance of the molecular biological markers of proliferation and apoptosis in the etiopathogenesis of genital cancers. It gives the results of examinations of 16 patients with histologically verified squamous cell carcinoma of the cervix uteri, 40 patients di agnosed as having CIN of different grades (CIN-1, CIN-2, CIN-3 — squamous cell carcinoma in situ, and 6 patients with the morphologically unaltered cervi- calepithelium,whosecervicalscrapeswereanalyzedfortheexpressionofthemRNAgenesССNB1,Ki-67,BA G,BCL-2,ESR1,andPRG. It is shown that the molecular genetic findings may be new prognostic markers that reflect the possible disease developmental pathways, sug- gesting the need for further investigation of biomarkers in order to prevent malignancies and to reduce their morbidity.

  6. SU-E-P-58: Dosimetric Study of Conventional Intensity-Modulated Radiotherapy and Knowledge-Based Radiation Therapy for Postoperation of Cervix Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ma, C; Yin, Y [Shandong Tumor Hospital, Jinan, Shandong Provice (China)

    2015-06-15

    Purpose: To compare the dosimetric difference of the target volume and organs at risk(OARs) between conventional intensity-modulated radiotherapy(C-IMRT) and knowledge-based radiation therapy (KBRT) plans for cervix cancer. Methods: 39 patients with cervical cancer after surgery were randomly selected, 20 patient plans were used to create the model, the other 19 cases used for comparative evaluation. All plans were designed in Eclipse system. The prescription dose was 30.6Gy, 17 fractions, OARs dose satisfied to the clinical requirement. A paired t test was used to evaluate the differences of dose-volume histograms (DVH). Results: Comparaed to C-IMRT plan, the KBRT plan target can achieve the similar target dose coverage, D98,D95,D2,HI and CI had no difference (P≥0.05). The dose of rectum, bladder and femoral heads had no significant differences(P≥0.05). The time was used to design treatment plan was significant reduced. Conclusion: This study shows that postoperative radiotherapy of cervical KBRT plans can achieve the similar target and OARs dose, but the shorter designing time.

  7. Exposure to low dose radiation and its effect

    International Nuclear Information System (INIS)

    The title subjects are easily explained. As an introduction, the concept of the ICRP Recommendation (2007) is explained briefly on its use of radiation protection and management. Natural radiation dose to ordinary Japanese is said to be the average 1.5 mSv/y in contrast to the whole world people, 2.4. Medical radiation dose to Japanese is estimated to amount to 2.3 mSv/y, to American, 3.0, and to people of medically advanced nations, 1.92. There are areas always exposed to the natural high dose radiation like Ramsar 10.2 mSv/y (Iran). The effect of such natural low dose has been shown to be all insignificant on cancer mortality in Yangjian area (3.3 mSv/y) in China, on lung cancer risk due to radon in Japan Misasa spa area (>10 mSv/y), and on cancer mortality among 176 thousands nuclear industry workers in Japan (average accumulated dose 12 mSv), etc. There have been such reports as increased bladder cancer in Chernobyl, increased leukemic relative risk of infants whose fathers worked in Sellafield nuclear facility, and acute death/health-injury of residents in the past Lou-Lan area where Chinese nuclear bombs were tested. Fallout data from 1955 to 2011 shows the process of radioactive materials fallen and peaks were due to nuclear tests and Chernobyl/Fukushima Accidents. Basic studies on low dose effect involve those of the radioadoptive response, radiation hormesis, bystander effect and cluster injury of DNA. In low dose-carcinogenesis relationship, presented are models of linear non-threhold (LNT), those estimating lower risk than LNT like linear quadratic (LQ) model, and higher risk like supra-linear model. Risks leading to cancer formation include the occupation and others like medical doctors, tobacco smoking and various anxieties/stresses. (T.T.)

  8. An experimental study on cervix cancer with combination of HSV-TK/GCV suicide gene therapy system and 60Co radiotherapy

    International Nuclear Information System (INIS)

    To evaluate the killing effect of HSV-TK/GCV suicide gene therapy system combined with 60Co radiotherapy on human cervical cancer Hela cell line in vitro and in vivo, and to explore the radiosensitization by HSV-TK/GCV system. HSV-TK/GCV suicide gene therapy system and 60Co radiotherapy were used separately or in combination on human cervical cancer Hela cell line in vitro and in vivo to compare their effects. Colony formation test and the rate of radiosensitization effect (E/O) were employed to observed the radiosensitization by HSV-TK/GCV system. HSV-TK/GCV suicide gene therapy system had strong therapeutic effects on Hela cells in vitro and in vivo (the inhibition rates were 45.8% and 39.5%, respectively), moreover, the combined administration of gene therapy and radiotherapy had stronger therapeutic effects in vitro and in vivo (the inhibition rate was 87.5% in vitro, and the inhibition rate was 87.9% in vivo) (P < 0.01). The inhibition rate by radiotherapy alone was 42.4% in vitro and 35.8% in vivo. The sensitivity of combined therapy to radiotherapy increased more than that of therapy alone, the ability of colony formation decreased (P < 0.01). The rate of radiosensitivity effect (E/O) was 3.17(> 1.4), indicating HSV-TK/GCV system could exert a sensitizing effect on 60Co radiotherapy of the transplanted human cervical cancer cell in nude mice. HSV-TK/GCV system had radiosensitization. Gene therapy combined with radiotherapy may be a good supplementary method for cervix cancer synthetic treatment

  9. Early and Late Bowel Complication Following Irradiation of Cancer of the Uterine Cervix-Whole Pelvis External Irradiation end High-Dose-Rate Interactively Irradiation

    International Nuclear Information System (INIS)

    Cervix cancer is the most common female cancer in Korea. In spite of their relatively local invasive tendency, still 44% of patient will develop recurrent cancer This result suggests that more aggressive local treatment may increase the cure rate but increased complication risk also cannot be avoidable. Various institutions proposed different treatment regimen, but recommended dose were about 4500 cGy for whole pelvis and 8000 cGy at point A, even though they agreed that those doses may not be satisfactory for control of bulky disease. 96 cases of invasive cervical cancer, treated with postoperative or primary radiation therapy were analyzed to determine the complication rate and prognostic factor in our treatment regimen which is 500-1000 cGy higher than other institution. Mean follow up duration was 21 months. Symptomatic patients including mild but persistent abdominal discomfort was 46%, but only 1 patient (1%) had operative treatment because of incomplete obstruction of small bowel. Most symptoms appeared within 12 months and most common complaints were frequent bowel movement. Barium enema and sigmoidoscopy were performed for persistent symptomatic patients. Only one patient had abnormal finding in barium enema which showed inefficiency of this method for detecting bowel complication. Patient age, total tumor dose, total TDF, rectal dose were not significant risk factors for complication, but boost dose, previous history of operation had some relationship with complication risk. Even though dose of point A and rectum is 500-1,000 cGy higher than other institution, such a low rate of severe complications may suggest that fear of complications should not be overestimated than cure rate and the possibility of more aggressive treatment for better local control should not be underestimated

  10. Stimulation of seeds by low dose irradiation

    International Nuclear Information System (INIS)

    The first section of the bibliography lists materials on the stimulation of seeds by low dose irradiation, with particular reference to stimulation of germination and yield. The second section contains a small number of selected references on seed irradiation facilities. (author)

  11. DoReMi workshop on multidisciplinary approaches to evaluating cancer risks associated with low-dose internal contamination; Approches multidisciplinaires pour l'evaluation du risque de cancer associe aux contaminations internes aux faibles doses: synthese du seminaire scientifique organise dans le cadre du projet europeen DoReMi

    Energy Technology Data Exchange (ETDEWEB)

    Laurier, D.; Guseva Canu, I.; Bertho, J.M.; Blanchardon, E.; Rage, E. [Institut de radioprotection et de surete nucleaire, IRSN, Fontenay-aux-Roses Cedex (France); Baatout, S. [Belgian Nuclear Research Centre, SCK-CEN, Mol (Belgium); Bouffler, S. [Health Protection Agency, Centre for Radiation Chemical and Environmental Hazards, HPA-CRCE, Chilton (United Kingdom); Cardis, E. [Centre for Research in Environmental Epidemiology, CREAL, Barcelona (Spain); Gomolka, M.; Kreuzer, M. [Federal Office for Radiation Protection, Department of Radiation Protection and Health, BfS, Neuherberg (Germany); Hall, J. [Inserm U612, Institut Curie, Orsay (France); Kesminiene, A. [International Agency for Research on Cancer, Section of Environment and Radiation, IARC, Lyon (France)

    2012-01-15

    A workshop dedicated to cancer risks associated with low-dose internal contamination was organised in March 2011, in Paris, in the framework of the DoReMi (Low Dose Research towards Multidisciplinary Integration) European Network of Excellence. The aim was to identify the best epidemiological studies that provide an opportunity to develop a multidisciplinary approach to improve the evaluation of the cancer risk associated with internal contamination. This workshop provided an opportunity for in-depth discussions between researchers working in different fields including (but not limited to) epidemiology, dosimetry, biology and toxicology. Discussions confirmed the importance of research on the health effects of internal contamination. Several existing epidemiological studies provide a real possibility to improve the quantification of cancer risk associated with internal emitters. Areas for future multidisciplinary collaborations were identified, that should allow feasibility studies to be carried out in the near future. The goal of this paper is to present an overview of the presentations and discussions that took place during this workshop. (authors)

  12. Activated T-cell Therapy, Low-Dose Aldesleukin, and Sargramostim in Treating Patients With Ovarian, Fallopian Tube, or Primary Peritoneal Cancer That is Stage III-IV, Refractory, or Recurrent

    Science.gov (United States)

    2016-02-15

    Malignant Ovarian Clear Cell Tumor; Malignant Ovarian Serous Tumor; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  13. Dosimetric Considerations to Determine the Optimal Technique for Localized Prostate Cancer Among External Photon, Proton, or Carbon-Ion Therapy and High-Dose-Rate or Low-Dose-Rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Georg, Dietmar, E-mail: Dietmar.Georg@akhwien.at [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Hopfgartner, Johannes [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Gòra, Joanna [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Kuess, Peter [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Kragl, Gabriele [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Berger, Daniel [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Hegazy, Neamat [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Goldner, Gregor; Georg, Petra [Department of Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria); Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University of Vienna/Allgemeines Krankenhaus der Stadt Wien, Vienna (Austria)

    2014-03-01

    Purpose: To assess the dosimetric differences among volumetric modulated arc therapy (VMAT), scanned proton therapy (intensity-modulated proton therapy, IMPT), scanned carbon-ion therapy (intensity-modulated carbon-ion therapy, IMIT), and low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy (BT) treatment of localized prostate cancer. Methods and Materials: Ten patients were considered for this planning study. For external beam radiation therapy (EBRT), planning target volume was created by adding a margin of 5 mm (lateral/anterior–posterior) and 8 mm (superior–inferior) to the clinical target volume. Bladder wall (BW), rectal wall (RW), femoral heads, urethra, and pelvic tissue were considered as organs at risk. For VMAT and IMPT, 78 Gy(relative biological effectiveness, RBE)/2 Gy were prescribed. The IMIT was based on 66 Gy(RBE)/20 fractions. The clinical target volume planning aims for HDR-BT ({sup 192}Ir) and LDR-BT ({sup 125}I) were D{sub 90%} ≥34 Gy in 8.5 Gy per fraction and D{sub 90%} ≥145 Gy. Both physical and RBE-weighted dose distributions for protons and carbon-ions were converted to dose distributions based on 2-Gy(IsoE) fractions. From these dose distributions various dose and dose–volume parameters were extracted. Results: Rectal wall exposure 30-70 Gy(IsoE) was reduced for IMIT, LDR-BT, and HDR-BT when compared with VMAT and IMPT. The high-dose region of the BW dose–volume histogram above 50 Gy(IsoE) of IMPT resembled the VMAT shape, whereas all other techniques showed a significantly lower high-dose region. For all 3 EBRT techniques similar urethra D{sub mean} around 74 Gy(IsoE) were obtained. The LDR-BT results were approximately 30 Gy(IsoE) higher, HDR-BT 10 Gy(IsoE) lower. Normal tissue and femoral head sparing was best with BT. Conclusion: Despite the different EBRT prescription and fractionation schemes, the high-dose regions of BW and RW expressed in Gy(IsoE) were on the same order of magnitude. Brachytherapy techniques

  14. Dosimetric Considerations to Determine the Optimal Technique for Localized Prostate Cancer Among External Photon, Proton, or Carbon-Ion Therapy and High-Dose-Rate or Low-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the dosimetric differences among volumetric modulated arc therapy (VMAT), scanned proton therapy (intensity-modulated proton therapy, IMPT), scanned carbon-ion therapy (intensity-modulated carbon-ion therapy, IMIT), and low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy (BT) treatment of localized prostate cancer. Methods and Materials: Ten patients were considered for this planning study. For external beam radiation therapy (EBRT), planning target volume was created by adding a margin of 5 mm (lateral/anterior–posterior) and 8 mm (superior–inferior) to the clinical target volume. Bladder wall (BW), rectal wall (RW), femoral heads, urethra, and pelvic tissue were considered as organs at risk. For VMAT and IMPT, 78 Gy(relative biological effectiveness, RBE)/2 Gy were prescribed. The IMIT was based on 66 Gy(RBE)/20 fractions. The clinical target volume planning aims for HDR-BT (192Ir) and LDR-BT (125I) were D90% ≥34 Gy in 8.5 Gy per fraction and D90% ≥145 Gy. Both physical and RBE-weighted dose distributions for protons and carbon-ions were converted to dose distributions based on 2-Gy(IsoE) fractions. From these dose distributions various dose and dose–volume parameters were extracted. Results: Rectal wall exposure 30-70 Gy(IsoE) was reduced for IMIT, LDR-BT, and HDR-BT when compared with VMAT and IMPT. The high-dose region of the BW dose–volume histogram above 50 Gy(IsoE) of IMPT resembled the VMAT shape, whereas all other techniques showed a significantly lower high-dose region. For all 3 EBRT techniques similar urethra Dmean around 74 Gy(IsoE) were obtained. The LDR-BT results were approximately 30 Gy(IsoE) higher, HDR-BT 10 Gy(IsoE) lower. Normal tissue and femoral head sparing was best with BT. Conclusion: Despite the different EBRT prescription and fractionation schemes, the high-dose regions of BW and RW expressed in Gy(IsoE) were on the same order of magnitude. Brachytherapy techniques were clearly superior in terms of

  15. A comparison of the biological effects of 125I seeds continuous low-dose-rate radiation and 60Co high-dose-rate gamma radiation on non-small cell lung cancer cells.

    Directory of Open Access Journals (Sweden)

    Zhongmin Wang

    Full Text Available To compare the biological effects of 125I seeds continuous low-dose-rate (CLDR radiation and 60Co γ-ray high-dose-rate (HDR radiation on non-small cell lung cancer (NSCLC cells.A549, H1299 and BEAS-2B cells were exposed to 125I seeds CLDR radiation or 60Co γ-ray HDR radiation. The survival fraction was determined using a colony-forming assay. The cell cycle progression and apoptosis were detected by flow cytometry (FCM. The expression of the apoptosis-related proteins caspase-3, cleaved-caspase-3, PARP, cleaved-PARP, BAX and Bcl-2 were detected by western blot assay.After irradiation with 125I seeds CLDR radiation, there was a lower survival fraction, more pronounced cell cycle arrest (G1 arrest and G2/M arrest in A549 and H1299 cells, respectively and a higher apoptotic ratio for A549 and H1299 cells than after 60Co γ-ray HDR radiation. Moreover, western blot assays revealed that 125I seeds CLDR radiation remarkably up-regulated the expression of Bax, cleaved-caspase-3 and cleaved-PARP proteins and down-regulated the expression of Bcl-2 proteins in A549 and H1299 cells compared with 60Co γ-ray HDR radiation. However, there was little change in the apoptotic ratio and expression of apoptosis-related proteins in normal BEAS-2B cells receiving the same treatment.125I seeds CLDR radiation led to remarkable growth inhibition of A549 and H1299 cells compared with 60Co HDR γ-ray radiation; A549 cells were the most sensitive to radiation, followed by H1299 cells. In contrast, normal BEAS-2B cells were relatively radio-resistant. The imbalance of the Bcl-2/Bax ratio and the activation of caspase-3 and PARP proteins might play a key role in the anti-proliferative effects induced by 125I seeds CLDR radiation, although other possibilities have not been excluded and will be investigated in future studies.

  16. Analysis of the Curative Effect of Preoperative Intra-Arterial Infusion Chemoembolization on Stage,IB2-IIB Uterine Cervix Cancer

    Institute of Scientific and Technical Information of China (English)

    Huashu Li; Fuxiang Liu; Guohe Zhou; Zhaoxia Mo

    2008-01-01

    OBJECTIVE To investigate the short-term and long-term therapeutic efficacy of preoperative intra-arterial infusion chemo-embolization on stage IB2-IIB Uterine cervix cancer (UCC). METHODS A total of 143 patients with Stage IB2-lIB UCC were divided into a clinical trial group and a control group. The patients in the clinical trial group (n/=86) were treated with a combined therapy, i.e. preoperative intra-arterial infusion chemo-embolization, surgical therapy and postoperative radiotherapy, and those in the control group(n=57)were given surgical therapy and post-operative radiotherapy. The adverse effects, changes in local lesion and pathological examinations of the cancer, and the state during the surgery were observed after the intra-arterial infusion chemo-embolization. The survival rate and recurrence rate between the two groups were compared. RESUITS The total effective rate of the intra- arterial infusion chemo-embolization on Stage IB2-IIB UCC was 93.02%. The treatment could reduce tumor size, bring about retro-conversions of the clinical stage of the tumors and pathological grade of the cancer cells, and decrease the quantity, of intra-operative blood loss as well as the operating time. It could significantly improve the 5-year survival rate (P<0.05), and reduce the 2 and 5-yeartumor recurrence rates(P<0.05). Moreover, its side effects were little. CONCLUSIOAN Preoperative intra-arterial infusion chemo-embolization can create conditions for radical operation, lower the postoperative recurrence rate, and improve the prognosis in the patients with UCC. It is an effctive therapy in treating UCC.

  17. Global DNA methylation responses to low dose radiation exposure

    International Nuclear Information System (INIS)

    Full text: High radiation doses cause breaks in the DNA which are considered the critical lesions in initiation of radiation-induced cancer. However, at very low radiation doses relevant for the general public, the induction of such breaks will be rare, and other changes to the DNA such as DNA methylation which affects gene expression may playa role in radiation responses. We are studying global DNA methylation after low dose radiation exposure to determine if low dose radiation has short- and/or long-term effects on chromatin structure. We developed a sensitive high resolution melt assay to measure the levels of DNA methylation across the mouse genome by analysing a stretch of DNA sequence within Long Interspersed Nuclear Elements-I (LINE I) that comprise a very large proportion of the mouse and human genomes. Our initial results suggest no significant short-term or longterm) changes in global NA methylation after low dose whole-body X-radiation of 10 J1Gyor 10 mGy, with a significant transient increase in NA methylation observed I day after a high dose of I Gy. If the low radiation doses tested are inducing changes in bal DNA methylation, these would appear to be smaller than the variation observed between the sexes and following the general stress of the sham-irradiation procedure itself. This research was funded by the Low Dose Radiation Research Program, Biological and Environmental Research, US DOE, Grant DE-FG02-05ER64104 and MN is the recipient of the FMCF/BHP Dose Radiation Research Scholarship.

  18. Lymphoma of the Cervix

    Directory of Open Access Journals (Sweden)

    Juanita Parnis

    2012-01-01

    Full Text Available Primary non-Hodgkins lymphoma of the uterine cervix is a very rare diagnosis. A 54-year-old woman presented with a 3-month history of postmenopausal bleeding per vaginum. On examination, a friable, fungating lesion was seen on the cervix. Histology revealed a CD 20 positive high-grade non-Hodgkin’s diffuse large B cell lymphoma from cervical biopsies and endometrial curettage. She was diagnosed as stage IE after workup and subsequently treated with six cycles of R-CHOP chemotherapy followed by radiotherapy of the involved field.

  19. Particularities in the biodistribution and pharmacokinetic of labeled peptide with 99mTc in regional administration of patient with cervix cancer

    International Nuclear Information System (INIS)

    This study had as objective characterize the biodistribution pharmacokinetic and dosimetry of labeled peptide with 99mTc in two dose levels, prepared in 2ml, starting from its intratumoral injection in patient with cervix cancer. The protocol selection to use, the correction and calculate methods were analysis object keeping in mind that antecedents of studies of this type didn't exist and that the administration intratumoral can originate new problems not foreseen in conventional intravenous studies. This study carried out mensurations of sensibility that should be corrected in a particular way. A careful protocol of acquisition was designed able to detect the behavior of the radio-peptide in the time, with a serial gathering of samples of blood and urine until the 24 hours, as well as images of the whole body up to 48h. For the quantification of the images they were necessary also the classic corrections of background and of overlapping of structures. The labeled peptide with 99mTc administered for intralesional way, like it was of waiting it presented a very high reception tumoral, being this maxim in the first images, however the product was absorbed quickly in blood, reaching its maximum levels in most of the patients as much in serum as in total blood, in the first 5-15 minutes of having administered. (Author)

  20. Definitive radiotherapy for uterine cervix cancer: long term results for patients treated in the period from 1998 till 2002 at the Institute of Oncology Ljubljana

    International Nuclear Information System (INIS)

    The aim of this retrospective study was to analyse results of the two-dimensional (2D) uterine cervix cancer treatment at the Institute of Oncology Ljubljana from 1998 till 2002, before the three-dimensional (3D) approach was introduced in our clinical practice. Ninety-eight patients with the following FIGO stage distribution were analysed: 10% IB, 7% IIA, 37% IIB, 4% IIIA and 42% IIIB. The influence of age, haemoglobin level, histology, grade, stage, lymph node status, cumulative point A dose, and an overall treatment time on the survival and local control (LC) were evaluated. Acute and late side effects were assessed. Five and 8-year overall survival (OS), disease specific survival (DSS) and LC rate were as follows: 47.2% and 43.0%, 54.7% and 53.4%, 74.9% and 72.5%, respectively. Point A dose and histology of the tumour influenced OS, positive lymph nodes DSS and point A dose LC rate. Probability of grade three and four late complications in the first five years was 7.1% for gastrointestinal tract and 3.3% for genitourinary system and vagina. Point A dose was independent predictor of OS and LC rate, lymph node status predicted DSS, while histology of the tumour influenced OS

  1. The OER at low dose-rates

    International Nuclear Information System (INIS)

    The author comments on a letter (Kal, H.B., and Barendsen, G.W., 1976, Br. J. Radiol., vol. 49, 1049) reviewing published values of the OER for low dose-rate γ-rays. Artefacts of the system may have been responsible for one very low OER value taken from work carried out in the early 1960s, but later work in which these problems were eliminated still yielded OER values significantly lower than for acute X- or γ-ray exposures. Consideration is given to significance of this reduction in OER for γ-rays at the low dose-rates characteristic of interstitial implants. The performance of these interstitial implants may be comparable with the most sophisticated and expensive pion or heavy ion treatments. (U.K.)

  2. Ionizing radiation: effects of low doses

    International Nuclear Information System (INIS)

    This article deals with the important and delicate subject posed by the study of the action on Man's health of low doses of ionizing radiation. A number of fundamental notions whose knowledge is indispensable in order to avoid doubtful meanings or misunderstandings are noted in this article. Following the reminder of these notions, the characteristics of the various types of pathological effects of radiation are indicated, as well as how it is possible for effects which are named ''aleatory'' to be evaluated with care so as to limit risks at low doses. The reader will easily understand that this article has to be somewhat didactic - it seemed best to proceed by well defined stages and to clearly specify numerous concepts whose meanings are not always clearly defined when such problems are treated

  3. Cytogenetic effects of low-dose radiation

    International Nuclear Information System (INIS)

    The effects of ionizing radiation on chromosomes have been known for several decades and dose-effect relationships are also fairly well established in the mid- and high-dose and dose-rate range for chromosomes of mammalian cells. In the range of low doses and dose rates of different types of radiation few data are available for direct analysis of the dose-effect relationships, and extrapolation from high to low doses is still the unavoidable approach in many cases of interest for risk assessment. A review is presented of the data actually available and of the attempts that have been made to obtain possible generalizations. Attention is focused on some specific chromosomal anomalies experimentally induced by radiation (such as reciprocal translocations and aneuploidies in germinal cells) and on their relevance for the human situation. (author)

  4. Epigenomic Adaptation to Low Dose Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Gould, Michael N. [Univ. of Wisconsin, Madison, WI (United States)

    2015-06-30

    The overall hypothesis of this grant application is that the adaptive responses elicited by low dose ionizing radiation (LDIR) result in part from heritable DNA methylation changes in the epigenome. In the final budget period at the University of Wisconsin-Madison, we will specifically address this hypothesis by determining if the epigenetically labile, differentially methylated regions (DMRs) that regulate parental-specific expression of imprinted genes are deregulated in agouti mice by low dose radiation exposure during gestation. This information is particularly important to ascertain given the 1) increased human exposure to medical sources of radiation; 2) increased number of people predicted to live and work in space; and 3) enhanced citizen concern about radiation exposure from nuclear power plant accidents and terrorist ‘dirty bombs.’

  5. Harderian Gland Tumorigenesis: Low-Dose and LET Response.

    Science.gov (United States)

    Chang, Polly Y; Cucinotta, Francis A; Bjornstad, Kathleen A; Bakke, James; Rosen, Chris J; Du, Nicholas; Fairchild, David G; Cacao, Eliedonna; Blakely, Eleanor A

    2016-05-01

    Increased cancer risk remains a primary concern for travel into deep space and may preclude manned missions to Mars due to large uncertainties that currently exist in estimating cancer risk from the spectrum of radiations found in space with the very limited available human epidemiological radiation-induced cancer data. Existing data on human risk of cancer from X-ray and gamma-ray exposure must be scaled to the many types and fluences of radiations found in space using radiation quality factors and dose-rate modification factors, and assuming linearity of response since the shapes of the dose responses at low doses below 100 mSv are unknown. The goal of this work was to reduce uncertainties in the relative biological effect (RBE) and linear energy transfer (LET) relationship for space-relevant doses of charged-particle radiation-induced carcinogenesis. The historical data from the studies of Fry et al. and Alpen et al. for Harderian gland (HG) tumors in the female CB6F1 strain of mouse represent the most complete set of experimental observations, including dose dependence, available on a specific radiation-induced tumor in an experimental animal using heavy ion beams that are found in the cosmic radiation spectrum. However, these data lack complete information on low-dose responses below 0.1 Gy, and for chronic low-dose-rate exposures, and there are gaps in the LET region between 25 and 190 keV/μm. In this study, we used the historical HG tumorigenesis data as reference, and obtained HG tumor data for 260 MeV/u silicon (LET ∼70 keV/μm) and 1,000 MeV/u titanium (LET ∼100 keV/μm) to fill existing gaps of data in this LET range to improve our understanding of the dose-response curve at low doses, to test for deviations from linearity and to provide RBE estimates. Animals were also exposed to five daily fractions of 0.026 or 0.052 Gy of 1,000 MeV/u titanium ions to simulate chronic exposure, and HG tumorigenesis from this fractionated study were compared to the

  6. A consideration of low dose radiation effects on human health

    International Nuclear Information System (INIS)

    On March 11, 2011, an earthquake categorized as 9 Mw occurred off the northeast coast of Japan. The subsequent destructive tsunami disabled emergency units of Fukushima Dai'ichi Nuclear Power Plant and caused partial meltdown of reactors and explosions. Resulting radiation releases forced large evacuations, bore concerns about food and water and fears against human health. In this manuscript, we described the effect of radiation, especially low dose radiation below 100 mSv, on cancer risk, focusing on fetuses and children. (author)

  7. Genomic Instability Induced by Low Dose Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Evans, Helen H.

    2006-07-15

    The goal of this project was to determine if genomic instability could be initiated by poorly repaired DNA damage induced by low doses of ionizing radiation leading to a mutator phenotype. Human cells were irradiated, then transfected with an unirradiated reporter gene at various times AFTER exposure. The vector carried an inactive GFP gene that fluoresced when the gene was activated by a delayed mutation. Fluorescent cells were measured in the interval of 50 hours to four days after transfection. The results showed that delayed mutations occurred in these cells after exposure to relatively low doses (0.3-1.0 Gy) of low or high ionizing radiation, as well as after treatment with hyrodgen peroxide (30-100 micromolar). The occurrence was both dose and time dependent, often decreasing at higher doses and later times. No marked difference was observed between the response of mis-match repair-proficient and -deficient cell lines. Although the results were quite reproducible within single experiments, difficulties were observed from experiment to experiment. Different reagents and assays were tested, but no improvement resulted. We concluded that this method is not sufficiently robust or consisent to be useful in the assay of the induction of genomic instability by low doses of radiation, at least in these cell lines under our conditions.

  8. More studies pending of low-dose radiation

    International Nuclear Information System (INIS)

    Workers in the 17 US Department of Energy's nuclear plants around the country are not the only sources of data on the health effects of low-dose radiation exposure. Those who live near these plants or work in other kinds of nuclear facilities are also candidates for study. This approach in the US has been prompted in part by the experience in Britain. A series of clusters that involve small numbers of cases of leukemia has been reported there, occurring in several areas where nuclear facilities are located. In the US, the Radiation Epidemiology Branch of the National Cancer Institute in Bethesda, Md, is completing a report on the results of a study of deaths from cancer among populations living near nuclear facilities. Epidemiologists have collected reports of deaths from cancer from 107 counties containing, or adjacent to, 62 nuclear facilities

  9. Complex damage, low doses and Bystander effects

    International Nuclear Information System (INIS)

    Ionizing radiations of all types can produce a wide array of biological effects that overlap with those produced by many other genotoxic agents. Ionizing radiation, however, has unique features that sets it apart and these features are likely to dominate its modes of action and consequences, especially at low doses. Radiation insult is always in the form of highly structured 'tracks' along the paths of moving charged particles. This feature largely determines the spectrum of initial DNA damage produced in cells or people, the repairability of the damage by cellular processes, and its spatial and temporal distribution in the irradiated material. At the DNA level a substantial proportion of the initial damage is clustered over a few base pairs within a few nanometres of the track, thereby forming local complex damage consisting of several strand breaks and/or damaged bases. Simple double-strand breaks are in the minority compared to more complex combinations, even from so-called sparsely-ionizing (or low-LET) radiations. At low doses, the nature of the radiation tracks determines also the distributions of the primary complex lesions over the larger subcellular, cellular and tissue scales. At exposure levels of natural background radiation and also in most situations of occupational or diagnostic medical exposure, cells are traversed by single isolated individual tracks, so it is the biological capabilities of these single tracks that must determine the probability of harmful effects, if any. Thus, questions relating to the linear no-threshold hypothesis versus thresholds, hormesis, hypersensitivity, and so on, reduce at the low-dose end to understanding the capabilities and consequences of a single track, or a small number, and the persistence and range of its influence in tissue. Much is now understood about the nature and consequences of immediate 'targeted' radiation damage in cells from radiation tracks in them and near their DNA. However, over the last decade

  10. Epidermoid Carcinoma of the Cervix and Pregnancy. A case presentation.

    Directory of Open Access Journals (Sweden)

    Práxedes Rojas Quintana

    2007-12-01

    Full Text Available A 25 year-old female patient with a 12 week pregnancy was presented. She was diagnosed with an ultered Pap test. She was referred to the cervix uterine pathology specialist where an exophytic lesion compatible to cervix uterine cancer in advanced stages. The treatment as well as the conduct followed by the specialist was really hard due to the patient´s pregnant condition.

  11. Shape priors for segmentation of the cervix region within uterine cervix images

    Science.gov (United States)

    Lotenberg, Shelly; Gordon, Shiri; Greenspan, Hayit

    2008-03-01

    The work focuses on a unique medical repository of digital Uterine Cervix images ("Cervigrams") collected by the National Cancer Institute (NCI), National Institute of Health, in longitudinal multi-year studies. NCI together with the National Library of Medicine is developing a unique web-based database of the digitized cervix images to study the evolution of lesions related to cervical cancer. Tools are needed for the automated analysis of the cervigram content to support the cancer research. In recent works, a multi-stage automated system for segmenting and labeling regions of medical and anatomical interest within the cervigrams was developed. The current paper concentrates on incorporating prior-shape information in the cervix region segmentation task. In accordance with the fact that human experts mark the cervix region as circular or elliptical, two shape models (and corresponding methods) are suggested. The shape models are embedded within an active contour framework that relies on image features. Experiments indicate that incorporation of the prior shape information augments previous results.

  12. Locoregional IL-2 low dose applications for gastrointestinal tumors

    Institute of Scientific and Technical Information of China (English)

    Zachary Krastev; Willem Den Otter; V Koltchakov; R Tomova; S Deredjian; A Alexiev; D Popov; B Tomov; Jan-Willem Koten; John Jacobs

    2005-01-01

    AIM: To explore the feasibility of local interleukin 2 (IL-2)in patients with different forms of abdominal cancer. This required experimentation with the time interval between IL-2 applications and the methods of application.METHODS: Sixteen patients with stages Ⅲ and Ⅳ of gastrointestinal malignancies (primary or metastatic) who were admitted to our Department of Gastroenterology were treated with locoregionally applied IL-2 in low doses.RESULTS: No major problems applying locoregional IL-2 were encountered. In 6 out of 16 patients, a modest but clinically worthwhile improvement was obtained. Adverse effects were minimal, The therapeutic scheme was well tolerated, even in patients in a poor condition.CONCLUSION: This study demonstrates the feasibility of low dose locoregional IL-2 application in advanced abdominal cancer. Local IL-2 therapy gives only negligible adverse effects. The results suggest that it is important to apply intratumorally. Local IL-2 may be given adjunct to standard therapeutic regimes and does not imply complex surgical interventions. These initial results are encouraging.

  13. Biological effect of low dose radiation

    International Nuclear Information System (INIS)

    This document describes the recent findings in studies of low dose radiation effect with those by authors' group. The low dose radiation must be considered in assessment of radiation effects because it induces the biological influence unexpected hitherto; i.e., the bystander effect and genetic instability. The former is a non-targeted effect that non-irradiated cells undergo the influence of directly irradiated cells nearby, which involves cell death, chromosome aberration, micronucleus formation, mutation and carcinogenesis through cellular gap junction and/or by signal factors released. Authors' group has found the radical(s) possessing as long life time as >20 hr released from the targeted cells, a possible mediator of the effect; the generation of aneuploid cells as an early carcinogenetic change; and at dose level <10 Gy, activation of MAPK signal pathway leading to relaxation of chromatin structure. The genetic instability means the loss of stability where replication and conservation of genome are normally maintained, and is also a cause of the late radiation effect. The group has revealed that active oxygen molecules can affect the late effect like delayed cell death, giant cell formation and chromosome aberration, all of which lead to the instability, and is investigating the hypothesis that the telomere instability resulted from the abnormal post-exposure interaction with its nuclear membrane or between chromatin and nuclear matrix, is enhanced by structural distortion of nuclear genes. As well, shown is the possible suppression of carcinogenesis by p53. The group, to elucidate the mechanism underlying the low dose radiation effect, is conducting their studies in consideration of the sequential bases of physical, chemical and biological processes. (R.T.)

  14. Low dose radiation and diabetes mellitus

    International Nuclear Information System (INIS)

    Induction of hormesis and adaptive response by low-dose radiatio (LDR) has been extensively indicated. It's mechanism may be related with the protective protein and antioxidants that LDR induced, which take effects on the diabetes mellitus (DM) and other diseases. This review will summarize available dat with emphasis on three points: the preventive effect of LDR on the development of diabetes, the therapeutic effect of LDR on diabetic complications and possible mechanisms by which LDR prevents the development of diabetes and diabetic complications. Finally, the perspectives of LDR clinical, diabetes-related implication are discussed. (authors)

  15. An evidence-based estimate of the appropriate rate of utilization of radiotherapy for cancer of the cervix

    International Nuclear Information System (INIS)

    Purpose: Current estimates of the proportion of cancer patients who will require radiotherapy (RT) are based almost entirely on expert opinion. The objective of this study was to calculate the proportion of incident cases of cervical cancer that should receive RT by application of an evidence-based approach. Methods and Materials: A systematic review of the literature was done to identify indications for RT for cervical cancer and to ascertain the level of evidence that supported each indication. A survey of Canadian gynecologic oncologists and radiation oncologists who treat cervical cancer was done to determine the level of acceptance of each indication among doctors who practice in the field. An epidemiologic approach was then used to estimate the incidence of each indication for RT in a typical North American population of patients with cervical cancer. Results: The systematic review of the literature identified 29 different indications for RT for cervical cancer. The majority of the 75 experts who responded to the mail survey stated that they 'usually' or 'always' recommended RT in all but one of the clinical situations that were identified as indications for RT on the basis of the systematic review. The analysis of epidemiologic data revealed that, in a typical North American population, 65.4% ± 2.5% of cervical cancer cases will develop one or more indications for RT at some point in the course of the illness, 63.4% ± 2.3% will develop indications for RT as part of their initial management, and 2.0% ± 0.9% will develop indications for RT for progressive or recurrent disease. The effects of variations in case mix on the need for RT was examined by sensitivity analysis, which suggested that the maximum plausible range for the appropriate rate of utilization of RT was 54.3% to 67.9%. The proportion of cases that required RT was stage dependent: 10.6% ± 1.2% in Stage IA, 74.9% ± 1.3% in Stage IB, 100% in Stages II and III, and 97.2% ± 1.1% in Stage IV

  16. 多层螺旋CT低剂量扫描在监测早期肺癌动态进展的应用价值研究%Evaluation of low-dose multislice spiral CT scanning in monitoring the dynamic progress of patients with lung cancer at early stage

    Institute of Scientific and Technical Information of China (English)

    邢雪莲

    2013-01-01

    Objective To investigate the value of multislice spiral CT ( MSCT ) low dose scanning in the monitoring of dynamic progress of patients with lung cancer at early stage. Methods 300 patients with lung cancer at early stage were closely followed-up, and their ordinary CT and low-dose CT image characteristics were analyzed. Results 1. In the diagnosis of early lung cancer respectively for the diameter less than 5mm, 5-10mm and greater than 10mm, there was no significant difference between the ordinary CT scan and the low-dose CT scan diagnosis ( P >0. 05 ). 2. In the follow-ups, there were 31 lesions without significant change, and 90 lesions became larger, 12 lesions of which had metastasis. Conclusion Multislice spiral CT scanning can relatively detect lung cancer lesions earlier and cause smaller radiation damage.%目的 探讨多层螺旋CT低剂量扫描在监测早期肺癌动态进展的价值.方法 对300例早期肺癌患者密切随访,分析其普通CT及低剂量CT图像特点.结果 (1)在直径小于5 mm,5~10 mm及大于10 mm的早期肺癌诊断中,普通CT与低剂量CT诊断符合率间无统计学差异(P>0.05).(2)随访过程中,31例病灶无明显变化,90例病灶径线变大.其中12例病灶出现转移.结论 多层螺旋CT低剂量扫描能够早期发现肺癌病灶,对受检者辐射损伤小,具有较高的应用价值.

  17. Dose Effect Relationship for Late Side Effects of the Rectum and Urinary Bladder in Magnetic Resonance Image-Guided Adaptive Cervix Cancer Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Georg, Petra, E-mail: petra.georg@akhwien.at [Department of Radiotherapy, Medical University of Vienna, Vienna (Austria); Poetter, Richard; Georg, Dietmar; Lang, Stefan; Dimopoulos, Johannes C.A.; Sturdza, Alina E.; Berger, Daniel; Kirisits, Christian [Department of Radiotherapy, Medical University of Vienna, Vienna (Austria); Doerr, Wolfgang [Department of Radiotherapy, Medical University of Vienna, Vienna (Austria); Department of Radiotherapy and Radiation Oncology, Medical Faculty Carl Gustav Carus, University of Technology Dresden, Dresden (Germany)

    2012-02-01

    Purpose: To establish dose-response relationships for late side effects of the rectum and bladder in cervix cancer patients after magnetic resonance image-guided adaptive brachytherapy (IGABT). Methods and Materials: A cohort of 141 patients was treated with 45 to 50.4 Gy with or without cisplatin plus 4 fractions of 7 Gy IGABT. Doses for the most exposed 2, 1, and 0.1-cm{sup 3} (D{sub 2cc}, D{sub 1cc}, D{sub 0.1cc}) volumes of the rectum and bladder were converted into the equivalent dose in 2 Gy fractions (EQD2), using a linear quadratic model ({alpha}/{beta} = 3 Gy). Late side effects were prospectively assessed (using late effects in normal tissues subjective, objective, management and analytic [LENT SOMA]) scales. Dose-response relationships were determined by logit analyses. Results: Eleven patients developed rectal side effects, and 23 patients had urinary side effects. A significant dose effect was found for all rectal dose-volume histogram (DVH) parameters for patients with side effect grades of 1 to 4 but was only significant for D{sub 2cc} and D{sub 1cc} for grades {>=}2. The ED10 values for D{sub 2cc} were 73 Gy for grades 1 to 4 and 78 Gy for grades 2 to 4 rectal morbidity. For bladder side effects, a significant dose effect was shown for all DVH parameters for complication grades {>=}2; the respective ED10 was 101 Gy. Conclusions: Well-defined dose-response curves could be established for D{sub 2cc} in the rectum and the urinary bladder.

  18. Genes activated by low dose radiation

    International Nuclear Information System (INIS)

    Gene expression profiles were examined in the mouse kidney and testis in order to investigate the molecular mechanisms of the life span-shortening effect of low dose-rate radiation. C57BL/6J male mice (7-8 wks old) were irradiated by cesium-137 gamma-rays for 485 days at rates of 0, 32, 650 and 13,000 nGy/min and organs were excised out. Gene expression was analyzed with cDNA microarray Illumina Sentrix Mouse-6. In the kidney, 4 genes concerning mitochondrial respiration (oxidative phosphorylation) were found to be up-regulated at the middle and high dose rates (expression level changed in >1.6 folds by irradiation). Significantly modulated genes were in 16 clusters, which exerted elevated expression level dose rate-dependently and found to be categorized in cytoplasm/mitochondria/energy pathways by the database ''Gene Ontology''. In the testis, gene expression pattern was different from that in kidney. Clustering analysis and database revealed that up-regulated genes belonged to ''DNA repair'', ''response to DNA damage'', DNA replication'' and ''Mitotic cell cycles''. Thus low dose radiation can cause the cellular oxidative stress by elevated respiratory activity in the kidney, and a type of emergent biological response in the testis. (R.T.)

  19. [Complications of low-dose amiodarone].

    Science.gov (United States)

    Feigl, D; Gilad, R; Katz, E

    1991-11-15

    Complications of low-dose amiodarone in 83 patients, in whom the drug was effective and who were followed for 1-13 years, are presented. Hypothyroidism was diagnosed in 11 (in 8 by the finding of elevated TSH). In 2 of the 3 in whom clinical signs of hypothyroidism were evident, amiodarone was continued, but thyroxine was also given. In 5 others thyrotoxicosis ensued. Propylthiouracil (PTU) was given and amiodarone was discontinued. PTU was then stopped within 4-8 months, without recurrence of the hyperthyroidism. In 1 patient pneumonitis resolved spontaneously a few weeks after stopping amiodarone. Because of gastrointestinal distress amiodarone was stopped in 1 patient. In none were liver enzymes elevated, nor was the nervous system affected clinically. Photosensitivity in 6 patients and skin discoloration in 2 did not necessitate discontinuation of the drug. Blurred vision was reported by 4, but its connection with amiodarone was not proven. There was sinus bradycardia in 2. There was no arrhythmic effect of amiodarone seen on ECG nor on Holter monitoring, nor was there any mortality. We conclude that amiodarone in low doses causes many complications, most of them mild and transient. However, in only a few cases is discontinuation of the drug indicated. PMID:1752553

  20. Comparison of CT based-CTV plan and CT based-ICRU38 plan in brachytherapy planning of uterine cervix cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jung Keun; Han, Tae Jong [Jeonju Univ., Jeonju (Korea, Republic of)

    2007-09-15

    Purpose : In spite of recent remarkable improvement of diagnostic imaging modalities such as CT, MRI, and PET and radiation therapy planing systems, ICR plan of uterine cervix cancer, based on recommendation of ICRU38(2D film-based) such as point A, is still used widely. A 3-dimensional ICR plan based on CT image provides Dose-Volume Histogram(DVH) information of the tumor and normal tissue. In this study, we compared tumor-dose, rectal-dose and bladder-dose through an analysis of DVH between CTV plan and ICRU38 plan based on CT image. Method and Material : We analyzed 11 patients with a cervix cancer who received the ICR of Ir-192 HDR. After 40Gy of external beam radiation therapy, ICR plan was established using PLATO(Nucletron) v.14.2 planning system. CT scan was done to all the patients using CT-simulator(Ultra Z, Philips). We contoured CTV, rectum and bladder on the CT image and established CTV plan which delivers the 100% dose to CTV and ICRU plan which delivers the 100% dose to the point A. Result : The volume(average{+-}SD) of CTV, rectum and bladder in all of 11 patients is 21.8{+-}6.6cm{sup 3}, 60.9{+-}25.0cm{sup 3}, 111.6{+-}40.1cm{sup 3} respectively. The volume covered by 100% isodose curve is 126.7{+-}18.9cm{sup 3} in ICRU plan and 98.2{+-}74.5cm{sup 3} in CTV plan(p=0.0001), respectively. In (On) ICRU planning 22.0cm{sup 3} of CTV volume was not covered by 100% isodose curve in one patient whose residual tumor size is greater than 4cm, while more than 100% dose was irradiated unnecessarily to the normal organ of 62.2{+-}4.8cm{sup 3} other than the tumor in the remaining 10 patients with a residual tumor less than 4cm in size. Bladder dose recommended by ICRU 38 was 90.1{+-}21.3% and 68.7{+-}26.6% in ICRU plan and in CTV plan respectively(p=0.001) while rectal dose recommended by ICRU 38 was 86.4{+-}18.3% and 76.9{+-}15.6% in ICRU plan and in CTV plan, respectively(p=0.08). Bladder and rectum maximum dose was 137.2{+-}50.1%, 101.1{+-}41.8% in ICRU plan

  1. Sentinel-lymph node procedure in breast, uterine cervix, prostate, vulva and penile cancers: Practical methodology; La pratique de la technique du ganglion sentinelle dans diverses indications: sein, col uterin, prostate, vulve et verge. Methodologie pratique

    Energy Technology Data Exchange (ETDEWEB)

    Brenot-Rossi, I. [Centre de Lutte Contre le Cancer, Institut Paoli-Calmettes, Service de Medecine Nucleaire, 13 - Marseille (France)

    2008-08-15

    The nodal status is the strongest prognostic factor in early stage cancers. The sentinel-lymph node (S.L.N.) is defined as the first draining lymph node of an organ; the lymph node status is determined by the histological results of S.L.N.. The lymphadenectomy, with high morbidity, is realised only in case of metastatic S.L.N.. The S.L.N. identification, in most of cases, is performed using the combination of blue dye and radiocolloid {sup 99m}Tc injections. The purpose of this article is to give some practical details about the S.L.N. isotopic procedure in breast cancer, vulva and penile cancer, uterine cervix and prostate cancer. (author)

  2. Risk of Low Dose/Low Dose Rate Ionizing Radiation to Humans Symposium at the EMS 2009 Annual Meeting - September 2006

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, William F.; von Borstel, Robert C.; Brenner,; Redpath, J. Leslie; Erickson, Barbra E.; Brooks,

    2009-11-12

    The low dose symposium thoughtfully addressed controversy of risk from low dose radiation exposure, hormesis and radon therapy. The stem cell symposium cogently considered the role of DNA damage and repair in hematopoietic stem cells underlying aging and malignancy and provocatively presented evidence that stem cells may have distinct morphologies and replicative properties, as well as special roles in cancer initiation. In the epigenetics symposium, studies illustrated the long range interaction of epigenetic mechanisms, the roles of CTCF and BORIS in region/specific regulation of epigenetic processes, the impact of DNA damage on epigenetic processes as well as links between epigenetic mechanisms and early nutrition and bystander effects.

  3. The role of polymorphisms of genes repair pathway to the radiotoxicity in patients with cancer of the cervix

    International Nuclear Information System (INIS)

    Background: In Brazil, cervical cancer is the second most common among women. Radiation therapy is part of its interdisciplinary management, playing an important role in their loco regional control. The major challenge of modern medicine in radiotherapy is to develop predictive methods that can determine the level of radiosensitivity of the patient and the healthy surrounding tissue in order to individualize the prescribed radiation dose, to prevent severe side effects and promoting better local tumor control. This study evaluated the acute and chronic adverse effects on the skin, lower gastrointestinal tract and urinary tract of radiotherapy in 47 cervical cancer patients. Methods and Materials: Biological material was collected and DNA from peripheral blood was extracted of ali patients studied. The fragments of TP53 and ATM were amplified to be sequenced, to verify if there are any polymorphisms witch could be responsible to the radiosensitivity of the patients. Results and Discussion: In a univariate analysis, the variable age was strongly associated with a risk of acute toxicity skin (p=O,023). Patients that received a high dose of external beam radiation and patients who have undergone brachytherapy, showed a significantly higher incidence of chronic urinary tract toxicity (p=O,031) and (p=O,019), respectively. The exchange G>A in the position 5557 of the A TM gene was significantly associated with the risk of acute lower gastrointestinal tract (p=O,008). There wasn't association between the other TP53 polymorphisms analyzed and the frequency of side effects (p>O,05). Our data revealed that patients who evolved significant association presented death (p=O,019) with the increase of chronic skin radiossensitivity. Conclusions: These observations corroborate the importance of investigating the genetic profile to predict adverse side effects in cervical cancer patients undergoing radiotherapy. These genes have an important role in DNA repair pathways and probably

  4. Detection of Cervical Cancer through Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy at Mymensingh Medical College Hospital.

    Science.gov (United States)

    Rahman, M F; Akhter, S N; Alam, M J; Sarker, A S; Uddin, M J; Bashar, A; Banu, S

    2016-07-01

    Cervical cancer is the second most common cause of cancer related morbidity and mortality in women with 50% mortality rate. It is preventable if cervical cellular changes are detected and managed at early stage. This was a retrospective study conducted at VIA center of outpatient department and Colposcopy clinic at in-patient department of Mymensingh Medical College Hospital, Bangladesh covering a period from September 2013 to November 2014. Objective of this study was detection of cervical cancer and precancerous condition amongst patients reported to VIA center and Colposcopy clinic. In primary screening at VIA Center, total respondents were 3604, their mean age was 35.9 and highest were in the age group 31 to 40 years. At VIA center, 110(3.05%) were found positive and highest were between 31 to 40 years. In Colposcopy Clinic, out of 700 patients, 51.7% were CIN 1, 4.9% CIN 2, 1.4% CIN 3, invasive carcinoma was 0.3% and unsatisfactory or inconclusive were 34.3%. Most of the respondents were housewives and majority had poor monthly income. Amongst respondents, 72.1% were from rural area and Colposcopic findings revealed in 62.5% abnormal cervical changes, 46.5% were from rural area. Mean age at marriage or age at first coitus was found 16.25 years and 92.7% were in 11 to 20 years. Maximum abnormal cervical findings including CIN were between the ages ranged from 11 to 20 years of marriage age. In patients having 1 - 5 number of child having abnormal (58%) cervical changes, 48% were CIN 1. Histopathology reports found 19.6% CIN 1 (Total CIN 20.7%), cervical carcinoma 1.3%, inflammatory 7.0% and 0.42% cases were reported normal. Amongst 438 histopathology advised cases, 230 respondent's reports with patients were not available. VIA followed by Colposcopy has been a feasible, easy and reliable tools for screening cervical cancer in Bangladesh. PMID:27612882

  5. Low dose irradiation creep of pure nickel

    International Nuclear Information System (INIS)

    A detailed climb-controlled glide model of low dose irradiation creep has been developed to rationalize irradiation creep data of pure nickel irradiated in a light ion irradiation creep apparatus. Experimental irradiation creep data were obtained to study the effects of initial microstructure and stress on low dose irradiation creep in pure nickel. Pure nickel specimens (99.992% Ni), with three different microstructures, were irradiated with 17 or 15 MeV deuterons at 473 K and stresses ranging from 0.35 to 0.9 of the unirradiated yield stress. Transmission electron microscopy revealed that the microstructure following irradiation to 0.05 dpa consisted of a high density of small dislocation loops, some small voids and network dislocations. The creep model predicted creep rates proportional to the mobile dislocation density and a comparison of experimental irradiation creep rates as a function of homologous stress revealed a dependence on initial microstructure of the magnitude predicted by the measured dislocation densities. The three microstructures that were irradiated consisted of 85% and 25% cold-worked Ni specimens and well-annealed Ni specimens. A weak stress dependence of irradiation creep was observed in 85% cold-worked Ni in agreement with experimental determinations of the stress dependence of irradiation creep by others. The weak stress dependence was shown to be a consequence of the stress independence of the dislocation climb velocity and the weak stress dependence of the barrier removal process. The irradiation creep rate was observed to be proportional to the applied stress. This linear stress dependence was suggested to be due to the stress dependence of the mobile dislocation density. 101 references, 27 figures, 11 tables

  6. Low Dose Ionizing Radiation Modulates Immune Function

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Gregory A. [Loma Linda Univ., CA (United States)

    2016-01-12

    In order to examine the effects of low dose ionizing radiation on the immune system we chose to examine an amplified adaptive cellular immunity response. This response is Type IV delayed-type hypersensitivity also called contact hypersensitivity. The agent fluorescein isothiocyanate (FITC) is a low molecular weight, lipophilic, reactive, fluorescent molecule that can be applied to the skin where it (hapten) reacts with proteins (carriers) to become a complete antigen. Exposure to FITC leads to sensitization which is easily measured as a hypersensitivity inflammatory reaction following a subsequent exposure to the ear. Ear swelling, eosinophil infiltration, immunoglobulin E production and cytokine secretion patterns characteristic of a “Th2 polarized” immune response are the components of the reaction. The reaction requires successful implementation of antigen processing and presentation by antigen presenting Langerhans cells, communication with naïve T lymphocytes in draining lymph nodes, expansion of activated T cell clones, migration of activated T cells to the circulation, and recruitment of memory T cells, macrophages and eosinophils to the site of the secondary challenge. Using this model our approach was to quantify system function rather than relying only on indirect biomarkers of cell. We measured the FITC-induced hypersensitivity reaction over a range of doses from 2 cGy to 2 Gy. Irradiations were performed during key events or prior to key events to deplete critical cell populations. In addition to quantifying the final inflammatory response, we assessed cell populations in peripheral blood and spleen, cytokine signatures, IgE levels and expression of genes associated with key processes in sensitization and elicitation/recall. We hypothesized that ionizing radiation would produce a biphasic effect on immune system function resulting in an enhancement at low doses and a depression at higher doses and suggested that this transition would occur in the

  7. Low Dose Ionizing Radiation Modulates Immune Function

    International Nuclear Information System (INIS)

    In order to examine the effects of low dose ionizing radiation on the immune system we chose to examine an amplified adaptive cellular immunity response. This response is Type IV delayed-type hypersensitivity also called contact hypersensitivity. The agent fluorescein isothiocyanate (FITC) is a low molecular weight, lipophilic, reactive, fluorescent molecule that can be applied to the skin where it (hapten) reacts with proteins (carriers) to become a complete antigen. Exposure to FITC leads to sensitization which is easily measured as a hypersensitivity inflammatory reaction following a subsequent exposure to the ear. Ear swelling, eosinophil infiltration, immunoglobulin E production and cytokine secretion patterns characteristic of a 'Th2 polarized' immune response are the components of the reaction. The reaction requires successful implementation of antigen processing and presentation by antigen presenting Langerhans cells, communication with naïve T lymphocytes in draining lymph nodes, expansion of activated T cell clones, migration of activated T cells to the circulation, and recruitment of memory T cells, macrophages and eosinophils to the site of the secondary challenge. Using this model our approach was to quantify system function rather than relying only on indirect biomarkers of cell. We measured the FITC-induced hypersensitivity reaction over a range of doses from 2 cGy to 2 Gy. Irradiations were performed during key events or prior to key events to deplete critical cell populations. In addition to quantifying the final inflammatory response, we assessed cell populations in peripheral blood and spleen, cytokine signatures, IgE levels and expression of genes associated with key processes in sensitization and elicitation/recall. We hypothesized that ionizing radiation would produce a biphasic effect on immune system function resulting in an enhancement at low doses and a depression at higher doses and suggested that this transition would occur in

  8. Genome instability induced by extreme low dose/low dose rate heavy ion radiation

    International Nuclear Information System (INIS)

    We irradiated normal human fibroblasts (HFL III) with carbon ions (290 MeV/u, 70 keV/um) at very low dose (1 mGy total dose) and low dose rate (1 mGy/6 h) and observed the growth kinetics for several months by continuous culturing. The growth of carbon irradiated cells started to slow down much earlier than that of non-irradiated control cells before reaching senescence. On the other hand, HFL III cells irradiated at the same dose and the dose rate of gamma-rays were slightly accelerated their growth. Our measurements on DNA double strand break (DSB) such as gamma-H2AX foci revealed a higher number of foci in carbon irradiated cells than in gamma-irradiated cells at a cell passage near senescence. Taken together, our results suggest that high linear energy transfer (LET) radiation causes different effects than low LET radiation even at very low doses and that the effect of single low dose irradiation can affect the stability of genome many generations after irradiation. (author)

  9. Uterine cervix cancer treatment at Radiumhemmet: 90 years′ experience. Time trends of age, stage, and histopathology distribution

    International Nuclear Information System (INIS)

    Since the introduction of screening programs for cervical cancer (CC) the incidence has decreased and CC is discovered at an earlier stage. The purpose of this study was to analyze time trends in age, stage, and histopathology over a 90-year period and to our knowledge this is the largest single institutional series in the literature of invasive cervical carcinoma (CC) cases. This is a retrospective study comprising 18,472 women treated for CC from 1914 until 2004 at Radiumhemmet, Stockholm. The material is part of the international CC statistics published since 1937 in the League of Nations' Annual Reports, and since 1958 under the patronage of International Federation of Gynecology and Obstetrics (FIGO). During the 90-year study period, the annual number of cases treated increased to over 400 up until 1965, after which there was a gradual drop to less than 100 cases in 2004. A pronounced shift toward earlier stages at diagnosis was noted. The mean age at diagnosis increased in all stages, predominantly in advanced stages. A reduction in squamous cell carcinoma (SCC) cases and a sixfold increase in the proportion of adenocarcinoma (AC) cases were observed. The mean age at diagnosis for squamous and AC cases shifted after 1970, when the SCC cases ultimately became 3 years older than the AC cases in contrast to around 1950 when they were 3 years younger than the AC cases. The changes in the distribution by age, stage, and histopathology during this 90-year period are probably associated with: improved social conditions and increased access to health care, the introduction of screening programs for CC in the 1960s, and a change in the risk factors for CC (changed sexual behavior, introduction of contraceptive pills, and changed smoking habits). This is a study on changes in the distribution by age, stage, and histopathology in a large series of cervical cancer treated in Sweden during a 90-year period. It also includes an historical review about the development

  10. Correlation of Traditional Point a With Anatomic Location of Uterine Artery and Ureter in Cancer of the Uterine Cervix

    International Nuclear Information System (INIS)

    Purpose: Point A, used for dose specification for intracavitary brachytherapy for cervical cancer, is the point at which the uterine artery and ureter cross. This study assessed compatibility of commonly used traditional point A (TPA) and actual anatomic point A (APA). Methods and Materials: We visualized and placed radiopaque clips at the APA during pelvic and paraaortic lymphadenectomy in 11 patients with cervical carcinoma. Orthogonal and oblique radiographs were obtained after insertion of brachytherapy applicators. We measured the distance between the TPA and APA and estimated the brachytherapy dose to each of the two points. Results: A total of 64 brachytherapy treatments were performed. The mean distances between the TPA and APA were 5.2 ± 1.0 cm on the right and 5.4 ± 1.1 cm on the left. The estimated brachytherapy doses delivered to the APA as a percentage of the presumed 500-cGy fraction size to the TPA were 35.2% (176.6 ± 59.0 cGy) on the right and 30.0% (150.2 ± 42.9 cGy) on the left. The marked discrepancy in the position of the two points was not related to individual kinetic variations during brachytherapy treatment, tumor size, or bladder filling. Conclusions: The conventional TPA does not provide an accurate estimate of the APA determined during lymphadenectomy, indicating a need to reevaluate the current practice for determining the brachytherapy prescription for cervical cancer. ( (ClinicalTrials.gov) Identifier, NCT00319462)

  11. Studies of health effects of low dose radiation and its application to medicare

    International Nuclear Information System (INIS)

    The articles contain following 7 topics of low dose radiation effects. Studies of Health Effects of Low dose Radiation and Its Application to Medicare'', describes the indication of Rn therapy and investigations of its usefulness mechanism mainly in Misasa Spa, Okayama Pref. ''Challenges for the Paradigm Shift (CRIEPI Studies)'', introduces studies against the paradigm that radiation dose is linearly and proportionally hazardous. ''Studies of High Background Radiation Area (CRIEPI Studies)'', describes global HBRA studies on chromosome affection and effect of smoking in HBRA. ''Is the Radiation Effect on Man Proportional to Dose? (CRIEPI Studies)'', describes studies of immature sperm irradiated at low dose against Linear-Non-threshold Theory (LNT) hypothesis. ''Induction of Radiation Resistance by Low Dose Radiation and Assessment of Its Effect in Models of Human Diseases (CRIEPI Studies)'', explains the adoptive response in radiation effect, suppression of carcinogenesis and immune regulation by previous low dose radiation in the mouse, and improvement of diabetes in the db/db mouse. ''Modulation of Biological Effects of Low Dose Radiation: Adoptive Response, Bystander Effect, Genetic Instability and Radiation Hormesis'', summarizes findings of each item. ''Cancer Treatment with Low dose Radiation to the Whole Body'', describes basic studies in the mouse tumor in relation to suppression of carcinogenesis and metastasis, immune activation and treatment, and successful clinical studies in patients with ovary, colon cancers and malignant lymphoma where survival has been significantly improved: a base of recent European Organization for Research and Treatment of Cancer (EORTC) clinical trials. The mechanism is essentially based on immune activation of patients to cure the disease. (R.T.)

  12. Magnetic resonance imaging for assessment of parametrial tumour spread and regression patterns in adaptive cervix cancer radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Schmid, Maximilian P.; Fidarova, Elena [Dept. of Radiotherapy, Comprehensive Cancer Center, Medical Univ. of Vienna, Vienna (Austria)], e-mail: maximilian.schmid@akhwien.at; Poetter, Richard [Dept. of Radiotherapy, Comprehensive Cancer Center, Medical Univ. of Vienna, Vienna (Austria); Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology, Medical Univ. of Vienna (Austria)] [and others

    2013-10-15

    Purpose: To investigate the impact of magnetic resonance imaging (MRI)-morphologic differences in parametrial infiltration on tumour response during primary radio chemotherapy in cervical cancer. Material and methods: Eighty-five consecutive cervical cancer patients with FIGO stages IIB (n = 59) and IIIB (n = 26), treated by external beam radiotherapy ({+-}chemotherapy) and image-guided adaptive brachytherapy, underwent T2-weighted MRI at the time of diagnosis and at the time of brachytherapy. MRI patterns of parametrial tumour infiltration at the time of diagnosis were assessed with regard to predominant morphology and maximum extent of parametrial tumour infiltration and were stratified into five tumour groups (TG): 1) expansive with spiculae; 2) expansive with spiculae and infiltrating parts; 3) infiltrative into the inner third of the parametrial space (PM); 4) infiltrative into the middle third of the PM; and 5) infiltrative into the outer third of the PM. MRI at the time of brachytherapy was used for identifying presence (residual vs. no residual disease) and signal intensity (high vs. intermediate) of residual disease within the PM. Left and right PM of each patient were evaluated separately at both time points. The impact of the TG on tumour remission status within the PM was analysed using {chi}2-test and logistic regression analysis. Results: In total, 170 PM were analysed. The TG 1, 2, 3, 4, 5 were present in 12%, 11%, 35%, 25% and 12% of the cases, respectively. Five percent of the PM were tumour-free. Residual tumour in the PM was identified in 19%, 68%, 88%, 90% and 85% of the PM for the TG 1, 2, 3, 4, and 5, respectively. The TG 3 - 5 had significantly higher rates of residual tumour in the PM in comparison to TG 1 + 2 (88% vs. 43%, p < 0.01). Conclusion: MRI-morphologic features of PM infiltration appear to allow for prediction of tumour response during external beam radiotherapy and chemotherapy. A predominantly infiltrative tumour spread at the

  13. MRI findings of small cell neuroendocrime carcinoma of the uterine cervix: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Won, You Sun; Yi, Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Kwak, Jeong Ja [Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-10-15

    Small cell neuroendocrine carcinoma of the uterine cervix is a rare primary neoplasm, accounting for less than 5% of all uterine cervical cancers. The tumor is known to have an aggressive behavior and poor prognosis. In this article, we present the MRI findings of 5 cases of pathologically-proven small cell neuroendocrine carcinoma of the uterine cervix, including diffusion-weighted images.

  14. Dosimetric evaluation of a combination of brachytherapy applicators for uterine cervix cancer with involvement of the distal vagina; Avaliacao dosimetrica de uma combinacao de aplicadores para braquiterapia de tumores do colo uterino com acometimento da porcao distal da vagina

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Roger Guilherme Rodrigues [Real e Benemerita Sociedade Portuguesa de Beneficencia, Sao Paulo, SP (Brazil). Servico de Radioterapia Estereotactica; Carvalho, Heloisa de Andrade; Stuart, Silvia Radwanski; Rubo, Rodrigo Augusto [Universidade de Sao Paulo (USP), SP (Brazil). Hospital das Clinicas. Servico de Radioterapia], e-mail: handrade@hcnet.usp.br; Seraide, Rodrigo Migotto [Centro de Oncologia Campinas, SP (Brazil)

    2009-07-15

    Objective: To evaluate an alternative brachytherapy technique for uterine cervix cancer involving the distal vagina, without increasing the risk of toxicity. Materials And Methods: Theoretical study comparing three different high-dose rate intracavitary brachytherapy applicators: intrauterine tandem and vaginal cylinder (TC); tandem/ring applicator combined with vaginal cylinder (TR+C); and a virtual applicator combining both the tandem/ring and vaginal cylinder in a single device (TRC). Prescribed doses were 7 Gy at point A, and 5 Gy on the surface or at a 5 mm depth of the vaginal mucosa. Doses delivered to the rectum, bladder and sigmoid colon were kept below the tolerance limits. Volumes covered by the isodoses, respectively, 50% (V50), 100% (V100), 150% (V150) and 200% (V200) were compared. Results: Both the combined TR+C and TRC presented a better dose distribution as compared with the TC applicator. The TR+C dose distribution was similar to the TRC dose, with V150 and V200 being about 50% higher for TR+C (within the cylinder). Conclusion: Combined TR+C in a two-time single application may represent an alternative therapy technique for patients affected by uterine cervix cancer involving the distal vagina. (author)

  15. Cervical cancer - screening and prevention

    Science.gov (United States)

    Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus ( ... can do to decrease your chance of having cervical cancer. Also, tests done by your health care provider ...

  16. Radon Exposure and the Definition of Low Doses-The Problem of Spatial Dose Distribution.

    Science.gov (United States)

    Madas, Balázs G

    2016-07-01

    Investigating the health effects of low doses of ionizing radiation is considered to be one of the most important fields in radiological protection research. Although the definition of low dose given by a dose range seems to be clear, it leaves some open questions. For example, the time frame and the target volume in which absorbed dose is measured have to be defined. While dose rate is considered in the current system of radiological protection, the same cancer risk is associated with all exposures, resulting in a given amount of energy absorbed by a single target cell or distributed among all the target cells of a given organ. However, the biological effects and so the health consequences of these extreme exposure scenarios are unlikely to be the same. Due to the heterogeneous deposition of radon progeny within the lungs, heterogeneous radiation exposure becomes a practical issue in radiological protection. While the macroscopic dose is still within the low dose range, local tissue doses on the order of Grays can be reached in the most exposed parts of the bronchial airways. It can be concluded that progress in low dose research needs not only low dose but also high dose experiments where small parts of a biological sample receive doses on the order of Grays, while the average dose over the whole sample remains low. A narrow interpretation of low dose research might exclude investigations with high relevance to radiological protection. Therefore, studies important to radiological protection should be performed in the frame of low dose research even if the applied doses do not fit in the dose range used for the definition of low doses. PMID:27218294

  17. Bone metastases in the patients of carcinoma cervix.

    OpenAIRE

    Baid B; Kumar L; Chander S; Rath G; Kumar S; Kriplani A; Batla N

    1992-01-01

    Seventeen of 620 patients (2.7%) of cancer cervix were diagnosed to have bone metastasis (BM). In three bone metastasis were seen at initial presentation; remaining 14 developed BM in 3 to 36 months after the diagnosis of cancer cervix. Backache (8), localised pain (8), in thigh/hip/neck paraparesis (1) were main symptoms. The duration of symptoms ranged from 1 to 4 (median 2.5) months. Lumber spine, pelvic bones and long bones were the commonest site of involvement. The lesions were s...

  18. low dose irradiation growth in zirconium

    International Nuclear Information System (INIS)

    Low dose neutron irradiation growth in textured and recrystallized zirconium, is studied, at the Candu Reactors Calandria temperature (340 K) and at 77 K. It was necessary to design and build 1: A facility to irradiate at high temperatures, which was installed in the Argentine Atomic Energy Commission's RA1 Reactor; 2: Devices to carry out thermal recoveries, and 3: Devices for 'in situ' measurements of dimensional changes. The first growth kinetics curves were obtained at 365 K and at 77 K in a cryostat under neutron fluxes of similar spectra. Irradiation growth experiments were made in zirconium doped with fissionable material (0,1 at %235U). In this way an equivalent dose two orders of magnitude greater than the reactor's fast neutrons dose was obtained, significantly reducing the irradiation time. The specimens used were bimetallic couples, thus obtaining a great accuracy in the measurements. The results allow to determine that the dislocation loops are the main cause of irradiation growth in recrystallized zirconium. Furthermore, it is shown the importance of 'in situ' measurements as a way to avoid the effect that temperature changes have in the final growth measurement; since they can modify the residual stresses and the overconcentrations of defects. (M.E.L.)

  19. Contraception. Low-dose pill launched.

    Science.gov (United States)

    1993-01-01

    At a vibrant ceremony in Kampala, Uganda, the Minister of Women in Development, Youth and Culture launched the new low-dose oral contraceptive Pilplan which provides women more options for birth spacing. Diplomats, physicians, government officials, and business leaders attended the ceremony at the Sheraton Hotel Kampala. A dance group did an interpretation of "Women in Uganda: Gaining Momentum." The Minister considered the introduction of this new pill as a turning point for reproductive rights. A baseline survey among Ugandan women has shown that although almost all women were familiar with the pill, only 36% have ever used it and only 15% were currently using it. 80% thought that pill use was preferable to having an unplanned pregnancy. These findings convinced the Minister that ignorance and misconception keep women from using the pill. The government, health providers, and others need to educate women about Pilplan and how to use it correctly. A bilateral agreement between the Ministry of Health and USAID set in motion a social marketing project which has now launched two contraceptive methods: Pilplan in 1993 and the Protector condom in 1990. USAID vowed to continue to support Pilplan, particularly if men could also help in supporting birth spacing. A Uganda-based pharmaceutical firm will distribute Pilplan in Uganda through pharmacies, clinics, and health facilities. Pilplan targets all middle- to low-income women. PMID:12319754

  20. Effects of low doses: Proof and inferences

    International Nuclear Information System (INIS)

    It is essential to discuss the plausibility of 'low-dose' effects from environmental exposures. The question, nonetheless, is wrongly labelled, for it is not the magnitude of the dose that matters, but rather the effect. The question thus concerns 'doses with low effects'. More precisely, because the low effects on large populations are not that small, even when epidemiological tools fail to detect them, it would be more accurate to talk about 'doses with undetectable or barely detectable effects'. Hereafter, we describe this 'low-effect dose' concept from the viewpoint of toxicology and epidemiology and discuss the fragile boundary line for these low-effect doses. Next, we review the different types of inference from observed situations (i.e., with high effects) to situations relevant to public health, to characterize the level of confidence to be accorded them. The first type is extrapolation - from higher to lower doses or from higher to lower dose rates. The second type is transposition - from humans to other humans or from animals to humans. The third type can be called 'analogy' as in 'read across' approaches, where QSAR (Quantitative Structure Activity Relationship) methodology can be used. These three types of inferences can be based on an estimate of the 'distance' between observed and predicted areas, but can also rely on knowledge and theories of the relevant mechanisms. The new tools of predictive toxicology are helpful both in deriving quantitative estimates and grounding inferences on sound bases. (author)

  1. Microdosimetric approach to the anlysis of cell responses at low dose and low dose rate

    International Nuclear Information System (INIS)

    An approach to the problem of radiation response is proposed and described by which effects produced at low doses and dose rates can be understood as the consequences of radiation absorption events in the nucleus of a single relevant cell and in its DNA. Radiation quality appears as the consequence of two related probabilities, that of energy deposition in the cell nucleus and that of energy deposition in DNA. The starting point is a ''gross sensitive volume'', GSV, identified with an average mammalian cell nucleus and composed of smaller sensitive volumes, identified with some critical parts of the DNA genome. The GSV leads to the definitions of an ''elemental dose'', the ''integral probability of responses of the GSV population'', and the smaller volumes lead to a ''relative local efficiency''. This approach is applied to various biological endpoints illustrating its merits. The level of dose below which the fraction of hit cells depends linearly on absorbed dose and is independent of dose rate, is delineated. Finally, guide lines for designing low dose and low dose rate experiments are proposed. (author)

  2. Adjuvant postoperative radiation therapy for carcinoma of the uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja; Moon, Hye Seong; Kim, Seung Cheol; Kim, Chong Il; Ahn, Jung Ja [College of Medicine, Ewha Womans Univ., Seoul (Korea, Republic of)

    2003-09-01

    This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study, The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, Iymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was 45 - 50 Gy. Vagina cuff irradiation was performed, after completion of the external beam irradiation, al a low-dose rate of CS-137, with the total dose of 4488-4932 chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months (15-108 months), The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95% and 94%, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Our results indicate that postoperative radiation therapy can

  3. Adjuvant postoperative radiation therapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study, The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, Iymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was 45 - 50 Gy. Vagina cuff irradiation was performed, after completion of the external beam irradiation, al a low-dose rate of CS-137, with the total dose of 4488-4932 chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months (15-108 months), The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95% and 94%, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Our results indicate that postoperative radiation therapy can

  4. 低剂量脾照射对局部晚期非小细胞肺癌放疗患者免疫系统的影响%The effects of low-dose splenic irradiation and radiotherapy on immune system of patients with locally advanced non-small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    Jun Liu; Hongsheng Yu; Qingjun Shang; Chao Yan; Peng Jiang; Xiang Wang

    2013-01-01

    Objective:The aim of the research was to study the effects of low-dose splenic irradiation and radiotherapy on immune system of patients with locally advanced non-small cell lung cancer (NSCLC). Methods:Twelve cases of stage III NSCLC in Tumor Radiotherapy Center of our hospital (the Affiliated Hospital of Medical College Qingdao University, China) were collected from July 2011 to July 2012; all patients were under 75 years old with clear pathology, measurable lesions and good personal statement. They were randomly divided into combined treatment group (D1 + D2) and control group (D1). The control group (D1) only received radiotherapy to the chest; combined treatment group (D1 + D2) received low-dose splenic irradiation plus conventional dose irradiation. Flow cytometry was used to detect the peripheral blood T lymphocyte immune indexes of patients before, during and after the treatment, classification by five blood cell analyzer was used to determine white blood cells, neutrophils, hemoglobin and platelet count. The radiation induced toxicity including esophagitis, pneumonia and gastrointestinal reaction was observed, as well as the dose when it happened. Results:There was no significant difference in the ratio between two groups in cells CD4+, CD8+ and CD4+/CD8+ after radiotherapy (P > 0.05). There was no change in these indicators in combined treatment group after treatment (P > 0.05), but it decreased in control group (P 0.05), but the patients in combined treatment group seemed to tolerate high dose well (P < 0.05). Conclusion:Low-dose splenic irradiation combined with radiotherapy to the chest can alleviate the injury degree of acute radiation induced the toxicity of locally advanced NSCLC patients, through affect the patient's immune function.

  5. Characteristics of repair following very low doses

    International Nuclear Information System (INIS)

    The effects of ionizing radiation on living systems being with the physical processes of energy deposition and develop through many stages of chemical reaction and biological response. The modeling effort attempts to organize the available data and theories of all of these stages into self-consistent models that can be compared and tested. In some cases, important differences among models result in only small differences in cell survival within the ranges of dose and dose rate that are normally investigated. To overcome this limitation, new ways of irradiating cells at extremes of dose rate, or ways of evaluating the effects of very small doses, are developed. Mathematical modeling and cellular studies complement each other. It has recently been found that some mechanisms are not adequate to account for the interaction of dose and repair time as they affect the reproductive survival of plateau-phase Chinese hamster ovary (CHO) cells. Repair of radiation-induced cellular damage plays a central role in the survival of cells exposed to doses of 1 Gy or more. This repair is responsible for the dose rate, split-dose and delayed plating effect and can be evaluated. Because split-dose and dose-rate experiments involve repair during irradiation and delayed plating experiments involve repair after irradiation is completed, it was originally thought that different repair processes were involved. It is now clear that this is not necessarily the case. Appropriately designed models can account for observed effects at conventional doses (1 Gy or more) whether they assume all damage is lethal unless repaired or some damage is innocuous unless it interacts with additional damage. The fact that the survival following a plating delay is always less than the survival following immediate plating at low doses indicates that the damage produced is probably not potentially lethal

  6. Breast cancer and ductal carcinoma in situ among women with prior squamous or glandular precancer in the cervix: a register-based study

    OpenAIRE

    B. T. Hansen; Nygård, M.; Falk, R S; Hofvind, S

    2012-01-01

    Background: Human papillomavirus and hormonal contraceptives may be risk factors for cervical precancer and malignant breast tumours. Methods: Standardised incidence ratios (SIRs) of malignant breast tumours during 1970–2008 were estimated separately for women with prior squamous and glandular cervical precancer. Results: Women with squamous precancer and women with glandular precancer in the cervix had a significantly higher risk of malignant breast tumours than the general female population...

  7. Comparative performance analysis of cervix ROI extraction and specular reflection removal algorithms for uterine cervix image analysis

    Science.gov (United States)

    Xue, Zhiyun; Antani, Sameer; Long, L. Rodney; Jeronimo, Jose; Thoma, George R.

    2007-03-01

    Cervicography is a technique for visual screening of uterine cervix images for cervical cancer. One of our research goals is the automated detection in these images of acetowhite (AW) lesions, which are sometimes correlated with cervical cancer. These lesions are characterized by the whitening of regions along the squamocolumnar junction on the cervix when treated with 5% acetic acid. Image preprocessing is required prior to invoking AW detection algorithms on cervicographic images for two reasons: (1) to remove Specular Reflections (SR) caused by camera flash, and (2) to isolate the cervix region-of-interest (ROI) from image regions that are irrelevant to the analysis. These image regions may contain medical instruments, film markup, or other non-cervix anatomy or regions, such as vaginal walls. We have qualitatively and quantitatively evaluated the performance of alternative preprocessing algorithms on a test set of 120 images. For cervix ROI detection, all approaches use a common feature set, but with varying combinations of feature weights, normalization, and clustering methods. For SR detection, while one approach uses a Gaussian Mixture Model on an intensity/saturation feature set, a second approach uses Otsu thresholding on a top-hat transformed input image. Empirical results are analyzed to derive conclusions on the performance of each approach.

  8. Low dose mercury toxicity and human health.

    Science.gov (United States)

    Zahir, Farhana; Rizwi, Shamim J; Haq, Soghra K; Khan, Rizwan H

    2005-09-01

    Post Minamata incident there has been awareness about mercury toxicity even among the general public. Previous researches contributed a vast amount of data regarding acute mercury exposure, but gradually information about the low dose [Ninomiya, T., Ohmori, H., Hashimoto, K., Tsuruta, K., Ekino, S., 1995. Expansion of methylmercury poisoning outside minamata: an epidemiological study on chronic methylmercury poisoninig outside of Minamata. Environ. Res. 70 (1) 47-50; Lebel, J., Mergler, D., Lucotte, M., Amorim, M., Dolbec, J., Miranda, D., Arantes, G., Rheault, I., Pichet, P., 1996. Evidence of early nervous system dysfunction in Amazonian populations exposed to low-levels of methylmercury. Neurotoxicology 17 (1) 157-167] of mercury toxicity has been trickling in. With mercury contaminating rain-, ground- and sea-water no one is safe. Polluted water leads to mercury laced fish, meat and vegetable. In aquatic environments, inorganic mercury is microbiologically transformed into lipophilic organic compound 'methylmercury'. This transformation makes mercury more prone to biomagnification in food chains. Consequently, populations with traditionally high dietary intake of food originating from fresh or marine environment have highest dietary exposure to mercury. Extensive research done on locals across the globe have already established this, persons who routinely consume fish or a particular species of fish are at an increased risk of methylmercury poisoning. The easy access of the toxicant to man through multiple pathways air, water, food, cosmetic products and even vaccines increase the exposure. Foetus and children are more susceptible towards mercury toxicity. Mothers consuming diet containing mercury pass the toxicant to foetus and to infants through breast milk. Decreased performance in areas of motor function and memory has been reported among children exposed to presumably safe mercury levels. Similarly, disruption of attention, fine motor function and verbal

  9. Results of radiation therapy for carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Fifty-nine consecutive patients who were treated with radiation therapy for carcinoma of the uterine cervix between April 1982 and December 1986 were reviewed. Twelve patients were treated with low dose-rate intracavitary irradiation using radium-226, and 46 were treated with high dose-rate irradiation using a remote afterloading system combined with external irradiation, and the other one was treated with external irradiation alone. The 5-year-survival rates for stage Ib, IIa, IIb, IIIb, and IVa were 77.8, 85.7, 87.5, 45.5 and 40.0%, respectively. The 5-year-survival rates for the low and high dose-rates irradiation were 66.7 and 73.9%, respectively. The most common complication of radiation therapy was rectal bleeding, which required conservative treatment (grade 2) in 11 (18.6%). The morbidities for the low and high dose-rates irradiation were similar. The causes of death in 17 patients were local recurrence in 14, metastases in 2 and other specified in one. These findings suggest that high dose-rate intracavitary irradiation is as effective as low dose-rate irradiation for carcinoma of the uterine cervix, and that further efforts for controlling the local tumors with stage IIIb disease without an increased rate of side-effects is required. (author)

  10. MELODI - Multidisciplinary European Low dose Initiative - First Draft of Strategic Research Agenda (SRA)

    International Nuclear Information System (INIS)

    The SRA Working Group of MELODI (Multidisciplinary European Low Dose Initiative) was tasked to develop a long-term strategic research agenda (SRA) to guide the coherent integration of national low dose research programmes. Priorities that need to be addressed concern fundamental mechanistic research ranging from radiation track structure and the deposition of energy in biologically important molecules; the resultant homeostatic perturbations and the steps in the cellular and tissue metabolic pathways that eventually lead to disease pathologies. In fact, the main priorities are here the step-wise elucidation of the mechanisms of radiation-induced (oxidative) stress responses and their impact on radiation-induced cancers and non cancer diseases. To achieve this a holistic approach is proposed staring with radiation-specific effects, radiation-induced molecular, biological and pathological effects involving a systems biology approach as well as molecular epidemiology and mathematical modelling in order to come up with more solid low dose health risk assessments. The pathologies considered are outlined in the report where the need is stressed for the MELODI platform to involve a constellation of classical and emerging technologies in a highly multidisciplinary approach. Elucidating the shapes of low-dose response relationships and resolving the question of thresholds is paramount to resolving questions of risk for both populations and individuals. Much is known about radiation-induced cancer in humans and animal models but this needs to be pursued particularly at low doses. More recently, the scientific community has realised that low radiation-induced health effects range well beyond cancer. The priority non-cancer areas that need to be brought into focus are cardiovascular, neurological and ophthalmic. (A.C.)

  11. MELODI - Multidisciplinary European Low dose Initiative - First Draft of Strategic Research Agenda (SRA)

    Energy Technology Data Exchange (ETDEWEB)

    Averbeck, D. [IRSN, Fontenay-aux-Roses (France); Lloyd, D. [Health Protection Agency, Chilton (United Kingdom); O' Neill, P. [Gray Institute for Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom)

    2010-10-11

    The SRA Working Group of MELODI (Multidisciplinary European Low Dose Initiative) was tasked to develop a long-term strategic research agenda (SRA) to guide the coherent integration of national low dose research programmes. Priorities that need to be addressed concern fundamental mechanistic research ranging from radiation track structure and the deposition of energy in biologically important molecules; the resultant homeostatic perturbations and the steps in the cellular and tissue metabolic pathways that eventually lead to disease pathologies. In fact, the main priorities are here the step-wise elucidation of the mechanisms of radiation-induced (oxidative) stress responses and their impact on radiation-induced cancers and non cancer diseases. To achieve this a holistic approach is proposed staring with radiation-specific effects, radiation-induced molecular, biological and pathological effects involving a systems biology approach as well as molecular epidemiology and mathematical modelling in order to come up with more solid low dose health risk assessments. The pathologies considered are outlined in the report where the need is stressed for the MELODI platform to involve a constellation of classical and emerging technologies in a highly multidisciplinary approach. Elucidating the shapes of low-dose response relationships and resolving the question of thresholds is paramount to resolving questions of risk for both populations and individuals. Much is known about radiation-induced cancer in humans and animal models but this needs to be pursued particularly at low doses. More recently, the scientific community has realised that low radiation-induced health effects range well beyond cancer. The priority non-cancer areas that need to be brought into focus are cardiovascular, neurological and ophthalmic. (A.C.)

  12. Interstitial brachytherapy with Ir-192 low-dose-rate in the treatment of primary and recurrent cancer of the oral cavity and oropharynx. Review of 318 patients treated between 1985 and 1997

    International Nuclear Information System (INIS)

    To evaluate the impact of postoperative interstitial brachytherapy with and without external radiotherapy in the treatment of primary and recurrent squamous cell carcinoma of the oral cavity and oropharynx. Patients and Methods: Between 1985 and 1997, a total of 318 patients were treated by interstitial Ir-192 low-dose-rate brachytherapy as part of their primary (n = 236) or recurrent treatment (n = 82). There were 263 male (83%) and 55 (17%) female patients. The distribution of UICC (1997) stages was as follows: I (61 patients, 19%), II (71 patients, 22%), III (58 patients, 18%), IV (128 patients, 40%). The primary tumor site was located in the oral cavity in 201 patients (63%), in the oropharynx in 86 patients (27%), lower lip in 19 patients (6%) and other regions in twelve cases (4%). Treatment concepts did not vary over the time and were dictated by the initial tumor extension: a total of 175 patients (55%) received a combination of surgery, interstitial b brachytherapy (23-25 Gy) and external radiotherapy (50-60 Gy), 60 patients (19%) surgery and interstitial brachytherapy (45-55 Gy) alone. Advanced disease not amenable to primary surgery was either treated by radiochemotherapy and interstitial brachytherapy in 39 patients (12%) or a combination of interstitial brachytherapy, external radiotherapy and interstitial hyperthermia in 44 patients (14%). Results: Overall survival rates following primary and recurrent treatment were 50 ± 4% and 29 ± 5%, respectively, at 5 years (p < 0.0001). A significant impact on overall survival rate was noted for UICC stage: patients in stage I/II had survival rates of 64 ± 5% and 57 ± 10%, respectively, while patients in stage III/IV had survival rates of 39 ± 5% and 15 ± 5%, respectively, at 5 years (p < 0.0001). In addition, grading (p = 0.01) and hemoglobin levels (p = 0.05) had a significant influence on overall survival. Local tumor control rates for all patients were 74 ± 3% and 57 ± 7% at 5 years following primary

  13. Low doses of radiation: epidemiological investigations

    International Nuclear Information System (INIS)

    Influence of small dozes of radiation was investigated with the help epidemiologic evidence. Correlation analysis, regression analysis and frequency analysis were used for investigating morbidity of various cancer illnesses. The pollution of the environment and the fallout of radionuclides in 1962 and 1986 years have an influence upon morbidity of cancer. Influence of small dozes of radiation on health of the population is multifactorial. Therefore depending on other adverse external conditions the influence of radiation in small dozes can be increased or is weakened. Such character of influence of radiation in small dozes proposes the differentiated approach at realization of preventive measures. Especially it concerns regions with favorable ecological conditions.

  14. Health Effects of Exposure to Low Dose of Radiation

    International Nuclear Information System (INIS)

    Human beings are exposed to natural radiation from external sources include radionuclides in the earth and cosmic radiation, and by internal radiation from radionuclides, mainly uranium and thorium series, incorporated into the body. Living systems have adapted to the natural levels of radiation and radioactivity. But some industrial practices involving natural resources enhance these radionuclides to a degree that they may pose risk to humans and the environment if they are not controlled. Biological effects of ionizing radiation are the outcomes of physical and chemical processes that occur immediately after the exposure, then followed by biological process in the body. These processes will involve successive changes in the molecular, cellular, tissue and whole organism levels. Any dose of radiation, no matter how small, may produce health effects since even a single ionizing event can result in DNA damage. The damage to DNA in the nucleus is considered to be the main initiating event by which radiation causes damage to cells that results in the development of cancer and hereditary disease. It has also been indicated that cytogenetic damage can occur in cells that receive no direct radiation exposure, known as bystander effects. This paper reviews health risks of low dose radiation exposure to human body causing stochastic effects, i.e. cancer induction in somatic cells and hereditary disease in genetic cells. (author)

  15. HiLo: Multicentre randomized phase III clinical trial of high vs low dose radioiodine, with or without recombinant human thyroid stimulating hormone (rhTSH), for remnant ablation for differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mallick, U. [Freeman Hospital, Newcastle, Newcastle upon Tyne (United Kingdom); Harmer, C.; Clarke, S.; Moss, L.; Nicol, A.; Clarke, P.; Smellie, J.; McCready, R.; Farnell, K.; Franklyn, J.; John, R.; Nutting, C.; Yap, B.; Lemon, C.; Wadlsey, J.; Gerrard, G.; Roques, T.; Macias, E.; Whitaker, S.; Abdul-Hamid, A.; Alvarez, P.; Kadalayil, L.; Hackshaw, A.

    2012-07-01

    Recommended treatment for most patients with differentiated thyroid cancer is surgery followed by radioiodine ablation. Current practice in many centres is to use a high administered activity of 3.7 GBq (100 mCi). However, a lower activity (1.1 GBq or 30 mCi) has advantages including a shorter stay in hospital isolation and lower risk of side effects, including the risk of a second cancer. Also, Thyrogen (rhTSH) allows patients to continue thyroid hormone replacement during ablation, avoiding symptoms of hypothyroidism and also reduces total body radiation dose. We conducted a large randomized factorial multi centre trial to simultaneously address whether ablation success rates are similar using (i) either 1.1 GBq or 3.7 GBq, and (ii) either Thyrogen or thyroid hormone withdrawal. It is the first ever national prospective trial in thyroid cancer in the UK. Final results will be available in 2011

  16. New approach for food allergy management using low-dose oral food challenges and low-dose oral immunotherapies

    Directory of Open Access Journals (Sweden)

    Noriyuki Yanagida

    2016-04-01

    With food allergies, removing the need to eliminate a food that could be consumed in low doses could significantly improve quality of life. This review discusses the importance of an OFC and OIT that use low doses of causative foods as the target volumes. Utilizing an OFC or OIT with a low dose as the target volume could be a novel approach for accelerating the tolerance to causative foods.

  17. Improving abdomen tumor low-dose CT images using a fast dictionary learning based processing

    International Nuclear Information System (INIS)

    In abdomen computed tomography (CT), repeated radiation exposures are often inevitable for cancer patients who receive surgery or radiotherapy guided by CT images. Low-dose scans should thus be considered in order to avoid the harm of accumulative x-ray radiation. This work is aimed at improving abdomen tumor CT images from low-dose scans by using a fast dictionary learning (DL) based processing. Stemming from sparse representation theory, the proposed patch-based DL approach allows effective suppression of both mottled noise and streak artifacts. The experiments carried out on clinical data show that the proposed method brings encouraging improvements in abdomen low-dose CT images with tumors. (paper)

  18. Health risks associated with low dose diagnostic or therapeutic radiation exposures

    International Nuclear Information System (INIS)

    The health risks to humans associated with exposure to low doses of ionizing radiation have been extrapolated from effects observed at high doses, dose rates, and mixed radiation qualities using a linear no threshold model. Based on this approach, it has been argued that human exposure to low doses of diagnostics X-rays and gamma-rays increase an individual's risk of developing cancer throughout their life-time. Also, repeated medical diagnostic procedures involving low dose exposures will have an additive effect and consequently further increase health risk. The specific aim of this seminar will be to address the relative risk associated with diagnostic X-rays from CT scans and gamma-rays from positron emission tomography (PET) scans. Objectives of the talk will include: 1) Defining low dose exposures at a cellular level and relate that to diagnostic or therapeutic exposures, 2) Describing modern tools in molecular cytogenetics to estimate radiation exposure and assess radiation risk, 3) Identifying the different cellular mechanisms that influence radiation risk at high and low dose exposures and relate that to individual radiation risk. (author)

  19. Clinical impact of de-regulated Notch-1 and Notch-3 in the development and progression of HPV-associated different histological subtypes of precancerous and cancerous lesions of human uterine cervix.

    Directory of Open Access Journals (Sweden)

    Richa Tripathi

    Full Text Available BACKGROUND: Cervical cancer is the leading cause of cancer related deaths among women in India. Limited reports are available for Notch-1 and Notch-3 protein in cervical carcinoma, which play crucial role in cell proliferation, differentiation, and apoptosis. METHODS: This study was designed to evaluate the role of Notch-1 and Notch-3 with context to HPV infection in cervical carcinoma. A total of 168 tissue biopsy samples comprising of tumor specimens (n = 98, precancer (n = 30 and non-neoplastic cervical tissues (n = 40 were screened for HPV infection by PCR and expression of Notch-1 and Notch-3 protein by Immunohistochemistry and Immunoblotting. RESULTS: 80% (24/30 were found to be positive for HPV in precancer and 86.7% (85/98 in cancer patients. Notch-1 expression of precancer and cancer cases was found to be significantly down-regulated with severity of disease in nuclear (3.43±0.29; 2.04±0.19, p = 0.0001, p = 0.0001 and cytoplasm (3.07±0.29; 2.29±0.17, p = 0.0001, p = 0.0001 obtained from different stages as compared to normal cervix tissue (5.40±0.19, 4.97±0.15; p<0.001; p<0.001. However, Notch-3 expression of above cases was significantly up-regulated with severity of disease and showed intense nuclear (4.17±0.39; 4.74±0.18, p = 0.0001, p = 0.0001 and cytoplasm (3.67±0.36; 4.48±0.18, p = 0.0001, p = 0.0001 of different stages as compared to normal cervix tissue (0.95±0.20, 0.70±0.20; p<0.001; p<0.001 respectively. CONCLUSIONS: These findings suggest that Notch-1 and Notch-3 may play an important role with synergistic effect of HPV in regulating development and proliferation of cervical cancer through the deregulation of Notch signalling. This study also shows the clinical utility of both proteins which may be used as predictable biomarkers in diagnosing different histological sub-types of HPV associated cervical cancer. Nevertheless, abnormal activation of this pathway may provide

  20. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G; Eugster-Hausmann, Michaela; Gut, Robert

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  1. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G; Eugster-Hausmann, Michaela; Gut, Robert

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  2. Breast and Gynecologic Cancer | Division of Cancer Prevention

    Science.gov (United States)

    This group conducts and fosters the development of research on the prevention and early detection of breast cancer, cervix and human papillomavirus (HPV | Prevention and early detection of breast, cervix, endometrial and ovarian cancers and their precursors.

  3. Investigation of the interacorporcal decay, elimination rate and diagnostic confidence of 57Co-bleomycine in patients with the uterine cervix cancer

    International Nuclear Information System (INIS)

    In 20 women with diagnosed squamous carcinoma of the uterine cervix the 57Co-Bleomycine was used for the estimation of the intracorporeal decay, elimination rate and neoplasmic tissue storage of the complex. Whole body scanner ''Scan modus'' type and gamma chamber were used. A rapid elimination of the examined complex with urine was noted, the blood concentration was significantly higher (p57Co-Bleomycine) can be applied as diagnostic means in cases of uterine squamous carcinoma and in its metastases. (author)

  4. The effects of gemcitabine and capecitabine combination chemotherapy and of low-dose adjuvant GM-CSF on the levels of myeloid-derived suppressor cells in patients with advanced pancreatic cancer.

    OpenAIRE

    Annels, NE; Shaw, VE; Gabitass, RF; Billingham, L.; Corrie, P; Eatock, M; Valle, J.; Smith, D; Wadsley, J.; Cunningham, D; Pandha, H; Neoptolemos, JP; Middleton, G.

    2013-01-01

    In pre-clinical models, the only two chemotherapy drugs which have been demonstrated to directly reduce the number of myeloid-derived suppressor cells (MDSCs) are gemcitabine and 5-fluorouracil. Here we analyze the dynamics of MDSCs, phenotyped as Lin-DR-CD11b+, in patients with advanced pancreatic cancer receiving the combination of gemcitabine and capecitabine, a 5-FU pro-drug. We found no evidence that gemcitabine and capecitabine directly reduce MDSC% in patients. Gemcitabine and capecita...

  5. Radiation therapy for carcinoma of the uterine cervix. Comparison of two brachytherapy schedules

    International Nuclear Information System (INIS)

    We compared the survival rates and late effects for two groups of cervical cancer patients treated with almost the same external radiotherapy but different remote afterloading systems (RALS) for high-dose-rate intracavitary radiation therapy regimens. A total of 218 patients with carcinoma of the uterine cervix were treated. For 98 patients, intracavitary brachytherapy was delivered with 6-7.5 Gy/fraction to Point A (Group A), and for 120, 5 Gy/fraction with a modified source step size (Group B). The 3-year cause-specific survival rates by stage and treatment schedule were Group A: 91% and Group B: 96% in Stage I, 89% and 92% in Stage II, 64% and 75% in Stage III, 44% and 69% in Stage IV. The survival curves did not reveal any statistically significant differences at any stage. The 3-year cumulative local failure rates were 14% in Group A and 7% in Group B (P = 0.1202), while the actuarial rates of developing rectal complication (Grade 2 or more) at 3 years were 25% in Group A and 4% in Group B (P < 0.0001). This retrospective analysis suggests that a low dose per fraction with modified source step size is advantageous because of yielding almost the same local control but with fewer rectal complications. (author)

  6. PREOPERATIVE THERAPY OF LOW-DOSE ASPIRIN IN INTERNAL MAMMARY ARTERY BYPASS OPERATIONS WITH AND WITHOUT LOW-DOSE APROTININ

    NARCIS (Netherlands)

    SCHONBERGER, JPAM; BREDEE, JJ; VANOEVEREN, W; VANZUNDERT, AAJ; VERKROOST, M; TERWOORST, J; BAVINCK, JH; BERREKLOUW, E; WILDEVUUR, CRH

    1993-01-01

    The effect of preoperative low-dose aspirin (1 mg/kg of body weight) and intraoperative low-dose aprotinin (2 million kallikrein inactivator units) treatment on perioperative blood loss and blood requirements in patients who undergo internal mammary artery bypass operations is unknown. Therefore, we

  7. Automatic evaluation of uterine cervix segmentations

    Science.gov (United States)

    Lotenberg, Shelly; Gordon, Shiri; Long, Rodney; Antani, Sameer; Jeronimo, Jose; Greenspan, Hayit

    2007-03-01

    In this work we focus on the generation of reliable ground truth data for a large medical repository of digital cervicographic images (cervigrams) collected by the National Cancer Institute (NCI). This work is part of an ongoing effort conducted by NCI together with the National Library of Medicine (NLM) at the National Institutes of Health (NIH) to develop a web-based database of the digitized cervix images in order to study the evolution of lesions related to cervical cancer. As part of this effort, NCI has gathered twenty experts to manually segment a set of 933 cervigrams into regions of medical and anatomical interest. This process yields a set of images with multi-expert segmentations. The objectives of the current work are: 1) generate multi-expert ground truth and assess the diffculty of segmenting an image, 2) analyze observer variability in the multi-expert data, and 3) utilize the multi-expert ground truth to evaluate automatic segmentation algorithms. The work is based on STAPLE (Simultaneous Truth and Performance Level Estimation), which is a well known method to generate ground truth segmentation maps from multiple experts' observations. We have analyzed both intra- and inter-expert variability within the segmentation data. We propose novel measures of "segmentation complexity" by which we can automatically identify cervigrams that were found difficult to segment by the experts, based on their inter-observer variability. Finally, the results are used to assess our own automated algorithm for cervix boundary detection.

  8. Using of electrical impedance tomography for diagnostics of the cervix uteri diseases

    Science.gov (United States)

    Trokhanova, O. V.; Chijova, Y. A.; Okhapkin, M. B.; Korjenevsky, A. V.; Tuykin, T. S.

    2010-04-01

    The report presents results of investigation of the neck of the womb (cervix) of 64 women aged from 19 to 70, that formed 4 clinical groups (1st group: 15 women without any pathology of the cervix, 2nd group: 27 women with the erosion, 3rd group: 11 women with dysplasia, 4th group: 11 women with cancer of the cervix). The aim of this research is to assess the capabilities of electrical impedance tomography in the diagnostics of the cervix diseases. The methods of the research were: visual examination with the speculum, colposcopy, and biopsy of the cervix. Also the new method of visualization of the cervix was used - electrical impedance tomography with the help of gynecological impedance tomograph (GIT). The following results were obtained. The electrical conductivity of the cervix in norm and in different pathology has different indices, which allow differential diagnostics of benign and malignant diseases. Summary: the method of electrical impedance tomography allows not only visually estimate portio vaginalis, but receive indices of electrical conductivity of the cervix on the depth up to 0.8 cm and thereby reveal pathological changes in epithelium without invasive and operative intervention.

  9. Hippocampal volumes in patients exposed to low-dose radiation to the basal brain. A case–control study in long-term survivors from cancer in the head and neck region

    International Nuclear Information System (INIS)

    An earlier study from our group of long time survivors of head and neck cancer who had received a low radiation dose to the hypothalamic-pituitary region, with no signs of recurrence or pituitary dysfunction, had their quality of life (QoL) compromised as compared with matched healthy controls. Hippocampal changes have been shown to accompany several psychiatric conditions and the aim of the present study was to test whether the patients’ lowered QoL was coupled to a reduction in hippocampal volume. Patients (11 men and 4 women, age 31–65) treated for head and neck cancer 4–10 years earlier and with no sign of recurrence or pituitary dysfunction, and 15 matched controls were included. The estimated radiation doses to the basal brain including the hippocampus (1.5 – 9.3 Gy) had been calculated in the earlier study. The hippocampal volumetry was done on coronal sections from a 1.5 T MRI scanner. Measurements were done by two independent raters, blinded to patients and controls, using a custom method for computer assisted manual segmentation. The volumes were normalized for intracranial volume which was also measured manually. The paired t test and Wilcoxon’s signed rank test were used for the main statistical analysis. There was no significant difference with respect to left, right or total hippocampal volume between patients and controls. All mean differences were close to zero, and the two-tailed 95% confidence interval for the difference in total, normalized volume does not include a larger than 8% deficit in the patients. The study gives solid evidence against the hypothesis that the patients’ lowered quality of life was due to a major reduction of hippocampal volume

  10. Ultra low-dose CT attenuation correction in PET SPM

    International Nuclear Information System (INIS)

    The use of CT images for attenuation correction (CTAC) allows significantly shorter scanning time and a high quality noise-free attenuation map compared with conventional germanium-68 transmission scan because at least 104 times greater of photon flux would be generated from a CT scan under standard operating condition. However, this CTAC technique would potentially introduce more radiation risk to the patients owing to the higher radiation exposure from CT scan. Statistic parameters mapping (SPM) is a prominent technique in nuclear medicine community for the analysis of brain imaging data. The purpose of this study is to assess the feasibility of low-dose CT (LDCT) and ultra low-dose CT (UDCT) in PET SPM applications. The study was divided into two parts. The first part was to evaluate of tracer uptake distribution pattern and quantity analysis by using the striatal phantom to initially assess the feasibility of AC for clinical purpose. The second part was to examine the group SPM analysis using the Hoffman brain phantom. The phantom study is to simulate the human brain and to reduce the experimental uncertainty of real subjects. The initial studies show that the results of PET SPM analysis have no significant differences between LDCT and UDCT comparing to the current used default CTAC. Moreover, the dose of the LDCT is lower than that of the default CT by a factor of 9, and UDCT can even yield a 42 times dose reduction. We have demonstrated the SPM results while using LDCT and UDCT for PET AC is comparable to those using default CT setting, suggesting their feasibility in PET SPM applications. In addition, the necessity of UDCT in PET SPM studies to avoid excess radiation dose is also evident since most of the subjects involved are non-cancer patients or children and some normal subjects are even served as a comparison group in the experiment. It is our belief that additional attempts to decrease the radiation dose would be valuable, especially for children and

  11. Ultra low-dose CT attenuation correction in PET SPM

    Science.gov (United States)

    Wang, Shyh-Jen; Yang, Bang-Hung; Tsai, Chia-Jung; Yang, Ching-Ching; Lee, Jason J. S.; Wu, Tung-Hsin

    2010-07-01

    The use of CT images for attenuation correction (CTAC) allows significantly shorter scanning time and a high quality noise-free attenuation map compared with conventional germanium-68 transmission scan because at least 10 4 times greater of photon flux would be generated from a CT scan under standard operating condition. However, this CTAC technique would potentially introduce more radiation risk to the patients owing to the higher radiation exposure from CT scan. Statistic parameters mapping (SPM) is a prominent technique in nuclear medicine community for the analysis of brain imaging data. The purpose of this study is to assess the feasibility of low-dose CT (LDCT) and ultra low-dose CT (UDCT) in PET SPM applications. The study was divided into two parts. The first part was to evaluate of tracer uptake distribution pattern and quantity analysis by using the striatal phantom to initially assess the feasibility of AC for clinical purpose. The second part was to examine the group SPM analysis using the Hoffman brain phantom. The phantom study is to simulate the human brain and to reduce the experimental uncertainty of real subjects. The initial studies show that the results of PET SPM analysis have no significant differences between LDCT and UDCT comparing to the current used default CTAC. Moreover, the dose of the LDCT is lower than that of the default CT by a factor of 9, and UDCT can even yield a 42 times dose reduction. We have demonstrated the SPM results while using LDCT and UDCT for PET AC is comparable to those using default CT setting, suggesting their feasibility in PET SPM applications. In addition, the necessity of UDCT in PET SPM studies to avoid excess radiation dose is also evident since most of the subjects involved are non-cancer patients or children and some normal subjects are even served as a comparison group in the experiment. It is our belief that additional attempts to decrease the radiation dose would be valuable, especially for children and

  12. Global DNA methylation responses to low dose radiation exposure

    International Nuclear Information System (INIS)

    At high radiation doses, breaks in the DNA are considered the critical lesions in initiation of radiation- induced cancer. However, at the very low radiation doses relevant for the general public, the induction of such breaks will be rare, and other changes to the DNA such as DNA methylation may play a role in radiation responses. DNA methylation is the addition of a methyl group to cytosine in the DNA, usually where a cytosine is adjacent to a guanine (CpG). Methylation affects the way in which genes are read, and is inherited from cell to cell on replication. It is known that high dose radiation can cause changes in methylation in the genome but less is known about the effect of low dose radiation on methylation. We developed a sensitive assay to measure the levels of DNA methylation across the mouse genome by analysing a stretch of DNA sequence within Long Interspersed Nuclear Elements-1(LINE1) that comprise a very large proportion of the mouse and human genomes. Using bisulphite modification followed by quantitative real-time polymerase chain reaction (PCP) and high- resolution melt analysis, a very large pool of DNA sequences from throughout the genome can be studied indicating gain or loss of methylation. We validated the assay in vitro using the chemical demethylating agent 5'-aza-2' -deoxycytidine with changes at as few as 3% of CpG's being reproducibly detected. We have demonstrated a difference in the baseline levels of in vivo DNA methylation between male and female mice and between different tissues. Our initial results suggest no significant short-term or long-term changes in global DNA methylation after low dose whole-body X-radiation of 10 -Gy or 10 mGy, with a significant transient increase in DNA methylation observed 1 day after a high dose of 1 Gy. If the low radiation doses tested are inducing changes in global DNA methylation, these would appear to be smaller than the natural variation observed between the sexes and following the general stress

  13. Ultra low-dose CT attenuation correction in PET SPM

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Shyh-Jen; Yang, Bang-Hung [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong Street, Sec. 2, Taipei 112, Taiwan (China); Department of Nuclear Medicine, Taipei Veterans General Hospital, Taiwan (China); Tsai, Chia-Jung [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong Street, Sec. 2, Taipei 112, Taiwan (China); Yang, Ching-Ching [Department of Radiological Technology, Tzu Chi College of Technology, Hualien, Taiwan (China); Lee, Jason J.S. [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong Street, Sec. 2, Taipei 112, Taiwan (China); Wu, Tung-Hsin, E-mail: tung@ym.edu.t [Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, 155 Li-Nong Street, Sec. 2, Taipei 112, Taiwan (China)

    2010-07-21

    The use of CT images for attenuation correction (CTAC) allows significantly shorter scanning time and a high quality noise-free attenuation map compared with conventional germanium-68 transmission scan because at least 10{sup 4} times greater of photon flux would be generated from a CT scan under standard operating condition. However, this CTAC technique would potentially introduce more radiation risk to the patients owing to the higher radiation exposure from CT scan. Statistic parameters mapping (SPM) is a prominent technique in nuclear medicine community for the analysis of brain imaging data. The purpose of this study is to assess the feasibility of low-dose CT (LDCT) and ultra low-dose CT (UDCT) in PET SPM applications. The study was divided into two parts. The first part was to evaluate of tracer uptake distribution pattern and quantity analysis by using the striatal phantom to initially assess the feasibility of AC for clinical purpose. The second part was to examine the group SPM analysis using the Hoffman brain phantom. The phantom study is to simulate the human brain and to reduce the experimental uncertainty of real subjects. The initial studies show that the results of PET SPM analysis have no significant differences between LDCT and UDCT comparing to the current used default CTAC. Moreover, the dose of the LDCT is lower than that of the default CT by a factor of 9, and UDCT can even yield a 42 times dose reduction. We have demonstrated the SPM results while using LDCT and UDCT for PET AC is comparable to those using default CT setting, suggesting their feasibility in PET SPM applications. In addition, the necessity of UDCT in PET SPM studies to avoid excess radiation dose is also evident since most of the subjects involved are non-cancer patients or children and some normal subjects are even served as a comparison group in the experiment. It is our belief that additional attempts to decrease the radiation dose would be valuable, especially for children

  14. Synergistic effect of exemestane and low-dose methotrexate on exemestane-resistant MCF-7 human breast cancer cells and reversal mechanism of drug-resistance%依西美坦与低剂量甲氨蝶呤对依西美坦耐药人乳腺癌细胞的协同效应及逆转耐药机制

    Institute of Scientific and Technical Information of China (English)

    居伶俐; 袁媛; 潘跃银

    2014-01-01

    Objective To investigate the combined effect of exemestane and low-dose methotrexate on exemestane-resistant MCF-7 human breast cancer cells( MCF-7/EXE). Methods Antiproliferative effects of exemestane and low-dose of methotrexate, alone and in combination on growth of MCF-7/EXE cells were assessed by using the MTT assay. Synergistic interaction between the two drugs was evaluated in vitro by using the combination index ( CI) method. The cell cycle distribution was analyzed by flow cytometry in a half inhibitory concentration of exemestane and low-dose of methotrexate . The changes of apoptosis on MCF-7/EXE cells exposed to two drugs alone or in com-bination were observed by fluorescence microscope. The expression of Bcl-2,AKT,P-AKT and cyclooxygenase-2 was investigated by Western blot. Results MTT assays indicated that the combination treatment apparently decreased the viability of MCF-7/EXE cells compared to single drug treatment (CI<0. 9). In addition, the combination of exemestane and low-dose methotrexate exhibited a synergistic inhibition of cell proliferation, arrested the cell cycle in the S phase significantly and produced a stronger inhibitory effects on P-AKT, Bcl-2 and cyclooxygenase-2 ex-pression than control or individual drug treatment. Conclusion The combination of the two inhibitors significantly increases the response as compared to single agent treatment, suggesting that combination treatment which can re-verse the resistance of exemestane could be a more effective approach to breast cancer.%目的研究依西美坦( EXE )与低剂量甲氨蝶呤( MTX)对依西美坦耐药人乳腺癌 MCF-7细胞( MCF-7/EXE)的增殖抑制作用及意义。方法使用 MTT 法检测EXE与低剂量MTX单药和联合给药对MCF-7/EXE细胞的增殖抑制作用,计算依西美坦与低剂量甲氨蝶呤联合给药时的联合指数(CI),评价两药间的相互作用。流式细胞术检测IC50浓度药物EXE组(120μmol/L)、低剂量MTX组(60 nmol

  15. Induction gemcitabine in standard dose or prolonged low-dose with cisplatin followed by concurrent radiochemotherapy in locally advanced non-small cell lung cancer: a randomized phase II clinical trial

    International Nuclear Information System (INIS)

    The optimal combination of chemotherapy with radiation therapy for treatment locally advanced non-small cell lung cancer (NSCLC) remains an open issue. This randomized phase II study compared gemcitabine in two different schedules and cisplatin - as induction chemotherapy, followed by radiation therapy concurrent with cisplatin and etoposid. Eligible patients had microscopically confirmed inoperable non-metastatic non-small cell lung cancer; fulfilled the standard criteria for platin-based chemotherapy; and signed informed consent. Patients were treated with 3 cycles of induction chemotherapy with gemcitabine and cisplatin. Two different aplications of gemcitabine were compared: patients in arm A received gemcitabine at 1250 mg/m2 in a standard half hour i.v. infusion on days 1 and 8; patients in arm B received gemcitabine at 250 mg/m2 in prolonged 6-hours i.v. infusion on days 1 and 8. In both arms, cisplatin 75 mg/m2 on day 2 was administered. All patients continued treatment with radiation therapy with 60–66 Gy concurrent with cisplatin 50 mg/m2 on days 1, 8, 29 and 36 and etoposid 50 mg/m2 on days 1–5 and 29–33. The primary endpoint was response rate (RR) after induction chemotherapy; secondary endpoints were toxicity, progression-free survival (PFS) and overall survival (OS). From September 2005 to November 2010, 106 patients were recruited to this study. No statistically signifficant differences were found in RR after induction chemotherapy between the two arms (48.1% and 57.4%, p = 0.34). Toxicity profile was comparable and mild with grade 3/4 neutropenia as primary toxicity in both arms. One patient in arm B suffered from acute peripheral ischemia grade 4 and an amputation of lower limb was needed. With a median follow-up of 69.3 months, progression-free survival and median survival in arm A were 15.7 and 24.8 months compared to 18.9 and 28.6 months in arm B. The figures for 1- and 3-year overall survival were 73.1% and 30.8% in arm A, and 81.5 % and

  16. Topics on study of low dose-effect relationship

    International Nuclear Information System (INIS)

    It is not exceptional but usually observed that a dose-effect relationship in biosystem is not linear. Sometimes, the low dose-effect relationship appears entirely contrary to the expectation from high dose-effect. This is called a 'hormesis' phenomena. A high dose irradiation inflicts certainly an injury on biosystem. No matter how low the dose may be, an irradiation might inflict some injury on biosystem according to Linear Non-Threshold hypothesis(LNT). On the contrary to the expectation, a low dose irradiation stimulates immune system, and promotes cell proliferation. This is called 'radiation hormesis'. The studies of the radiation hormesis are made on from four points of view as follows: (1) radiation adaptive response, (2) revitalization caused by a low dose stimulation, (3) a low dose response unexpected from the LNT hypothesis, (4) negation of the LNT hypothesis. The various empirical proofs of radiation hormesis are introduced in the report. (M . Suetake)