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Sample records for combined postoperative radiotherapy

  1. Prognostic value and importance of surgery combined with postoperative radiotherapy for oral and oropharyngeal cancer

    International Nuclear Information System (INIS)

    Maciejewski, A.

    2001-01-01

    The aim of this paper is to evaluate the efficacy of surgery for patients with oral cavity or oropharyngeal cancer, and is impact on the final results of treatment combined with postoperative radiotherapy. Furthermore, predictive and prognostic value of clinical and histopatological postoperative factors were analysed, and estimation of clinical applicability of modified scale for risk of postoperative local and/or nodal recurrence according to Peters was checked. Material includes 218 cases of the advanced oral cavity or oropharyngeal cancer. All data were subdivided into 4 groups depending on treatment strategy. For the analysis of the treatment efficacy (overall and disease-free survival) many predictive and prognostic factors have been considered. Despite of multivariate logistic regression analysis of these factors, the risk of local recurrence was related to the results of combined treatment based on the modified numerical risk scale adapted from Peters. The risk value is the sum of scores given to individual prognostic factors. Time interval between surgery and radiotherapy (TI) and overall treatment time (TTT) have been accounted for the analysis. Generally; optimal results were noted in the group B, where surgery has been combined with postoperative radiotherapy. In case of surgery combined with preoperative radiotherapy (group E) 5-year DFS was 30%, and in the case when radiotherapy was delayed and applied when recurrence after primary surgery has occurred, the 5-year DFS was not higher than 20%. Macro- and microscopic surgical radicalism has been found one of the most important and significant prognostic factors. For positive margins (m+) 5-year DFS significantly decreases to about 20%. Surgical macro- and microradicalism has an important impact (p = 0.013) on the incidence of distant metastases. The scoring system for the recurrence was based on Peters scale. The sum of the risk scores (TRRI+n) for individual prognostic factors allow to allocate

  2. Postoperative radiotherapy for intracranial meningioma

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    Chun, Ha Chung; Lee, Myung Za

    2001-01-01

    To evaluate the effectiveness and tolerance of postoperative external radiotherapy for patients with intracranial meningiomas. The records of thirty three patients with intracranial meningiomas who were treated with postoperative external irradiation at our institution between Feb, 1988 and Nov, 1999 were retrospectively analyzed. Median age of patients at diagnosis was 53 years with range of 17 to 68 years. Sites of involvement were parasagital, cerebral convexity, sphenoid ridge, parasellar and tentorium cerebella. Of 33 evaluated patients, 15 transitional, 10 meningotheliomatous, 4 hemangiopericytic, 3 atypical and 1 malignant meningioma were identified. Four patients underwent biopsy alone and remaining 29 patients underwent total tumor resection. A dose of 50 to 60 Gy was delivered in 28-35 daily fractions over a period of 5 to 7 weeks. Follow-up period ranged from 12 months to 8 years. The actuarial survival rates at 5 and 7 years for entire group of patients were 78% and 67%, respectively. The corresponding disease free survival rates were 73% and 61 %, respectively. The overall local control rate at 5 years was 83%. One out of 25 patients in benign group developed local failure, while 4 out of 8 patients in malignant group did local failure (p <0.05), Of 4 patients who underwent biopsy alone, 2 developed local failure. There was no significant difference in 5 year actuarial survival between patients who underwent total tumor resection and those who did biopsy alone. Patients whose age is under 60 showed slightly better survival than those whose age is 60 or older, although this was not statistically significant. There was no documented late complications in any patients. Based on our study, we might conclude that postoperative external beam radiotherapy tends to improve survival of patients with intracranial meningiomas comparing with surgery alone

  3. Postoperative interstitial radiotherapy of keloids

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    Clavere, P.; Bonnafoux-Clavere, A.; Roullet, B.; Morzel, A.; Rhein, B.; Bonnetblanc, J.M.; Olivier, J.P.

    1993-01-01

    During an 8-year period, 21 patients with keloids (27 keloids) were treated with keloidectomy and post-operative interstitial radiotherapy by an iridium 192 wire. Only one patient had been previously treated by corticoids, without results. A dose of 12 Gy (three patients) to 15 Gy (18 patients) was delivered at a point 2.5 mm from the axis of the wire. The follow-up time was from 2 - 104 months. The success rate, at 7 months, was close to 88%. Ao recurrence occurred in three patients without relation to the method used, the lesion-age or the localization of the lesions. There were no side-effects. This method represents an effective, non-constraining and safe treatment for keloids if the contra-indications are respected

  4. Long-term bresults of radiotherapy combined with nedaplatin and 5-fluorouracil for postoperative loco-regional recurrent esophageal cancer: update on a phase II study

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    Jingu Keiichi

    2012-11-01

    Full Text Available Abstract Background In 2006, we reported the effectiveness of chemoradiotherapy for postoperative recurrent esophageal cancer with a median observation period of 18 months. The purpose of the present study was to update the results of radiotherapy combined with nedaplatin and 5-fluorouracil (5-FU for postoperative loco-regional recurrent esophageal cancer. Methods Between 2000 and 2004, we performed a phase II study on treatment of postoperative loco-regional recurrent esophageal cancer with radiotherapy (60 Gy/30 fractions/6 weeks combined with chemotherapy consisting of two cycles of nedaplatin (70 mg/m2/2 h and 5-FU (500 mg/m2/24 h for 5 days. The primary endpoint was overall survival rate, and the secondary endpoints were progression-free survival rate, irradiated-field control rate and chronic toxicity. Results A total of 30 patients were enrolled in this study. The regimen was completed in 76.7% of the patients. The median observation period for survivors was 72.0 months. The 5-year overall survival rate was 27.0% with a median survival period of 21.0 months. The 5-year progression-free survival rate and irradiated-field control rate were 25.1% and 71.5%, respectively. Grade 3 or higher late toxicity was observed in only one patient. Two long-term survivors had gastric tube cancer more than 5 years after chemoradiotherapy. Pretreatment performance status, pattern of recurrence (worse for patients with anastomotic recurrence and number of recurrent lesions (worse for patients with multiple recurrent lesions were statistically significant prognostic factors for overall survival. Conclusions Radiotherapy combined with nedaplatin and 5-FU is a safe and effective salvage treatment for postoperative loco-regional recurrent esophageal cancer. However, the prognosis of patients with multiple regional recurrence or anastomotic recurrence is very poor.

  5. Three dimensional conformal postoperative radiotherapy for ...

    African Journals Online (AJOL)

    Introduction: Postoperative radiotherapy of the parotid gland could be achieved with various radiotherapy techniques. However they irradiate differently the surrounding organs at risk (OARs) in particular the cochlea, oral cavity & contralateral parotid causing significant increase in the risk of oral mucositis, xerostomia, and ...

  6. Postoperative radiotherapy for locally advanced gastric cancer

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    Lee, M. Z.; Chun, H. C.; Kim, I. S.; Chung, T. J. [Hanyang Univ., Seoul (Korea, Republic of). Coll. of Medicine

    1997-06-01

    Radical gastrectomy is main treatment of gastric cancer. We analyzed patients with stage III and IV stomach cancer who had radical operation and received postoperative radiation therapy combined with or without chemotherapy retrospectively. From March 1985 to June 1993, 68 patients treated with curative resection and received postoperative adjuvant radiotherapy with 36Gy or more were evaluated. Median age was 60years(range 28-66 yrs). Thirty seven patients had non signet ring adenocarcinoma, 29 signet ring cell, 2 other cell. Patients with stage IIIA, IIIB, IV disease were 19, 25 and 24 respectively. Chemotherapy was given to all patients except two. Five-year overall survival and disease-free survival rate were 36.6% and 33.6T, respectively. Recurrence was documented in 34 patients. High recurrence was seen in omentum and peritoneum with 23.5%, and remnant stomach, anastomosis site, A-loop and E-loop had also high recurrence with 13.2%. In field locoregional recurrence was 20.7% and total distant metastases were 39.7%. Total intraabdominal failure was 47.1% and extraabdominal failure was 13.2%. Treatment toxicity was considered to be acceptable. 22.1% of patients had grade 3 and only 1 patient had grade 4 leukopenia. Six patients(8.8%) had weigh loss more than 10%. Treatment toxicity was acceptable with combined treatment with chemotherapy and radiotherapy. Locoregional recurrence was relatively low compared to distant failure with addition of irradiation. Peritoneal and omental seeding was high. Five-year survival was increased with combined modality. Radiation may eradicate minimal residual disease and improve survival. Furthermore to reduce intraabdominal failure, role of intraabdominal chemotherapy in addition to combined chemotherapy plus radiation has to be explored. (author).

  7. Combined electron/photon (E/P) postoperative radiotherapy (RT) for early breast cancer based on central lung distance (CLD) values

    International Nuclear Information System (INIS)

    Akahane, Keiko; Takahashi, Satoshi; Nakamura, Michiko

    2008-01-01

    Combined electron/photon (E/P) method has been introduced since 1999 in the postoperative radiotherapy (RT) for 27 early breast cancer patients out of 491, whose central lung disease (CLD) exceeded over 2.5 cm. Several parameters were analyzed between the conventional method and E/P method. Remarkable improvement was established as follows, CLD 2.64 vs. 1.26 cm, maximum lung distance (MLD) 2.75 vs. 1.40 cm and maximum heart distance (MHD) 1.81 vs. 0.58 cm, respectively (p<0.0001). Combined E/P method would be valid to avoid lung complications and long-term cardiac mortality. (author)

  8. Postoperative radiotherapy dose requirement in standard combined-modality practice for head and neck squamous cell carcinoma: Analysis of salient surgical and radiotherapy parameters in 2 cohorts.

    Science.gov (United States)

    Mohanti, Bidhu K; Thakar, Alok; Kaur, Jaspreet; Bahadur, Sudhir; Malik, Monica; Gandhi, Ajeet K; Bhasker, Suman; Sharma, Atul

    2017-09-01

    This study compared 2 sequential cohorts to identify the postoperative radiotherapy (PORT) dose requirement for head and neck squamous cell carcinoma (HNSCC). Two distinct PORT dose regimens were prescribed over 11 years; group 1 received 56 Gy or less, and group 2 received 60 Gy or more. The 2D and 3D techniques were used. Two sequential cohorts consisted of 478 patients, with mean and median follow-up for group 1 and 2 as: 37.0 versus 28.5 months and 13.8 versus 13.1 months, respectively. Grades 3-4 mucosal toxicities (11.4% vs 28.3%), hospitalization (3.2% vs 17.4%), and nasogastric feeding (11.9% vs 29.7%) were higher in group 2. The 2-year disease-free survival (DFS) was higher with PORT >60 Gy for the following factors: age ≤ 50 years (P = .041); ≥ 4 positive nodes (P = .029); and overall treatment time (OTT) ≥ 100 days (P = .042). Except for the benefit of doses >60 Gy for limited parameters, a lower PORT dose did not compromise the results and can potentially reduce the morbidities and healthcare costs. © 2017 Wiley Periodicals, Inc.

  9. Postoperative radiotherapy for merkel cell carcinoma

    International Nuclear Information System (INIS)

    Inoue, Kazuya; Asakawa, Isao; Katayama, Emiko; Kajitani, Chikae; Tamamoto, Tetsuro; Hasegawa, Masatoshi; Fukumoto, Takaya; Asada, Hideo

    2014-01-01

    Seven patients with Merkel cell carcinoma (MCC) who visited our department of radiation oncology from February 2005 to July 2011 received postoperative radiotherapy (50-60 Gy). All patients were alive without recurrence (median follow-up period: 47.6 (14.7-88.4) months). All of them had grade 2 dermatitis, and one grade 2 oral mucositis and three grade 2 lymphedema were observed. No adverse event grade 3 (CTCAE v4.0) or over was observed. In our hospital, clinical results of postoperative radiotherapy for MCC were fairly good, and adverse events were acceptable during the follow-up period. (author)

  10. Postoperative radiotherapy for rectal and rectosigmoid cancer

    International Nuclear Information System (INIS)

    Aleman, B.M.P.; Lebesque, J.V.; Hart, A.A.M.

    1992-01-01

    Between 1984 and 1988, 206 patients were treated with pelvic radiotherapy after macroscopically complete surgery for rectal or (recto)sigmoid cancer. Depending on an estimation of the amount of small bowel in the intended treatment volume a total dose was, in general, 45 or 50 Gy. An additional boost of 10 Gy was given to 6 patients because of microscopically involved surgical margins. For tumor stage B a statistically significant trend (p=0.017) for higher local control with higher total dose was observed comparing patients treated with a total dose of 45 Gy or less, with more than 45 Gy but less than 50 Gy or with a total dose of 50 Gy or more. This finding illustrates the impact of total dose on local control for postoperative radiotherapy for rectal carcinoma. (author). 18 refs., 1 fig., 1 tab

  11. Therapeutic options and postoperative wound complications after extremity soft tissue sarcoma resection and postoperative external beam radiotherapy.

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    Abouarab, Mohamed H; Salem, Iman L; Degheidy, Magdy M; Henn, Dominic; Hirche, Christoph; Eweida, Ahmad; Uhl, Matthias; Kneser, Ulrich; Kremer, Thomas

    2018-02-01

    Soft tissue sarcomas occur most commonly in the lower and upper extremities. The standard treatment is limb salvage surgery combined with radiotherapy. Postoperative radiotherapy is associated with wound complications. This systematic review aims to summarise the available evidence and review the literature of the last 10 years regarding postoperative wound complications in patients who had limb salvage surgical excision followed by direct closure vs flap coverage together with postoperative radiotherapy and to define the optimal timeframe for adjuvant radiotherapy after soft tissue sarcomas resection and flap reconstruction. A literature search was performed using PubMed. The following keywords were searched: limb salvage, limb-sparing, flaps, radiation therapy, radiation, irradiation, adjuvant radiotherapy, postoperative radiotherapy, radiation effects, wound healing, surgical wound infection, surgical wound dehiscence, wound healing, soft tissue sarcoma and neoplasms. In total, 1045 papers were retrieved. Thirty-seven articles were finally selected after screening of abstracts and applying dates and language filters and inclusion and exclusion criteria. Plastic surgery provides a vast number of reconstructive flap procedures that are directly linked to decreasing wound complications, especially with the expectant postoperative radiotherapy. This adjuvant radiotherapy is better administered in the first 3-6 weeks after reconstruction to allow timely wound healing and avoid local recurrence. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  12. Combined radiotherapy-chemotherapy

    International Nuclear Information System (INIS)

    Steel, G.G.

    1989-01-01

    This paper presents the clinically confirmed benefits of combined chemotherapy-radiotherapy. They have been found in a small group of diseases that respond to chemotherapy alone. According to the author, only when a drug or drug combination has the ability to eradicate occult disease or substantially to reduce the size of objectively measurable disease is there likely to be an demonstrable benefit from its use in conjunction with radiotherapy. It is the author's belief that the immediate future lies in selecting drugs and patients in which a good chemotherapeutic response can be expected, avoiding drugs that seriously enhance radiation damage to normal tissues and keeping drug and radiation treatments far enough apart in time to minimize interactions

  13. Postoperative radiotherapy for parotid gland malignancy

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    Eom, Keun Yong; Wu, Hong Gyun; Kim, Jae Sung; Park, Charn Il; Kim, Kwang Hyun; Lee, Chae Seo [Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, In Ah [Bundang Seoul National University Hospital, Seongnam (Korea, Republic of)

    2005-09-15

    The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Between 1980 and 2002, 130 patients with parotid malignancy were registered in the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative irradiation. There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. The overall 5 and 10 year survival rates were 85 and 76%, respectively. The five-year locoregional control rate was 85%, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal involvement and a positive resection margin were associated with poor locoregional control.

  14. Therapeutic Results of Radiotherapy in Rectal Carcinoma -Comparison of Sandwich Technique Radiotherapy with Postoperative Radiotherapy

    International Nuclear Information System (INIS)

    Huh, Gil Cha; Suh, Hyun Suk; Lee, Hyuk Sang; Kim, Re Hwe; Kim, Chul Soo; Kim, Hong Yong; Kim, Sung Rok

    1996-01-01

    Purpose : To evaluate the potential advantage for 'sandwich' technique radiotherapy compared to postoperative radiotherapy in respectable rectal cancer. Between January 1989 and May 1994, 60 patients with respectable rectal cancer were treated at Inje University Seoul and Sanggye Paik Hospital.Fifty one patients were available for analysis : 20 patients were treated with sandwich technique radiotherapy and 31 patients were treated with postoperative radiotherapy. In sandwich technique radiotherapy(RT), patients were treated with preoperative RT 1500 cGy/5fx followed by immediate curative resection. Patients staged as Astler-Coller B2, C were considered for postoperative RT with 2500-4500 cGy. In postoperative RT, total radiation dose of 4500-6120 cGy, 180 cGy daily at 4-6 weeks was delivered. Patients were followed for median period of 25 months. Results : The overall 5-year survival rates for sandwich technique RT group and postoperative RT group were 60% and 71%, respectively(p>0.05). The 5-year disease free survival rates for each group were 63%. There was no difference in local failure rate between two groups(11% versus 7%). Incidence of distant metastasis was 11%(2/20) in the sandwich technique RT group and 20%(6/31) in the postoperative RT group(p>0.05). The frequencies of acute and chronic complications were comparable in both groups. Conclusion : The sandwich technique radiotherapy group shows local recurrence and survival similar to those of postoperative RT alone group but reduced distant metastasis compared to postoperative RT group. But long term follow-up and large number of patients is needed to make an any firm conclusion regarding the value of this sandwich technique RT

  15. Tolerance of radiotherapy combined with adjuvant chemotherapy in breast cancer

    International Nuclear Information System (INIS)

    Hrafnkelsson, J.; Nilsson, K.; Soederberg, M.

    1987-01-01

    Forty-three postmenopausal breast cancer patients with axillary lymph node metastasis were randomized to receive postoperative radiotherapy (45 Gy) or the combination of radiotherapy and 6 months of chemotherapy. Forty-three premenopausal patients had postoperative radiotherapy and were randomized to receive one of two different chemotherapy combinations. Pulmonary fibrosis was roentgenologically registered in approximately 70% of the total patient population six months after initiation of therapy. Addition of chemotherapy with doxorubicin and cyclophosphamide significantly increased the proportion of patients with pulmonary fibrosis compared with patients treated with radiotherapy only or radiotherapy combined with cyclophosphamide, methotrexate and 5-fluorouracil. Premenopausal patients tolerated the combination of radiotherapy and chemotherapy better than postmenopausal patients of whom approximately 30% did not tolerate 65% or more of prescribed total dose of chemotherapy. (orig.)

  16. Postoperative craniospinal radiotherapy of medulloblastoma in children and young adults

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    Golubičić Ivana V.

    2003-01-01

    Full Text Available PURPOSE The aim of this study was: 1. to evaluate treatment results of combined therapy (surgery, postoperative craniospinal radiotherapy with or without chemotherapy and 2. to assess factors affecting prognosis (extend of tumor removal, involvement of the brain stem, extent of disease postoperative meningitis, shunt placement, age, sex and time interval from surgery to start of postoperative radiotherapy. PATIENTS AND METHODS During the period 1986-1996, 78 patients with medulloblastoma, aged 1-22 years (median 8.6 years, were treated with combined modality therapy and 72 of them were evaluable for the study end-points. Entry criteria were histologically proven diagnosis, age under 22 years, and no history of previous malignant disease. The main characteristics of the group are shown in Table 1. Twenty-nine patients (37.2% have total, 8 (10.3% near total and 41 (52.5% partial removal. Seventy-two of 78 patients were treated with curative intent and received postoperative craniospinal irradiation. Radiotherapy started 13-285 days after surgery (median 36 days. Only 13 patients started radiotherapy after 60 days following surgery. Adjuvant chemotherapy was applied in 63 (80.7% patients. The majority of them (46 73% received chemotherapy with CCNU and Vincristine. The survival rates were calculated with the Kaplan-Meier method and the differences in survival were analyzed using the Wilcoxon test and log-rank test. RESULTS The follow-up period ranged from 1-12 years (median 3 years. Five-year overall survival (OS was 51% and disease-free survival (DFS 47% (Graph 1. During follow-up 32 relapses occurred. Patients having no brain stem infiltration had significantly better survival (p=0.0023 (Graph 2. Patients with positive myelographic findings had significantly poorer survival compared to dose with negative myelographic findings (p=0.0116. Significantly poorer survival was found in patients with meningitis developing in the postoperative period

  17. Combination of post-operative radiotherapy and cetuximab for high-risk cutaneous squamous cell cancer of the head and neck: A propensity score analysis.

    Science.gov (United States)

    Palmer, Joshua D; Schneider, Charles J; Hockstein, Neil; Hanlon, Alexandra L; Silberg, Jordan; Strasser, Jon; Mauer, Elizabeth A; Dzeda, Michael; Witt, Robert; Raben, Adam

    2018-03-01

    The objective of this study was to investigate the safety, tolerability and preliminary efficacy of radiotherapy plus cetuximab in high risk CSCC patients. Patients with high-risk CSCC diagnosed between 2006 and 2013 were analyzed. Patients were divided into two groups: radiotherapy alone versus radiotherapy plus cetuximab. Among 68 patients meeting study criteria, we identified 29 treated with cetuximab plus RT and 39 with RT alone. Primary analysis examined disease-free and overall survival, freedom from local and distant recurrence in the propensity score matched cohort. Propensity score analysis was performed with weighted factors including: Charlson Comorbidity Index score, age. KPS, primary location, T and N stage, recurrent status, margin status, LVSI, PNI and grade. Toxicity was assessed using the CTCAE v4.0. Median follow-up for living patients was 30 months. Patients in the cetuximab group were more likely to have advanced N stage, positive margins and recurrent disease. After propensity score matching the groups were well balanced. Six patients experienced ≥ grade 3 acute toxicity in the cetuximab group. The 1-year, 2-year and 5-year progression free survival (PFS) for patients in the cetuximab group were 86%, 72% and 66%, respectively. The 1-year, 2-year and 5-year overall survival (OS) for patients in the cetuximab group was 98%, 80% and 80%, respectively. Although limited by small numbers, the combination of cetuximab and radiotherapy in CSCC appears well tolerated there were more long-term survivors and less distant metastasis in the cetuximab group. These promising finding warrant further studies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Postoperative radiotherapy after laser surgery with or without chemotherapy in head and neck evolved cancers

    International Nuclear Information System (INIS)

    Ryll, L.; Pradier, O.; Nitsche, M.; Christiansen, H.; Hess, C.

    2007-01-01

    We compared concurrent combination chemoradiotherapy and adjuvant radiotherapy after laser surgery in patients with stage 3/4 non metastatic squamous cell head and neck cancer. Combination chemotherapy and concurrent irradiation after laser surgery was not superior to surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, the collective is small, and the follow-up to short to conclude. (authors)

  19. Three dimensional conformal postoperative radiotherapy for ...

    African Journals Online (AJOL)

    Azza Helal

    2013-06-17

    Jun 17, 2013 ... during postoperative 3DCRT treatment of parotid gland cancer patients. ... contralateral parotid, oral cavity, cochlea, spinal cord, brain stem, eyes, lenses and ... xerostomia, dry ear, ear infections, hearing deficits and ipsilat-.

  20. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

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    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  1. Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

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    Kim, Tae Hyung; Kim, Mi Sun; Choi, Seo Hee; Suh, Yang Gun; Koh, Yoon Woo; Kim, Se Hun; Choi, Eun Chang; Keum, Ki Chang [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-15

    We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

  2. Efficacy of post-operative radiotherapy in the treatment of breast cancer

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    Api, P; Corcione, S; Magnoni, G

    1985-01-01

    A clinical evaluation regarding the efficacy of post-operative radiotherapy in 294 patients with breast cancer is presented. In the author's opinion post-operative radiotherapy is fundamental in the treatment of this tumor. 21 refs.

  3. Basis for new strategies in postoperative radiotherapy of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Choi, N.C.H.; Grillo, H.C.; Gardiello, M.; Scannel, J.G.; Wilkins, E.W. Jr.

    1980-01-01

    In order to improve our understanding of the role of postoperative radiotherapy and to search for new strategies in the management of N 1 , N 2 , T 3 stage carcinoma of the lung, we analyzed results of treatment in 148 of 166 patients who were registered at the Massachusetts General Hospital Tumor Registry from 1971 to 1977 with a pathological diagnosis of N 1 , N 2 , T 3 carcinoma of the lung after pulmonary resection. Ninety-three patients received postoperative radiotherapy and another 55 were followed without further treatment. Patients with adenocarcinoma showed significant improvement of survival by postoperative radiotherapy; actuarial NED (no evidence of disease) survival rates were 85% and 51% at 1 year, and 43% and 8% at 5 years for S + RT (patients treated with surgery plus postoperative radiotherapy) and S (patients treated with surgery only) groups, respectively, (P 2 , T 3 stages. Regional recurrence was the most common failure in squamous cell carcinoma; 76% (13/17) and 45% (10/22) of all failures were in the regional area in S and S + RT groups. Regional failure in S + RT group was noted with radiation dose up to 5000 rad (TDF 82) which suggests radiation dose higher than 5000 rad in future trial

  4. Occult carcinoma discovered after simple hysterectomy treated with postoperative radiotherapy

    International Nuclear Information System (INIS)

    Crane, Christopher H.; Schneider, Bernard F.

    1999-01-01

    Purpose: Treatment of patients with occult carcinoma of the cervix discovered after simple hysterectomy is controversial. The purpose of this review is to examine our results with postoperative radiotherapy and to compare them to similar reports and to reports of treatment with radical parametrectomy. Methods and Materials: Between November 1979 and April:, 18 patients were treated with radiotherapy at the University of Virginia for invasive carcinoma of the cervix discovered after simple hysterectomy. Simple hysterectomy was performed in all 18 patients for a variety of indications. After surgery gross residual carcinoma remained in four patients; and microscopic disease was present at the surgical margins in two patients. The remaining patients had no evidence of residual disease. All 18 patients had postoperative radiotherapy with or without brachytherapy. The endpoints for this study were local control, survival, and treatment-related toxicity. Actuarial rates were calculated using the Life method. Results: Median follow-up for all 18 patients was 42 months (range 2-202 months). Both the 5 and the 10-year actuarial local control rates were 88%. Five and 10-year actuarial overall survival rates were both 93%. Two patients had both local and distant cancer recurrences. There were no recurrences among the six patients treated with external beam alone. The remaining patients are all alive without evidence of disease, including two patients who had gross residual disease after surgery, and one patient with both microscopic positive margin and a positive lymph node (the only patient to undergo lymph node sampling). There was no severe acute morbidity and only one patient had severe late morbidity. Conclusions: Invasive carcinoma found after simple hysterectomy may be treated safely and effectively with postoperative radiotherapy. Patients with known residual disease following surgery do poorly with either radiotherapy or reoperation, but treatment with radiotherapy

  5. Postoperative radiotherapy of supratentorial anaplastic gliomas

    International Nuclear Information System (INIS)

    Wendt, T.G.; Bacherler, B.; Baumer, K.; Rohloff, R.; Willich, N.

    1986-01-01

    Between 1970 and 1983, 149 patients with high grade anaplastic supratentorial gliomas received a postoperative irradiation during primary treatment. 118 out of these patients had an anaplastic astrocytoma, 18 an anaplastic oligodendroglioma, and 13 an anaplastic ependymoma. Most of these patients were treated by irradiation of a great volume with 50 Gy within five weeks, the others by irradiation of the total brain with 50 Gy within five weeks and saturation with 10 Gy within one week. The one-year survival of the total group was 35.5% and the two-year survival 10.6%. Patients at an age of less than 40 years show a significantly longer survival than older patients (one-year survival rates 40% and 30.7%, respectively). Patients suffering from anaplastic tumors with astrocytic and oligodendrocytic differentiation have a comparable prognosis. Patients suffering from anaplastic tumors with ependymal differentiation, however, have prolonged survival times. The therapy results of different treatment methods are discussed using the communications of literature. (orig.) [de

  6. Postoperative radiotherapy for stage II and III rectal cancer

    International Nuclear Information System (INIS)

    Qian Liting; Song Yongwen; Liu Xinfan; Yu Zihao; Qian Tunan; Li Yexiong

    2003-01-01

    Objective: To evaluate the impact of postoperative adjuvant radiotherapy, compared with surgery alone for rectal cancer. Methods: From January 1994 to October 1997, 192 patients with stage II or III rectal cancer were treated by radical resection and postoperative radiotherapy (Group S + R) and 51 patients with the same stage lesions underwent surgery alone (Group S). The median dose of radiation was 50(32-62) Gy. Kaplan-Meier method and Log-rank test were used for analysis. Results: The 5-year overall and disease-free survival rates were 60.3% and 58.3%, respectively. The overall 5-year survival rate was 59.4% in Group S + R and 64.7% in Group S, and the 5-year disease-free survival rates were 57.0% and 66.4%, respectively. There were no significant differences between either group (P=0.601 and P=0.424). The disease-free survival was not significantly prolonged in Group S + R as compared with that of Group S. The local recurrence rate was evidently reduced in Group S + R (15.8% v 26.8%, P=0.043). Conclusion: Local recurrence is a major cause of morbidity and mortality in rectal cancer. Postoperative radiotherapy, though reduces the incidence of local recurrence, does not improve the survival in the treatment of stage II and III diseases

  7. Postoperative radiotherapy of uterine sarcoma: A multicentric retrospective study

    International Nuclear Information System (INIS)

    Champetier, C.; Cowen, D.; Hannoun-Levi, J.M.; Resbeut, M.; Azria, D.; Salem, N.; Tessier, E.; Ellis, S.

    2011-01-01

    Purpose. - Surgery is the treatment of choice for localized uterine sarcomas. We conducted a retrospective study to define prognostic factors. Patients and methods. - We studied 111 cases of patients treated by adjuvant radiotherapy for uterine sarcoma in seven French centers. The median decline was 31 months. We conducted a univariate analysis to identify factors correlated with local recurrence. The statistically significant factors were studied in multivariate analysis by Cox model. Results. - The median dose of external beam radiotherapy was 45 Gy. Forty-three percent of patients had vaginal vault brachytherapy and 21 % chemotherapy. Only 6.3 % of patients had complications of acute grade III and 8.1 % of long-term sequelae of radiotherapy. The survival rate at 5 years was 74.6 %. They noted 12.6 % of isolated locoregional recurrences, against 29.7 % for distant recurrences, 80 % were pulmonary. Factors correlated with the risk of locoregional relapse were menopausal status (P = 0.045) and surgical margins suspicious or not healthy (P = 0.0095). The chemotherapy did not improve overall survival or disease free survival but the numbers were low. Conclusion. - The postoperative radiotherapy provides good local control in this disease. Brachytherapy is sometimes done, but it does not improve local control. Chemotherapy is not a standard localized stage but the rate of metastatic recurrence calls for the development of strategies involving systemic treatment with radiotherapy. (authors)

  8. Postoperative radiotherapy for prostate cancer. Morbidity of local-only or local-plus-pelvic radiotherapy

    International Nuclear Information System (INIS)

    Waldstein, Cora; Poetter, Richard; Widder, Joachim; Goldner, Gregor; Doerr, Wolfgang

    2018-01-01

    The aim of this work was to characterise actuarial incidence and prevalence of early and late side effects of local versus pelvic three-dimensional conformal postoperative radiotherapy for prostate cancer. Based on a risk-adapted protocol, 575 patients received either local (n = 447) or local-plus-pelvic (n = 128) radiotherapy. Gastrointestinal (GI) and genitourinary (GU) side effects (≥grade 2 RTOG/EORTC criteria) were prospectively assessed. Maximum morbidity, actuarial incidence rate, and prevalence rates were compared between the two groups. For local radiotherapy, median follow-up was 68 months, and the mean dose was 66.7 Gy. In pelvic radiotherapy, the median follow-up was 49 months, and the mean local and pelvic doses were 66.9 and 48.3 Gy respectively. Early GI side effects ≥ G2 were detected in 26% and 42% of patients respectively (p < 0.001). Late GI adverse events were detected in 14% in both groups (p = 0.77). The 5-year actuarial incidence rates were 14% and 14%, while the prevalence rates were 2% and 0% respectively. Early GU ≥ G2 side effects were detected in 15% and 16% (p = 0.96), while late GU morbidity was detected in 18% and 24% (p = 0.001). The 5-year actuarial incidence rates were 16% and 35% (p = 0.001), while the respective prevalence rates were 6% and 8%. Despite the low prevalence of side effects, postoperative pelvic radiotherapy results in significant increases in the actuarial incidence of early GI and late GU morbidity using a conventional 4-field box radiotherapy technique. Advanced treatment techniques like intensity-modulated radiotherapy (IMRT) or volumetric modulated arc radiotherapy (VMAT) should therefore be considered in pelvic radiotherapy to potentially reduce these side effects. (orig.) [de

  9. Postoperative adjuvant MVP Chemotherapy and Radiotherapy for Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Kim, Jong Hoon; Choi, Eun Kyung; Chang, Hye Sook

    1995-01-01

    Purpose : Since February 1991, a prospective study for non-small cell lung cancer patients who underwent radical resection and had a risk factor of positive resection margin or regional lymph node metastasis has been conducted to evaluated the effect of MVP chemotherapy and radiotherapy on the pattern of failure, disease free and overall survival, and tolerance of combined treatment. Materials and Methods : Twenty nine patients were registered to this study until Sep. 1993 ; of these 26 received planned therapy. Within 3 weeks after radical resection, two cycles of MVP(Motomycin C 6 mg/m 2 , Vinblastin 6 mg/m 2 , Cisplatin 6 mg/m 2 ) chemotherapy was given with 4 weeks intervals. Radiotherapy (5040 cGy tumor bed dose and 900 cGy boost to high risk area) was started 3 to 4 weeks after chemotherapy. Results : One and two year overall survival rates were 76.5% and 8.6% respectively. Locoregional failure developed in 6 patients (23.1%) and distant failure in 9 patients(34.6%). Number of involved lymph nodes, resection margin positivity showed some correlation with failure pattern but T-stage and N-stage showed no statistical significance. The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. Postoperative combined therapy were well tolerated without definite increase of complication rate, and compliance rate in this study was 90%. Conclusion : 1) MVP chemotherapy showed no effect on locoregional recurrence, ut appeared to decrease the distant metastasis rate and 2) combined treatments were well tolerated in all patients. 3) The group of patients who received chemotherapy within 2 weeks postoperatively and radiotherapy within 70 days showed lower incidence of distant metastasis. 4) Addition of chemotherapy to radiotherapy failed to increase the overall or disease free survival

  10. Postoperative radiotherapy prophylaxis of periarticular ossification after total hip replacement

    International Nuclear Information System (INIS)

    Sauer, R.; Seegenschmiedt, M.H.; Andreas, P.; Goldmann, A.; Beck, H.

    1992-01-01

    Since June 1988, we have treated 77 patients or 80 hips respectively with prophylactic irradiation. Individual risk factors included severe coxarthrosis grade IV, ipsi- or contralateral heterotopic ossification and severe hip trauma. As of July 1991 60 patients with a minimum follow-up of six months could be analyzed using clinical and radiological scoring systems. The patients had been prospectively randomized in two different treatment arms: 32 patients were treated with low dose (LD), five times 2 Gy daily fractions to a total dose of 10 Gy, whereas 28 patients were treated with high dose (HD), ten times 2 Gy (eight patients) or five times 3.5 Gy (20 patients). Operative procedures and individual risk factors were equally distributed in both groups. 23 patients (38% received indometacin three times 25 mg for six weeks, 19 patients (32%) diphosphonate EHDP 20 mg/kg body weight and 18 patients (30%) had no additional medication. 56/60 (93%) patients developed no significant heterotopic ossification and/or remained without impairment of their postoperative radiological and clinical hip status according to the applied Brooker and Harris Scores. Only 4/60 (7%) patients demonstrated treatment failures developing postoperative worsening one grade of Brooker score in two patients and two and three grades of Brooker score in the two others. Only 1/49 patients experienced a treatment failure, when radiotherapy had been initiated before and at postoperative day 4 compared to 3/11 patients initiated after postoperative day 4 (p [de

  11. Comparative Analysis between preoperative Radiotherapy and postoperative Radiotherapy in Clinical Stage I and II Endometrial Carcinoma

    International Nuclear Information System (INIS)

    Keum, Ki Chang; Lee, Chang Geol; Chung, Eun Ji; Lee, Sang Wook; Kim, Woo Cheol; Chang, Sei Kyung; Oh, Young Taek; Suh, Chang Ok; Kim, Gwi Eon

    1995-01-01

    Purpose : To obtain the optical treatment method in patients with endometrial carcinoma(clinical stage FIGO I, II) by comparative analysis between preoperative radiotherapy(pre-op R) and postoperative radiotherapy(post-op RT). Materials and Methods : A retrospective review of 62 endometrial carcinoma patients referred to the Yonsei Cancer Center for radiotherapy between 1985 and 1991 was undertaken. Of 62 patients, 19 patients(Stage I; 12 patients, Stage II; 7 patients) received pre-op RT before TAH(Total Abdominal Hysterectomy) and BSO(Bilateral Salphingoophorectomy) (Group 1) and 43 patients( Stage 1; 32 patients, Stage 2; 11 patients) received post-op RT after TAH and BSO (Group 2). Pre-op irradiation was given 4-6 weeks prior to surgery and post-op RT was administered on 4-5 weeks following surgery. All patients exept 1 patient(Group2; ICR alone) received external irradiation. Seventy percent(13/19) of pre-op RT group and 54 percent(23/42) of post-op RT group received external pelvic irradiation and intracavitary radiation therapy(ICR). External radiation dose was 39.6-55Gy(median 45Gy) in 5-6 week through opposed AP/PA fields or 4-field box technique treating daily, five days per week, 180cGy per fraction. ICR doses were prescribed to point A(20-39.6 Gy, median 39Gy) in Group 1 and 0.5cm depth from vaginal surface (18-30 Gy, median 21Gy) in Group2. Results : The overall 5 year survival rate was 95%. No survival difference between pre-op and post-op RT group.(89.3% vs 97.7%, p>0.1) There was no survival difference by stage, grade and histology between two groups. The survival rate was not affected by presence of residual tumor of surgical specimen after pre-op RT in Group 1(p>0.1), but affected by presence of lymph node metastasis in post-op RT group(p<0.5). The complication rate of pre-op RT group was higher than post-op RT.(16% vs 5%) Conclusion : Post-op radiotherapy offers the advantages of accurate surgical-pathological staging and low complication rate

  12. Postoperative radiotherapy for malignant tumors of the submandibular gland

    International Nuclear Information System (INIS)

    Storey, Mark R.; Garden, Adam S.; Morrison, William H.; Eicher, Susan A.; Schechter, Naomi R.; Ang, K. Kian

    2001-01-01

    Purpose: This retrospective study assessed the outcome and patterns of failure for patients with malignant submandibular tumors treated with surgery and postoperative radiation. Methods and Materials: Between 1965 and 1995, 83 patients aged 11-83 years old received postoperative radiotherapy after resection of submandibular gland carcinomas. The most common radiation technique was an appositional field to the submandibular gland bed using electrons either alone or mixed with photons. Primary tumor bed doses ranged from 50 to 69 Gy (median, 60 Gy). Regional lymph nodes (ipsilateral Levels I-IV) were irradiated in 66 patients to a median dose of 50 Gy. Follow-up time ranged from 5 to 321 months (median, 82 months). Results: Actuarial locoregional control rates were 90%, 88%, and 88% at 2, 5, and 10 years, respectively. The corresponding disease-free survival rates were 76%, 60%, and 53%, because 27 of 74 patients (36%) who attained locoregional control developed distant metastases. Adenocarcinoma, high-grade histology, and treatment during the earlier years of the study were associated with worse locoregional control and disease-free survival. The median survival times for patients with and without locoregional control were 183 months and 19 months, respectively. Actuarial 2-, 5-, and 10-year survival rates were 84%, 71%, and 55%, respectively. Late complications occurred in 8 patients (osteoradionecrosis, 5 patients). Conclusions: High-risk cancers of the submandibular gland have a historic control rate of approximately 50% when treated with surgery alone. In the current series, locoregional control rates for high-risk patients with submandibular gland cancers treated with surgery and postoperative radiotherapy were excellent, with an actuarial locoregional control rate of 88% at 10 years

  13. Early versus delayed postoperative radiotherapy for treatment of low-grade gliomas

    Science.gov (United States)

    Sarmiento, J Manuel; Venteicher, Andrew S; Patil, Chirag G

    2015-01-01

    Background In most people with low-grade gliomas (LGG), the primary treatment regimen remains a combination of surgery followed by postoperative radiotherapy. However, the optimal timing of radiotherapy is controversial. It is unclear whether to use radiotherapy in the early postoperative period, or whether radiotherapy should be delayed until tumour progression occurs. Objectives To assess the effects of early postoperative radiotherapy versus radiotherapy delayed until tumour progression for low-grade intracranial gliomas in people who had initial biopsy or surgical resection. Search methods We searched up to September 2014 the following electronic databases: the Cochrane Register of Controlled Trials (CENTRAL, Issue 8, 2014), MEDLINE (1948 to Aug week 3, 2014), and EMBASE (1980 to Aug week 3, 2014) to identify trials for inclusion in this Cochrane review. Selection criteria We included randomised controlled trials (RCTs) that compared early versus delayed radiotherapy following biopsy or surgical resection for the treatment of people with newly diagnosed intracranial LGG (astrocytoma, oligodendroglioma, mixed oligoastrocytoma, astroblastoma, xanthoastrocytoma, or ganglioglioma). Radiotherapy may include conformal external beam radiotherapy (EBRT) with linear accelerator or cobalt-60 sources, intensity-modulated radiotherapy (IMRT), or stereotactic radiosurgery (SRS). Data collection and analysis Three review authors independently assessed the trials for inclusion and risk of bias, and extracted study data. We resolved any differences between review authors by discussion. Adverse effects were also extracted from the study report. We performed meta-analyses using a random-effects model with inverse variance weighting. Main results We included one large, multi-institutional, prospective RCT, involving 311 participants; the risk of bias in this study was unclear. This study found that early postoperative radiotherapy is associated with an increase in time to

  14. Influence of the timing of surgery and postoperative radiotherapy on treatment results

    International Nuclear Information System (INIS)

    Fietkau, R.

    2000-01-01

    Background: The timing of surgery and postoperative radiotherapy - especially if combined with chemotherapy - has been a subject of interest over the past years. Methods: This analysis was based on a literature review of mostly retrospective publications. Data concerning the interval between surgery and radiotherapy were correlated with the locoregional control, incidence of distant metastases and prognosis of breast cancer, lung carcinoma, and head and neck carcinomas. Results and Conclusions: The reviewed data did not show a clear relationship of the time interval between surgery and start of radiotherapy and locoregional control. However, evaluation of the data was difficult, because in most publications, retrospective analyses were performed and other prognostically more relevant parameters may influence locoregional control stronger than the time interval. In patients with head and neck carcinomas, there is a negative effect of time interval between surgery and radiotherapy on local control if unfavorable factors exist, i.e., close surgical margins, unfavorable pathohistological parameters and low radiation dose. In patients with breast cancer who do not receive chemotherapy, there are inconsistent reports in the literature. If additional chemotherapy is necessary, the sequence surgery, chemotherapy and radiotherapy seems adequate. Although some data suggest that delaying the initiation of radiotherapy due to chemotherapy may increase the risk of local recurrences, there may, on the other hand, be an increased likelihood of systemic metastases, if radiotherapy is applied before chemotherapy. Concerning lung cancer, only one retrospective analysis exists suggesting a better survival of patients with an interval of more than 36 days between surgery and radiotherapy as compared to patients with a shorter interval. (orig.) [de

  15. Postoperative radiotherapy for low grade glioma of the brain

    International Nuclear Information System (INIS)

    Chun, Ha Chung; Lee, Myung Za

    2000-01-01

    To evaluate the effectiveness and tolerance of postoperative external beam radiotherapy for patients with low grade glioma of the brain and define the optimal radiotherapeutic regimen. Between June, 1985 and May, 1998, 72 patients with low grade gliomas were treated with postoperative radiotherapy immediately following surgery. Median age was 37 years with range of 11 to 76 years. Forty one patients were male and 31 patients were female with male to female ratio of 1.3:1. Of those patients, 15 underwent biopsy alone and remaining 57 did subtotal resection. The distribution of the patients according to histologic type was as follows: astrocytomas-42 patients (58%), mixed oligodendrogliomas-19 patients (27%), oligodendrogliomas-11 patients (15%). Two patients were treated with whole brain irradiation followed by cone down boost and remaining 70 patients were treated with localized field with appropriate margin. All of the patients were treated with conventional once a day fractionation. Most of patients received total tumor dose of 5000-5500 cGy. The overall 5 and 7 year survival rates for entire group of 72 patients were 61% and 50%. Corresponding disease free survival rates for entire patients were 53% and 45%, respectively. The 5 and 7 year overall survival rates for astrocytomas, mixed oligodendrogliomas, and oligodendrogliomas were 48% and 45%, 76% and 56%, and 80% and 52%, respectively. Patients who underwent subtotal resection showed better survival rates than those who did biopsy alone. The overall 5 year survival rates for subtotal resection patients and biopsy alone patients were 67% and 43%, respectively. Forty six patients who were 40 years or younger survived better than 26 patients who were 41 years or older (overall survival rate at 5 years, 69% vs 45%). Although one patient was not able to complete the treatment because of neurological deterioration, there was no significant treatment related acute toxicities. Postoperative radiotherapy was safe and

  16. Randomized clinical trial of post-operative radiotherapy versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement

    International Nuclear Information System (INIS)

    Racadot, Severine; Mercier, Mariette; Dussart, Sophie; Dessard-Diana, Bernadette; Bensadoun, Rene-Jean; Martin, Michel; Malaurie, Emmanuelle; Favrel, Veronique; Housset, Martin; Durdux, Catherine; Journel, Catherine; Calais, Gilles; Huet, Jocelyne; Pillet, Gerard; Hennequin, Christophe; Haddad, Elias; Diana, Christian; Blaska-Jaulerry, Brigitte; Henry-Amar, Michel; Gehanno, Pierre

    2008-01-01

    Background and purpose: Post-operative radiotherapy is indicated for the treatment of head and neck cancers. In vitro, chemotherapy potentiates the cytotoxic effects of radiation. We report the results of a randomized trial testing post-operative radiotherapy alone versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement. Materials and methods: The study involved patients undergoing curative-intent surgery for head and neck cancers with histological evidence of lymph node involvement. Patients were randomly assigned to receive radiotherapy alone (54-72 Gy, 30-40 fractions, 6-8 weeks) or identical treatment plus concomitant Carboplatin (50 mg/m 2 administered by IV infusion twice weekly). Results: Between February 1994 and June 2002, 144 patients were included. With a median follow-up of 106 months (95% confidence interval (CI) [92-119]), the 2-year rate of loco-regional control was 73% (95% CI: 0.61-0.84) in the combined treatment group and 68% (95% CI: 0.57-0.80) in the radiotherapy group (p = 0.26). Overall survival did not differ significantly between groups (hazard ratio for death, 1.05; 95% CI: 0.69-1.60; p = 0.81). Conclusions: Twice-weekly administration of carboplatin concomitant to post-operative radiotherapy did not improve local control or overall survival rates in this population of patients with node-positive head and neck cancers

  17. Targeting IAP proteins in combination with radiotherapy

    International Nuclear Information System (INIS)

    Fulda, Simone

    2015-01-01

    The efficacy of radiotherapy critically depends on the activation of intrinsic cell death programs in cancer cells. This implies that evasion of cell death, a hallmark of human cancers, can contribute to radioresistance. Therefore, novel strategies to reactivate cell death programs in cancer cells are required in order to overcome resistance to radiotherapy. Since Inhibitor of Apoptosis (IAP) proteins are expressed at high levels in multiple cancers and block cell death induction at a central point, therapeutic targeting of IAP proteins represents a promising approach to potentiate the efficacy of radiotherapy. The current review discusses the concept of targeting IAP proteins in combination with radiotherapy

  18. Retrospective study of 48 cases of post-operative radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Mnejja, W.; Yahiaoui, S.; Siala, W.; Daoud, J.; Ghorbel, A.; Frikha, M.

    2011-01-01

    The authors report a study which aimed at assessing therapeutic results after post-operative radiotherapy of 48 patients suffering from head and neck cancers. The analysis is made in terms of cancer control, survival without recurrence and global survival. The post-operative radiotherapy improves the disease control rate. Ganglionary attack and capsular failure are survival prognosis factors. The concomitant association of chemo-therapy and radiotherapy should improve therapeutic results. Short communication

  19. Postoperative interstitial radiotherapy of keloids. Curietherapie postoperatoire des cicatrices cheloides

    Energy Technology Data Exchange (ETDEWEB)

    Clavere, P; Bonnafoux-Clavere, A; Roullet, B; Morzel, A; Rhein, B; Bonnetblanc, J M; Olivier, J P [Centre Hospitalier Universitaire, 87 - Limoges (France)

    1993-01-01

    During an 8-year period, 21 patients with keloids (27 keloids) were treated with keloidectomy and post-operative interstitial radiotherapy by an iridium 192 wire. Only one patient had been previously treated by corticoids, without results. A dose of 12 Gy (three patients) to 15 Gy (18 patients) was delivered at a point 2.5 mm from the axis of the wire. The follow-up time was from 2 - 104 months. The success rate, at 7 months, was close to 88%. Ao recurrence occurred in three patients without relation to the method used, the lesion-age or the localization of the lesions. There were no side-effects. This method represents an effective, non-constraining and safe treatment for keloids if the contra-indications are respected.

  20. Postoperative radiotherapy for prostate cancer. Morbidity of local-only or local-plus-pelvic radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Waldstein, Cora; Poetter, Richard; Widder, Joachim; Goldner, Gregor [Medical University of Vienna, Department of Radiation Oncology, Comprehensive Cancer Center, General Hospital of Vienna, Vienna (Austria); Doerr, Wolfgang [Medical University of Vienna, Department of Radiation Oncology, Comprehensive Cancer Center, General Hospital of Vienna, Vienna (Austria); Medical University of Vienna, Christian-Doppler Laboratory for Medical Radiation Research for Radiooncology, Vienna (Austria)

    2018-01-15

    The aim of this work was to characterise actuarial incidence and prevalence of early and late side effects of local versus pelvic three-dimensional conformal postoperative radiotherapy for prostate cancer. Based on a risk-adapted protocol, 575 patients received either local (n = 447) or local-plus-pelvic (n = 128) radiotherapy. Gastrointestinal (GI) and genitourinary (GU) side effects (≥grade 2 RTOG/EORTC criteria) were prospectively assessed. Maximum morbidity, actuarial incidence rate, and prevalence rates were compared between the two groups. For local radiotherapy, median follow-up was 68 months, and the mean dose was 66.7 Gy. In pelvic radiotherapy, the median follow-up was 49 months, and the mean local and pelvic doses were 66.9 and 48.3 Gy respectively. Early GI side effects ≥ G2 were detected in 26% and 42% of patients respectively (p < 0.001). Late GI adverse events were detected in 14% in both groups (p = 0.77). The 5-year actuarial incidence rates were 14% and 14%, while the prevalence rates were 2% and 0% respectively. Early GU ≥ G2 side effects were detected in 15% and 16% (p = 0.96), while late GU morbidity was detected in 18% and 24% (p = 0.001). The 5-year actuarial incidence rates were 16% and 35% (p = 0.001), while the respective prevalence rates were 6% and 8%. Despite the low prevalence of side effects, postoperative pelvic radiotherapy results in significant increases in the actuarial incidence of early GI and late GU morbidity using a conventional 4-field box radiotherapy technique. Advanced treatment techniques like intensity-modulated radiotherapy (IMRT) or volumetric modulated arc radiotherapy (VMAT) should therefore be considered in pelvic radiotherapy to potentially reduce these side effects. (orig.) [German] Ziel der vorgestellten Arbeit ist es, die Haeufigkeit frueher und spaeter Nebenwirkungen nach postoperativer Bestrahlung von Prostatakarzinompatienten zu analysieren. Verglichen wurden dabei die Nebenwirkungen von lokaler

  1. Phase I trial of split-dose induction docetaxel, cisplatin, and 5-fluorouracil (TPF chemotherapy followed by curative surgery combined with postoperative radiotherapy in patients with locally advanced oral and oropharyngeal squamous cell cancer (TISOC-1

    Directory of Open Access Journals (Sweden)

    Oertel Katrin

    2012-10-01

    Full Text Available Abstract Background Induction chemotherapy (ICT with docetaxel, cisplatin and fluorouracil (TPF followed by radiotherapy is an effective treatment option for unresectable locally advanced head and neck cancer. This phase I study was designed to investigate the safety and tolerability of a split-dose TPF ICT regimen prior to surgery for locally advanced resectable oral and oropharyngeal cancer. Methods Patients received TPF split on two dosages on day 1 and 8 per cycle for one or three 3-week cycles prior to surgery and postoperative radiotherapy or radiochemotherapy. Docetaxel was escalated in two dose levels, 40 mg/m2 (DL 0 and 30 mg/m2 (DL −1, plus 40 mg/m2 cisplatin and 2000 mg/m2 fluorouracil per week using a 3 +3 dose escalation algorithm. Results Eighteen patients were enrolled and were eligible for toxicity and response. A maximum tolerated dose of 30 mg/m2 docetaxel per week was reached. The most common grade 3+ adverse event was neutropenia during ICT in 10 patients. Surgery reached R0 resection in all cases. Nine patients (50% showed complete pathologic regression. Conclusions A split-dose regime of TPF prior to surgery is feasible, tolerated and merits additional investigation in a phase II study with a dose of 30 mg/m docetaxel per week. Trial registration number NCT01108042 (ClinicalTrials.gov Identifier

  2. Risk factors for postoperative complications after total laryngectomy following radiotherapy or chemoradiation

    DEFF Research Database (Denmark)

    Wulff, N B; Kristensen, C.A.; Andersen, E

    2015-01-01

    OBJECTIVES: To determine the rates of and risk factors for postoperative complications following total laryngectomy in patients treated with radiotherapy or chemoradiation. DESIGN: Retrospective longitudinal study. SETTING: Tertiary medical centres. PARTICIPANTS: A total of 143 patients undergoin...

  3. The Role of Postoperative Radiotherapy in the Management of Intracranial Meningiomas

    International Nuclear Information System (INIS)

    Chang, Sei Kyung; Suh, Chang Ok; Shin, Hyun Soo; Kim, Gwi Eon

    1994-01-01

    Purpose: To evaluate the role of postoperative radiotherapy in the management of primary or recurrent intracranial meningiomas. Methods and Materials: A retrospective review of 34 intracranial meningioma patients referred to the Yonsei Cancer Center for postoperative radiotherapy between 1981 and 1990 was undertaken. Of the 34 patients, 24 patients received elective postoperative radiotherapy after total or subtotal resection(Group 1), and 10 patients received postoperative radiotherapy as a salvage treatment for recurrent tumors(Group 2). Ten patients received postoperative radiotherapy after total resection, and twenty-four after subtotal resection. Ten patients who had total tumor resection were referred for radiotherapy either because of angioblastic or malignant histologic type (4 patients in Group 1) or because of recurrent disease after initial surgery(6 patients in Group 2). Radiation dose of 50-56Gy was delivered over a period of 5-5.5 weeks using 4MV LINAC or Co-60 teletherapy unit. Results: Overall actuarial progression free survival (PFS) at 5 years was 80%. Survival was most likely affected by histologic subtypes. Five year PFS rate was 52% for benign angioblastic histology, as compared with 100% for classic benign histology. For malignant meningiomas, 5 year PFS rate was 44%. The recurrence rates of classic, angioblastic, and malignant type were 5%(1/21), 80%(4/5), and 50%(4/8), respectively. The duration between salvage post-operative radiotherapy and recurrence was longer than the duration between initial surgery and recurrence in the patients of group 2 with angioblastic or malignant histology. Conclusion: Postoperative radiotherapy of primary or recurrent intracranial meningiomas appears to be effective modality, especially in the patients with classic meningiomas. In angioblastic or malignant histologies, a more effective approach seems to be needed for decreasing recurrence rate

  4. Combined radiotherapy-chemotherapy in clinical practice

    International Nuclear Information System (INIS)

    Horwich, A.

    1989-01-01

    This paper investigates the combination of radiotherapy and chemotherapy performed over the last 15 years. The improvement of the therapeutic ratio of anti- cancer effect to normal tissue toxicity and its requirement of a thorough understanding of the biological effects of each modality and of how these effects may interact is presented. Early studies and conclusions are examined

  5. Postoperative radiotherapy after laser surgery with or without chemotherapy in head and neck evolved cancers; Radiotherapie postoperatoire apres chirurgie laser avec ou sans chimiotherapie dans les cancers evolues de la tete et du cou

    Energy Technology Data Exchange (ETDEWEB)

    Ryll, L.; Pradier, O. [Centre Hospitalier Universitaire Morvan, Dept. de Cancerologie, Brest (France); Nitsche, M.; Christiansen, H.; Hess, C. [Universitatsklinikum, Dept. de Cancerologie, Goettingen (Germany)

    2007-11-15

    We compared concurrent combination chemoradiotherapy and adjuvant radiotherapy after laser surgery in patients with stage 3/4 non metastatic squamous cell head and neck cancer. Combination chemotherapy and concurrent irradiation after laser surgery was not superior to surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, the collective is small, and the follow-up to short to conclude. (authors)

  6. Planned combined radiotherapy and surgery

    International Nuclear Information System (INIS)

    Silverman, C.L.; Marks, J.E.

    1987-01-01

    Though the planned combined use of surgery and radiation has been shown to be beneficial for other tumors, the authors feel that the present evidence is far from persuasive in demonstrating a definite superiority of combined therapy over surgery or radiation alone for advanced laryngeal tumors. The actuarial or disease-free survival rates for patients treated with combined therapy have not been significantly increased over those obtained with a single modality in any randomized, well-controlled study, although the trend is toward improved local regional control. Many of the retrospective studies are probably flawed by selection bias; the patients selected for combined treatment generally have more advanced cancers and represent a worse prognostic group. It is clear from this review that the positive value of irradiation for advanced transglottic and supraglottic tumors needs to be documented by a controlled study that compares surgery alone with salvage radiation at time of recurrence to surgery plus adjuvant radiation. The authors feel that such a study is needed to put to rest the present controversy before they can advocate a course of treatment that is expensive, time-consuming, and difficult for the patients to tolerate owing to severe acute side effects and potentially morbid late effects (xerostomia, necrosis) that can greatly lessen the quality of life for these patients

  7. Combination of radiotherapy and selective chemotherapy in the treatment of advanced ovarian carcinomas

    International Nuclear Information System (INIS)

    Dietz, R.; Brachetti, A.; Universitaet des Saarlandes, Homburg/Saar

    1982-01-01

    A report is given on 160 patients suffering from ovarian carcinomas the stages which were exactly determined by TNM classification. 32 patients had tumors of the stages T1-T3, 128 patients had tumors of the stage T4. All T3 subgroups showed favorable results after radical surgery and a postoperative combination of radiotherapy and selective cytostatic chemotherapy. The therapy plans including radiotherapy had more advantages than those without radiotherapy. Furthermore, the cytostatic treatment was more successful after a chemotherapy resistance test than after blind administration of cytostatic drugs. (orig.) [de

  8. Combined effects of radiotherapy and non-specific immunotherapy

    International Nuclear Information System (INIS)

    Yamashita, Takashi; Hayakawa, Yukiko; Mochizuki, Yukio

    1985-01-01

    Local and systemic effects of the combined use of radiotherapy and administration of OK-432 were examined using tumor-bearing mice. Tumor regrowth was inhibited by local administration of OK-432 following radiotherapy. Systemic inhibitory effects of OK-432 on tumors were not seen. When radiotherapy is performed in combination with administration of OK-432, synergistic effects will be observed. (Namekawa, K.)

  9. Spatial aspects of combined modality radiotherapy

    International Nuclear Information System (INIS)

    Bodey, Rachel K.; Evans, Phil M.; Flux, Glenn D.

    2005-01-01

    Background and purpose: A combined modality radiotherapy (CMRT) incorporates both external beam radiotherapy (EBT) and targeted radionuclide therapy (TRT) components. The spatial aspects of this combination were explored by utilising intensity modulated radiotherapy (IMRT) to provide a non-uniform EBT dose distribution. Patients and methods: Three methods of prescribing the required non-uniform distribution of EBT dose are described, based on both physical and biological criteria according to the distribution of TRT uptake. The results and consequences of these prescriptions are explored by application to three examples of patient data. Results: The planning procedure adopted allowed IMRT plans to be produced that met the prescription requirements. However, when the treatment was planned as a CMRT, compared with the use of EBT alone, more satisfactory target doses could be achieved with lower doses to normal tissues. The effects of errors in EBT delivery and in the functional data were found to cause a non-uniform prescription to tend towards the uniform case. Conclusions: The methods and results are relevant for more general biological treatment planning, in which IMRT may be used to produce dose distributions prescribed according to tumour function. The effects of delivery and dose calculation errors can have a significant impact on how such treatments should be planned

  10. Results of postoperative radiotherapy for resectable hilar cholangiocarcinoma

    NARCIS (Netherlands)

    Gerhards, Michael F.; van Gulik, Thomas M.; González González, Dioniso; Rauws, Erik A. J.; Gouma, Dirk J.

    2003-01-01

    The aim of this study was to assess the value of radiotherapy, and especially intraluminal brachytherapy, after resection of hilar cholangio-carcinoma by analyzing long-term complications and survival. Between 1983 and 1998, 112 patients underwent resection of a hilar cholangio-carcinoma. Of the 91

  11. Local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer.

    Science.gov (United States)

    Kimoto, Takuya; Yamazaki, Hideya; Suzuki, Gen; Aibe, Norihiro; Masui, Koji; Tatekawa, Kotoha; Sasaki, Naomi; Fujiwara, Hitoshi; Shiozaki, Atsushi; Konishi, Hirotaka; Nakamura, Satoaki; Yamada, Kei

    2017-09-01

    Radiotherapy is an effective treatment for the postoperative loco-regional recurrence of esophageal cancer; however, the optimal treatment field remains controversial. This study aims to evaluate the outcome of local field radiotherapy without elective nodal irradiation for postoperative loco-regional recurrence of esophageal cancer. We retrospectively investigated 35 patients treated for a postoperative loco-regional recurrence of esophageal cancer with local field radiotherapy between December 2008 and March 2016. The median irradiation dose was 60 Gy (range: 50-67.5 Gy). Thirty-one (88.6%) patients received concurrent chemotherapy. The median follow-up period was 18 months (range: 5-94 months). The 2-year overall survival was 55.7%, with a median survival time of 29.9 months. In the univariate analysis, the maximal diameter ≤20 mm (P = 0.0383), solitary lesion (P = 0.0352), and the complete remission after treatment (P = 0.00411) had a significantly better prognosis. A total of 27 of 35 patients (77.1%) had progressive disease (loco-regional failure [n = 9], distant metastasis [n = 7], and both loco-regional failure and distant metastasis [n = 11]). No patients had Grade 3 or greater mucositis. Local field radiotherapy is a considerable treatment option for postoperative loco-regional recurrence of esophageal cancer. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  12. Postoperative radiotherapy in patients with salivary duct carcinoma. Clinical outcomes and prognostic factors

    International Nuclear Information System (INIS)

    Shinoto, Makoto; Shioyama, Yoshiyuki; Nakamura, Katsumasa

    2013-01-01

    This study sought to investigate the clinical outcome and the role of postoperative radiotherapy for patients with salivary duct carcinoma (SDC) who had undergone surgery and postoperative radiotherapy. We performed a retrospective analysis of 25 SDC patients treated between 1998 and 2011 with surgery and postoperative radiotherapy. The median prescribed dose was 60 Gy (range, 49.5-61.4 Gy). The clinical target volume (CTV) was defined as the tumor bed in four patients, the tumor bed and ipsilateral neck in 14 patients, and the tumor bed and bilateral neck in six patients. Local control (LC), disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method, and prognostic variables were analyzed with the log-rank test. The 5-year LC, DFS and OS were 67%, 45% and 47%, respectively. Disease recurrence was found in 12 patients: seven as local, four as regional and eight as distant failure. Perineural and lymphovascular invasion was a significant prognostic factor for LC (P=0.03). Local failure was common, and the presence of local recurrence significantly affected the OS (P<0.05). We conclude that surgery and postoperative radiotherapy is expected to decrease the risk of local failure and contribute to good prognoses for patients with SDC. It might be advisable to have the CTV include the cranial nerves involved and the corresponding parts of the skull base in cases of pathologically positive perineural invasion. (author)

  13. Radio-induced malignancies after breast cancer postoperative radiotherapy in patients with Li-Fraumeni syndrome

    International Nuclear Information System (INIS)

    Heymann, Steve; Bourgier, Céline; Delaloge, Suzette; Rahal, Arslane; Caron, Olivier; Frebourg, Thierry; Barreau, Lise; Pachet, Corinne; Mathieu, Marie-Christine; Marsiglia, Hugo

    2010-01-01

    There are no specific recommendations for the management of breast cancer patients with germ-line p53 mutations, an exceptional genetic condition, particularly regarding postoperative radiotherapy. Preclinical data suggested that p53 mutations conferred enhanced radiosensitivity in vitro and in vivo and the few clinical observations showed that Li-Fraumeni families were at a higher risk of secondary radio-induced malignancies. We reviewed a cohort of patients with germ-line p53 mutations who had been treated for breast cancer as the first tumor event. We assessed their outcome and the incidence of secondary radio-induced malignancies. Among 47 documented Li-Fraumeni families treated from 1997 to 2007 at the Institut Gustave Roussy, 8 patients had been diagnosed with breast cancer as the first tumor event. Three patients had undergone conservative breast surgery followed by postoperative radiotherapy and five patients had undergone a mastectomy (3 with postoperative radiotherapy). Thus, 6/8 patients had received postoperative radiotherapy. Median follow-up was 6 years. Median age at the diagnosis of the primary breast cancer was 30 years. The histological characteristics were as follows: intraductal carcinoma in situ (n = 3), invasive ductal carcinoma (n = 4) and a phyllodes tumor (n = 1). Among the 6 patients who had received adjuvant radiotherapy, the following events had occurred: 3 ipsilateral breast recurrences, 3 contralateral breast cancers, 2 radio-induced cancers, and 3 new primaries (1 of which was an in-field thyroid cancer with atypical histology). In contrast, only one event had occurred (a contralateral breast cancer) among patients who had not received radiation therapy. These observations could argue in favor of bilateral mastectomy and the avoidance of radiotherapy

  14. Combined radiotherapy and chemotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Inuyama, Yukio; Fujii, Masato; Tanaka, Juichi; Takaoka, Tetsuro; Hosoda, Hyonosuke; Kawaura, Mitsuhiro; Toji, Masao

    1988-01-01

    There are 4 modalities of combined radiotherapy and chemotherapy which include (1) concurrent radiotherapy and chemotherapy, (2) sequential use of radiotherapy and chemotherapy (pre-radiation chemotherapy), (3) pre-radiation chemotherapy followed by concurrent radiation and chemotherapy, and (4) alternating use of radiotherapy and chemotherapy based upon Looney's hypothesis. We studied concurrent use of radiotherapy and UFT by means of animal experimentation and clinical trials. The results obtained revealed that UFT was a most suitable agent together with 5-fluorouracil for concurrent application of radiotherapy and chemotherapy. Neo-adjuvant chemotherapy including pre-radiation chemotherapy was also studied in cases of maxillary sinus carcinoma and nasopharyngeal carcinoma. From the results, it seemed desirable to use cisplatin and bleomycin analogs sequentially in combined chemotherapy and radiotherapy. Neo-adjuvant chemotherapy should be studied successively to improve local tumor control rates and prevent distant metastases. For future perspectives, new trials of alternating radiotherapy and chemotherapy based upon Looney's hypothesis seem necessary. (author)

  15. Postoperative high-dose pelvic radiotherapy for N+ prostate cancer: Toxicity and matched case comparison with postoperative prostate bed-only radiotherapy

    International Nuclear Information System (INIS)

    Van Praet, Charles; Ost, Piet; Lumen, Nicolaas; De Meerleer, Gert; Vandecasteele, Katrien; Villeirs, Geert; Decaestecker, Karel; Fonteyne, Valérie

    2013-01-01

    Purpose: To report on toxicity of postoperative high-dose whole-pelvis radiotherapy (WPRT) with androgen deprivation therapy for lymph node metastasized (N1) prostate cancer (PC). To perform a matched-case analysis to compare this toxicity profile to postoperative prostate bed-only radiotherapy (PBRT). Materials and methods: Forty-eight N1-PC patients were referred for WPRT and 239 node-negative patients for PBRT. Patients were matched 1:1 according to pre-treatment demographics, symptoms, treatment and tumor characteristics. Mean dose to the prostate bed was 75 Gy (WPRT–PBRT) and 54 Gy to the elective nodes (WPRT) in 36 or 37 fractions. End points are genito-urinary (GU) and gastro-intestinal (GI) toxicity. Results: After WPRT, 35% developed grade 2 (G2) and 4% G3 acute GU toxicity. Acute GI toxicity developed in 42% (G2). Late GU toxicity developed in 36% (G2) and 7% (G3). One patient had G4 incontinence. Recuperation occurred in 59%. Late GI toxicity developed in 25% (G2) with 100% recuperation. Incidence of acute and late GI toxicity was higher following WPRT compared to PBRT (p ⩽ 0.041). GU toxicity was similar. With WPRT mean dose to bladder and rectosigmoid were higher. Conclusions: Postoperative high-dose WPRT comes at the cost of a temporary increase in G2. GI toxicity compared to PBRT because larger volumes of rectosigmoid are irradiated

  16. Postoperative radiotherapy for lung cancer: Is it worth the controversy?

    OpenAIRE

    Billiet, Charlotte; Peeters, Stephanie; Decaluwe, Herbert; Vansteenkiste, Johan; Mebis, Jeroen; De Ruysscher, Dirk

    2016-01-01

    Introduction: The role of postoperative radiation therapy (PORT) in patients with completely resected non-small cell lung cancer (NSCLC) with pathologically involved mediastinal lymph nodes (N2) remains unclear. Despite a reduction of local recurrence (LR), its effect on overall survival (OS) remains unproven. Therefore we conducted a review of the current literature. Methods: To investigate the benefit and safety of modern PORT, we identified published phase III trials for PORT. We investiga...

  17. Postoperative radiotherapy of uterine sarcoma: A multicentric retrospective study; Radiotherapie postoperatoire dans les sarcomes uterins: etude retrospective multicentrique

    Energy Technology Data Exchange (ETDEWEB)

    Champetier, C.; Cowen, D. [Service de radiotherapie, hopital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05 (France); Hannoun-Levi, J.M. [Centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice (France); Resbeut, M. [Centre de radiotherapie Saint-Louis, rue Andre-Blondel, 83100 Toulon (France); Azria, D. [Centre Val-d' Aurelle-Paul-Lamarque, 208, rue des Apothicaires, 34298 Montpellier cedex 5 (France); Salem, N. [Institut Paoli-Calmettes, 232, boulevard Sainte-Marguerite, 13009 Marseille (France); Tessier, E. [Centre azureen de radiotherapie, 1, place du Docteur-Jean-Luc-Broquerie, 06250 Mougins (France); Ellis, S. [Centre catalan de radiotherapie, 80, rue Pascal-Marie-Agasse, 66000 Perpignan (France)

    2011-04-15

    Purpose. - Surgery is the treatment of choice for localized uterine sarcomas. We conducted a retrospective study to define prognostic factors. Patients and methods. - We studied 111 cases of patients treated by adjuvant radiotherapy for uterine sarcoma in seven French centers. The median decline was 31 months. We conducted a univariate analysis to identify factors correlated with local recurrence. The statistically significant factors were studied in multivariate analysis by Cox model. Results. - The median dose of external beam radiotherapy was 45 Gy. Forty-three percent of patients had vaginal vault brachytherapy and 21 % chemotherapy. Only 6.3 % of patients had complications of acute grade III and 8.1 % of long-term sequelae of radiotherapy. The survival rate at 5 years was 74.6 %. They noted 12.6 % of isolated locoregional recurrences, against 29.7 % for distant recurrences, 80 % were pulmonary. Factors correlated with the risk of locoregional relapse were menopausal status (P = 0.045) and surgical margins suspicious or not healthy (P = 0.0095). The chemotherapy did not improve overall survival or disease free survival but the numbers were low. Conclusion. - The postoperative radiotherapy provides good local control in this disease. Brachytherapy is sometimes done, but it does not improve local control. Chemotherapy is not a standard localized stage but the rate of metastatic recurrence calls for the development of strategies involving systemic treatment with radiotherapy. (authors)

  18. Treatment Result of Postoperative Radiotherapy of Carcinoma of the Uterine Cervix

    International Nuclear Information System (INIS)

    Park, Charn Il; Kim, Il Han; Ha, Sung Whan; Lee, Hyo Pyo; Shin, Myon Woo; Kim, Jung Soo

    1985-01-01

    The early carcinoma of the uterine cervix may be treated by either radical surgery or radical radiotherapy according to the patient characteristics, and the survival is high with either treatment. But, because of the size of the lesion, metastasis to lymph nodes, and vascular space invasion by tumor have all been shown to influence recurrence and survival, postoperative radiotherapy may be considered as their histopathologic finding after radical surgery. However, there are still debates on the increasing survival rates with postoperative radiotherapy. Two hundreds and three patients with carcinoma of the uterine cervix who were treated with postoperative radiotherapy from February 1979 to September 1982 in the Department of Therapeutic Radiology, Seoul National University were analyzed and following results were obtained. 3-year actuarial survival rate and 3-year disease free survival rate were 83.4% and 73.4% respectively and 3-year actuarial survival rates by stages were 90.7% for I B, 69.6% for II A, and 85.2% for II b. The overall acute complication rate was 57.6%; tolerable cases was 50.2% and severe cases was 7.4%, Late complication rate was 7.9% and the major late complication were intestinal obstruction, aggravated urinary symptom, radiation cystitis in ORDER of frequency

  19. Postoperative localization of porta hepatis and abdominal vasculature in pancreatic malignancies: Implications for postoperative radiotherapy planning

    International Nuclear Information System (INIS)

    Kresl, John J.; Bonner, James A.; Bender, Claire E.; Grill, Joseph P.; Gunderson, Leonard L.

    1997-01-01

    Purpose: To evaluate changes in preoperative and postoperative positions of structures used to define target volumes (i.e., pancreatic bed, porta hepatis, local-regional lymph nodes) for postoperative irradiation of pancreatic malignancies as defined by abdominal computed tomographs. Methods and Materials: Eleven consecutive patients who had Whipple resection and postoperative irradiation for pancreatic cancer were evaluated. Preoperative and postoperative computed tomographs of each patient were evaluated for the position of the portal vein bifurcation and the origin of the celiac axis and superior mesenteric artery. The length along the x (medial-lateral position) and y (anterior-posterior position) axes was determined with calipers to the closest millimeter. Length along the z axis (cephalad-caudad position) was determined with the computed tomographic sectional interval between images. Statistical significance of the change in the structure's position along the x, y, or z axis between preoperative and postoperative computed tomographs was assessed with the paired t-test. Results: Evaluation of the preoperative and postoperative positions of the portal vein, celiac axis, and superior mesenteric artery along the x, y, and z axes revealed a statistically significant change in the location of the portal vein and celiac axis postoperatively. The median change of the celiac axis in the anterior-posterior position was significant (p = 0.0047), but the mean change was only 2 mm and not considered clinically significant. The median change for the portal vein was 0.97 cm and 1.07 cm along the y and x axes, respectively, and was significant (p = 0.008 and p = 0.0001). The range in position change for the portal vein was 0.0 to 2.0 cm along the y axis and 0.4 to 1.9 along the x axis. The remaining mean changes in position along all axes for all the structures were less than 3 mm (not statistically significant). Conclusions: The mean position of the portal vein

  20. The impact of postoperative supraclavicular radiotherapy on tracheoesophageal groove lymph node metastasis in esophageal carcinoma

    International Nuclear Information System (INIS)

    Qian Pudong; Lu Jinchen; Mei Zeru; Zhu Jun

    2005-01-01

    Objective: To evaluate the prognostic factors of tracheoesophageal groove lymph node (TEGLN) metastasis in postoperative esophageal carcinoma. Methods: From January 1996 to December 1997, 101 postoperative cervical and thoracic esophageal carcinoma patients proved absence from tracheoesophageal groove lymph node (TEGIAN) metastasis before and after operation by physical examination and computer tomography examination were entered into this study. The patients were divided into three groups according to the treatment of supraclavicular region: no prophylactic radiotherapy (group A-, 30 patients); prophylactic radiotherapy with local dose < 45 Gy (Group B-, 71 patients); and prophylactic radiotherapy with local dose ≥45 Gy (Group C-, 19 patients). Radiotherapy was delivered by cobalt- 60 or 6 MV X-ray with the prescribed dose normalized to the point of tracheoesophageal groove, i. e, 5 cm in depth. The tracheoesophageal groove lymph node metastasis after treatment was observed. Results: The incidence of tracheoesophageal groove lymph node metastasis was 20% (6/30), 9.6% (5/71) and 0% (0/19) in groups A, B and C. Univariate analysis showed that there was significant difference of TEGLN metastasis between groups A and C only (P=0.039), but higher dose to supraclavicular region tended to lower the incidence of TEGLN metastasis. Multivariate analysis showed that only prophylactic radiotherapy to the supraclavicular region was independent prognostic factor for TEGLN metastasis (P=0.037). Gender, primary tumor site and pathological stage had no significant impact on TEGLN metastasis. Conclusions: Postoperative prophylactic supraclavicular region irradiation can lower the incidence of tracheoesophageal groove lymph node metastasis in esophageal carcinoma. Radiotherapy dose should not be less than 45 Gy and should be routinely normalized to a point 5 cm deep in the tracheoesophageal groove. (authors)

  1. Comparative analysis of the effects of belly board and bladder distension in postoperative radiotherapy of rectal cancer patients

    International Nuclear Information System (INIS)

    Kim, T.H.; Kim, D.Y.; Cho, K.H.

    2005-01-01

    Purpose: To compare the effect of reducing the irradiated small-bowel volume with the use of belly board, bladder distension or both methods combined, in patients with rectal cancer undergoing postoperative pelvic radiotherapy. Patients and methods: This study enrolled 20 consecutive patients with rectal cancer who were scheduled to receive postoperative pelvic radiotherapy. All patients underwent four sets of CT scans under four different methods as follows: group I: empty bladder without the use of a belly board; group II: empty bladder with the use of a belly board; group III: bladder distension without the use of a belly board; group IV: bladder distension with the use of a belly board. The conventional three-field treatment plan was made using a three-dimensional treatment planning system. The irradiated small-bowel volume was calculated at 10% intervals from 10% to 100% of the prescribed dose. Results: The volume of the irradiated small bowel decreased in the order of group I, group II, group III, and group IV at all dose levels (p 3 (33.9±12.9%) in group II, 76.6±30.5 cm 3 (55.1±17.8%) in group III, and 98.5±36.7 cm 3 (70.7±14.5%) in group IV. Conclusion: Bladder distension was a more effective method than the belly board for reducing the irradiated small-bowel volume in postoperative pelvic radiotherapy of rectal cancer patients. The combination of the belly board and bladder distension showed an additive effect and was the most effective method for reducing the irradiated small-bowel volume. (orig.)

  2. Patterns of relapse following surgery and postoperative intensity modulated radiotherapy for oral and oropharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Collan, Juhani; Vaalavirta, Leila; Kajanti, Mikael; Tenhunen, Mikko; Saarilahti, Kauko (Dept. of Oncology, Helsinki Univ. Central Hospital, and Univ. of Helsinki, Helsinki (Finland)), E-mail: kauko.saarilahti@hus.fi; Lundberg, Marie; Baeck, Leif; Maekitie, Antti (Dept. of Otorhinolaryngology - Head and Neck Surgery, Helsinki Univ. Central Hospital, and Univ. of Helsinki, Helsinki (Finland))

    2011-10-15

    Background. To investigate the patterns of relapse following intensity modulated radiotherapy (IMRT) given after radical surgery for oral and oropharyngeal squamous cell cancer. Patients and methods. One hundred and two patients with oral or oropharyngeal cancer were treated with radical surgery followed by IMRT up to a mean total dose of 60 Gy between years 2001 and 2007. Thirty-nine of the patients (%) also received concomitant weekly cisplatin. Forty of the patients had oral and 62 had oropharyngeal cancer. Data on the tumour, patient and treatment factors were collected. Following therapy the patients were followed by clinical examination, endoscopy and MRI/CT at 2- to 3-months interval up to 2 years and thereafter at 6-month intervals. Results. The mean follow-up time of the patients was 55 months (range, 26-106 months). The rate for local tumour control for the whole cohort was 92.2%: 87.5% for oral cancer patients and 96.7% for oropharyngeal cancer patients. The 5-year disease specific survival was 90.2% and 5-year overall survival 84.3%. During the follow-up eight locoregional recurrences were observed, three at the primary tumour site and one at regional nodal site and four at both sites. The mean time to primary tumour recurrence was seven months (range, 2-10 months) and to nodal recurrence seven months (range, 2-12 months). Distant metastasis occurred in six (6%) patients. The factors associated with poor prognosis were the primary tumour size and tumour site with oral cancers having worse outcome. The treatment was well tolerated with no unexpected toxicities. The most frequent late toxicity was dysphagia necessitating permanent PEG in five patients. This was correlated with the advanced primary tumour size and resulting in wide tumour excision and reconstruction. Conclusions. Surgery combined with postoperative radiotherapy given as IMRT results in low level of tumour recurrence

  3. Patterns of relapse following surgery and postoperative intensity modulated radiotherapy for oral and oropharyngeal cancer

    International Nuclear Information System (INIS)

    Collan, Juhani; Vaalavirta, Leila; Kajanti, Mikael; Tenhunen, Mikko; Saarilahti, Kauko; Lundberg, Marie; Baeck, Leif; Maekitie, Antti

    2011-01-01

    Background. To investigate the patterns of relapse following intensity modulated radiotherapy (IMRT) given after radical surgery for oral and oropharyngeal squamous cell cancer. Patients and methods. One hundred and two patients with oral or oropharyngeal cancer were treated with radical surgery followed by IMRT up to a mean total dose of 60 Gy between years 2001 and 2007. Thirty-nine of the patients (%) also received concomitant weekly cisplatin. Forty of the patients had oral and 62 had oropharyngeal cancer. Data on the tumour, patient and treatment factors were collected. Following therapy the patients were followed by clinical examination, endoscopy and MRI/CT at 2- to 3-months interval up to 2 years and thereafter at 6-month intervals. Results. The mean follow-up time of the patients was 55 months (range, 26-106 months). The rate for local tumour control for the whole cohort was 92.2%: 87.5% for oral cancer patients and 96.7% for oropharyngeal cancer patients. The 5-year disease specific survival was 90.2% and 5-year overall survival 84.3%. During the follow-up eight locoregional recurrences were observed, three at the primary tumour site and one at regional nodal site and four at both sites. The mean time to primary tumour recurrence was seven months (range, 2-10 months) and to nodal recurrence seven months (range, 2-12 months). Distant metastasis occurred in six (6%) patients. The factors associated with poor prognosis were the primary tumour size and tumour site with oral cancers having worse outcome. The treatment was well tolerated with no unexpected toxicities. The most frequent late toxicity was dysphagia necessitating permanent PEG in five patients. This was correlated with the advanced primary tumour size and resulting in wide tumour excision and reconstruction. Conclusions. Surgery combined with postoperative radiotherapy given as IMRT results in low level of tumour recurrence

  4. Preoperative vs. postoperative radiotherapy in the treatment of soft tissue sarcomas: a matter of presentation

    International Nuclear Information System (INIS)

    Pollack, Alan; Zagars, Gunar K.; Goswitz, Mary S.; Pollock, Raphael A.; Feig, Barry W.; Pisters, Peter W.T.

    1998-01-01

    Purpose: Radiotherapy for soft tissue sarcoma is typically preoperative or postoperative, with advocates of each. In this study, the relationship of the sequencing of radiotherapy and surgery to local control was examined. Methods and Materials: The cohort consisted of 453 patients with Grade 2-3 malignant fibrous histiocytoma, synovial sarcoma, or liposarcoma treated from 1965-1992. Retroperitoneal sarcomas were excluded. Median follow-up was 97 months. There were 3 groups of patients that were classified by the treatment administered at our institution: preoperative radiotherapy to a median dose of 50 Gy given before excision at MDACC (Preop; n = 128); postoperative radiotherapy to a median dose of 64 Gy given after excision at MDACC (Postop; n = 165); and radiotherapy to a median dose of 65 Gy without excision at MDACC (RT Alone; n = 160). Those in the RT Alone Group had gross total excision at an outside center prior to referral. Results: Histological classification, whether locally recurrent at referral, and final MDACC margins were independent determinants of local control in Cox proportional hazards multivariate analysis using the entire cohort. The type of treatment was not significant; however, tumor status at presentation (gross disease vs. excised) affected these findings greatly. Gross disease treated with Preop was controlled locally in 88% at 10 years, as compared to 67% with Postop (p = 0.01). This association was independently significant for patients treated primarily (not for recurrence). In contrast, for those presenting after excision elsewhere, 10-year local control was better with Postop (88% vs. 73%, p = 0.07), particularly for patients treated primarily (91% vs. 72%, p 0.02 in univariate analysis; p = 0.06 in multivariate analysis). Re-excision at MDACC (Postop) resulted in enhanced 10-year local control over that with RT Alone (88% vs. 75%, p = 0.06), and was confirmed to be an independent predictor in multivariate analysis (p = 0

  5. Radiotherapy

    Directory of Open Access Journals (Sweden)

    Rema Jyothirmayi

    1999-01-01

    Full Text Available Purpose. Conservative treatment in the form of limited surgery and post-operative radiotherapy is controversial in hand and foot sarcomas, both due to poor radiation tolerance of the palm and sole, and due to technical difficulties in achieving adequate margins.This paper describes the local control and survival of 41 patients with soft tissue sarcoma of the hand or foot treated with conservative surgery and radiotherapy. The acute and late toxicity of megavoltage radiotherapy to the hand and foot are described. The technical issues and details of treatment delivery are discussed. The factors influencing local control after radiotherapy are analysed.

  6. The outcome of the postoperative radiotherapy of autonomic nerve preserving operation for lower rectal cancer

    International Nuclear Information System (INIS)

    Takahashi, Keiichi; Mori, Takeo; Yasuno, Masamichi

    1997-01-01

    It is unclear whether adjuvant radiotherapy before or after surgery is effective for locally advanced, resectable lower rectal cancer. This study consists of a prospective randomized trial of postoperative radiotherapy for locally advanced curatively resected lower rectal carcinoma. We divided patients into two groups, one with postoperative 50 Gy radiation therapy to pelvic wall (N=64), and the other with no radiation therapy (N=46). The 5 year disease-free rate was 61.8% in the radiation group and 70.6% in the no radiation group. There was statistically no significant difference between these two groups. The local recurrence rate was 2.7% (radiation therapy group: 1.6%, no radiation therapy group: 4.3%). This local recurrence rate was very low. These results made us suspect that postoperative radiation therapy was not always necessary to prevent local recurrence. Postoperative complications had a higher incidence in the radiation therapy group than in the no-radiation therapy group. In the radiation therapy group, 35.5% of the patients suffered from diarrhea or frequent defecation, and 10.8% from severe abdominal pain. We operated on 4 cases of radiation-induced ileal stenosis and ileus. Postoperative radiation therapy did not help prevent local recurrence even though many complications resulted. (author)

  7. Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients

    International Nuclear Information System (INIS)

    Berglund, G.; Bolund, C.; Fornander, T.; Rutqvist, L.E.; Sjoeden, P.-O.

    1991-01-01

    Late effects of adjuvant treatment on perceived health and quality of life were assessed through a questionnaire mailed to 448 premenopausal and postmenopausal breast cancer patients, free from recurrence 2-10 years after primary therapy. The patients had been randomised to postoperative radiotherapy or adjuvant chemotherapy as adjuncts to primary surgery. The differences between the two treatments were generally small. However, the radiotherapy patients had significantly greater problems with decreased stamina, symptoms related to the operation scar and anxiety. The chemotherapy patients had significantly more problems with smell aversion. Activity level inside and outside the home, anxiousness and depressive symptoms were similar in both groups. The chemotherapy patients scored their overall quality of life higher than the radiotherapy patients. (author)

  8. Late effects of adjuvant chemotherapy and postoperative radiotherapy on quality of life among breast cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Berglund, G.; Bolund, C.; Fornander, T.; Rutqvist, L.E. (Karolinska Sjukhuset, Stockholm (Sweden)); Sjoeden, P.-O. (Uppsala Univ. (Sweden))

    1991-09-01

    Late effects of adjuvant treatment on perceived health and quality of life were assessed through a questionnaire mailed to 448 premenopausal and postmenopausal breast cancer patients, free from recurrence 2-10 years after primary therapy. The patients had been randomised to postoperative radiotherapy or adjuvant chemotherapy as adjuncts to primary surgery. The differences between the two treatments were generally small. However, the radiotherapy patients had significantly greater problems with decreased stamina, symptoms related to the operation scar and anxiety. The chemotherapy patients had significantly more problems with smell aversion. Activity level inside and outside the home, anxiousness and depressive symptoms were similar in both groups. The chemotherapy patients scored their overall quality of life higher than the radiotherapy patients. (author).

  9. Long term outcomes after salvage radiotherapy for postoperative locoregionally recurrent non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Chang Hoon; Kim, Jae Sung [Dept. of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Mi Young [Dept. of Radiation Oncology, Kyungpook National University Medical Center, Daegu (Korea, Republic of)

    2017-03-15

    The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

  10. The efficacy of postoperative radiotherapy in localized primary soft tissue sarcoma treated with conservative surgery

    International Nuclear Information System (INIS)

    Zhao, Ru-Ping; Yu, Xiao-Li; Zhang, Zhen; Jia, Li-Juan; Feng, Yan; Yang, Zhao-Zhi; Chen, Xing-Xing; Wang, Jian; Ma, Sheng-Lin; Guo, Xiao-Mao

    2016-01-01

    To evaluate the efficacy of postoperative radiotherapy (RT) on local failure-free survival (LFFS), distant metastasis-free survival (DMFS) and overall survival (OS) in patients with localized primary soft tissue sarcoma (STS) and to identify prognostic factors. Between January 2000 and July 2010, 220 consecutive patients with localized primary STS, who received conservative surgery with or without postoperative RT, were enrolled in the study. Survival curves were constructed by the Kaplan-Meier method and log-rank test was used to assess statistical significance. Multivariate analysis was applied to identify the prognostic factors. After a median follow-up of 68 months (range, 5–127 months), the 5-year LFFS, DMFS and OS were 70.0, 78.2 and 71.2 %, respectively. Tumor size, histological subtypes, margin status and postoperative RT were independent predictors for OS. Postoperative RT was associated with a significant reduced local recurrence risk versus surgery alone (hazard ratio [HR] = 0.408, 95 % confidence interval [CI] 0.235–0.707, P = 0.001), with 5-year LFFS of 81.1 and 63.6 %, respectively (log-rank, P = 0.004). The log-rank test showed that postoperative RT had a tendency of improving OS compared with surgery alone, with 5-year OS of 74.8 and 65.0 %, respectively (P = 0.089). Multivariate analysis demonstrated that postoperative RT significantly reduced mortality rate compared with surgery alone (HR = 0.512, 95 % CI 0.296–0.886, p = 0.017), especially in patients with liposarcoma (p = 0.034). Postoperative radiotherapy reduce both local recurrence and STS mortality in patients with localized primary STS. The efficacy of RT on survival warrants further prospective study. The online version of this article (doi:10.1186/s13014-016-0605-y) contains supplementary material, which is available to authorized users

  11. Classical prognostic factors in patients with non-advanced endometrial cancer treated with postoperative radiotherapy

    International Nuclear Information System (INIS)

    Karolewski, K.; Kojs, Z.; Jakubowicz, J.; Urbanski, K.; Michalak, A.

    2006-01-01

    Aim: Analysis of classical prognostic factors in patients with non-advanced endometrial cancer treated with postoperative radiotherapy. Materials/Methods: In the years 1985 - 1999, 705 patients underwent postoperative radiotherapy due to endometrial cancer: 529 patients with FIGO stage I and 176 with FIGO stage II cancer. Mean age was 58 years. In 96% of patients endometrioid adenocarcinoma was found. In 49.9% the cancer had a high, in 27.9% a medium, and in 22.2% a low degree of differentiation. Results: 82% of patients had 5-year disease-free survival. In univariate analysis a significantly higher rate of disease-free survival was observed in: patients younger than 60, with moderately and well differentiated cancers, with stage I endometrioid adenocarcinoma with less than 50% myometrial invasion. In multivariate analysis degree of cancer differentiation was the only independent prognostic factor. Conclusions: In a group of patients with non-advanced endometrial cancer treated with postoperative radiotherapy, degree of cancer differentiation is the primary prognostic factor. (authors)

  12. Prophylactic post-operative radiotherapy prevents heterotopic ossification following traumatic acetabular fracture

    International Nuclear Information System (INIS)

    Meyer, Joseph T.; Hixson, William C.; Jennelle, Richard L. S.; Alonso, Jorge E.; Raben, David; Spencer, Sharon S.; Kim, Robert Y.

    1996-01-01

    Purpose/Objective: To determine the effect of post-operative radiation on the incidence of heterotopic ossification following traumatic acetabular fracture. Materials and Methods: A retrospective analysis was performed of the medical records and radiographs of all patients who received prophylactic radiotherapy to prevent heterotopic ossification. These results were compared to a similar group of patients receiving no prophylactic radiotherapy following traumatic acetabular fracture. Between 1987 and 1994, sixty-six patients received prophylactic radiotherapy to prevent heterotopic ossification. Results: Thirty-six patients (55%) received radiotherapy following operative repair of a traumatic acetabular fracture (median follow-up: 210 days). Three dose schedules were utilized: (28(36)) (77.8%) received 700 cGy/1 fx, (2(36)) (5.5%) 800 cGy/1 fx, and (6(36)) (16.7%) 1000 cGy/5 fxs. These patients were retrospectively compared with thirty-four patients who received similar operative management of traumatic acetabular fractures without post-operative radiotherapy (median follow-up: 378 days). Of the patients with heterotopic ossification, 96% developed it within 180 days. Complications and delayed wound healing rates were not significantly different in patients treated with or without post-operative radiotherapy, 6.4% and 6.3% respectively (p=0.49). The incidence of heterotopic ossification at last follow-up in patients treated with and without post-operative radiotherapy was (5(36)) (13.9%) and (19(34)) (55.9%), respectively (p=0.000332). For all patients, type of surgical approach was associated with development of heterotopic ossification: posterior, (7(38)) (18.4%), ilio-inguinal (1(3)) (33.3%), tri-radiate (13(19)) (68.4%), p=.000511. In patients receiving post-operative radiotherapy, variables associated with heterotopic ossification included dose (p=.00962), injury-to-radiation interval (p=.0038), and surgery-to-radiation interval (p=.0238). Fifty percent ((3

  13. Role of postoperative radiotherapy in the treatment of Merkel tumours: experience at the Henri Mondor Hospital on 21 cases

    International Nuclear Information System (INIS)

    Calitchi, E.; Pan, Q.; Diana, C.; Belkacemi, Y.; Lagrange, J.L.

    2010-01-01

    As Merkel tumour treatment modalities are still a matter of discussion, the authors report the experience gained on 21 patients in the radiotherapy department of the Henri Mondor Hospital between 1990 and 2005. The treatment always comprised a surgical exeresis followed by radiotherapy. The authors analyse the obtained results which confirm the interest of postoperative radiotherapy. The detailed analysis of modalities (radiation type, total dose, irradiation volume) allows an optimal irradiation scheme to be proposed. Short communication

  14. Potential clinical predictors of outcome after postoperative radiotherapy of non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Buetof, R. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); Kirchner, K.; Appold, S. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Loeck, S. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); Rolle, A. [Lungenfachklinik Coswig, Department of Thoracic and Vascular Surgery, Coswig (Germany); Hoeffken, G. [Lungenfachklinik Coswig, Department of Pneumology, Coswig (Germany); Krause, M.; Baumann, M. [Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Department of Radiation Oncology, Dresden (Germany); Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, OncoRay National Center for Radiation Research in Oncology, Dresden (Germany); German Cancer Consortium (DKTK), Dresden (Germany); German Cancer Research Center (DKFZ), Heidelberg (Germany); Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany)

    2014-03-15

    The aim of this analysis was to investigate the impact of tumour-, treatment- and patient-related cofactors on local control and survival after postoperative adjuvant radiotherapy in patients with non-small cell lung cancer (NSCLC), with special focus on waiting and overall treatment times. For 100 NSCLC patients who had received postoperative radiotherapy, overall, relapse-free and metastases-free survival was retrospectively analysed using Kaplan-Meier methods. The impact of tumour-, treatment- and patient-related cofactors on treatment outcome was evaluated in uni- and multivariate Cox regression analysis. No statistically significant difference between the survival curves of the groups with a short versus a long time interval between surgery and radiotherapy could be shown in uni- or multivariate analysis. Multivariate analysis revealed a significant decrease in overall survival times for patients with prolonged overall radiotherapy treatment times exceeding 42 days (16 vs. 36 months) and for patients with radiation-induced pneumonitis (8 vs. 29 months). Radiation-induced pneumonitis and prolonged radiation treatment times significantly reduced overall survival after adjuvant radiotherapy in NSCLC patients. The negative impact of a longer radiotherapy treatment time could be shown for the first time in an adjuvant setting. The hypothesis of a negative impact of longer waiting times prior to commencement of adjuvant radiotherapy could not be confirmed. (orig.) [German] Das Ziel der vorliegenden Analyse war, den Einfluss von tumor-, patienten- und therapieabhaengigen Kofaktoren auf die lokoregionale Tumorkontrolle und das Ueberleben nach postoperativer adjuvanter Strahlentherapie bei Patienten mit einem nicht-kleinzelligen Bronchialkarzinom (NSCLC) zu untersuchen. Ein spezieller Fokus lag dabei auf der Wartezeit zwischen Operation und Beginn der Strahlentherapie sowie der Gesamtbehandlungszeit der Strahlentherapie. Fuer 100 Patienten, die eine postoperative

  15. Postoperative radiotherapy for oral cavity cancers: Impact of anatomic subsite on treatment outcome

    International Nuclear Information System (INIS)

    Zelefsky, M.J.; Harrison, L.B.; Fass, D.E.; Armstrong, J.; Spiro, R.H.; Shah, J.P.; Strong, E.W.

    1990-01-01

    We have retrospectively reviewed the treatment results of postoperative radiotherapy (RT) for advanced oral cavity cancers. The purpose of this study was to determine the impact of anatomic subsite on the results of treatment. Between 1975 and 1985, 51 patients with squamous cell carcinoma of the oral tongue (OT = 29 patients) and floor of mouth (FOM = 22 patients) were treated with combined surgery plus RT. All had an indication(s) for RT including advanced primary disease (T3 or T4) (29 patients), close or positive margins (34 patients), and multiple positive neck nodes and/or extracapsular extension (41 patients). With a median follow-up of 6 years, the 5-year actuarial local control rate was 74% and the rate of distant metastasis (DM) was 34%. Despite the similar T stage, margin status and median RT dose, the 5-year actuarial local failure rate was 38% for OT vs. 11% for FOM (p = 0.03). Furthermore, the median survival after recurrence was 9 months for OT and 40 months for FOM (p = 0.02). At 5 years the determinate survival for both sites was (55%), and the likelihood of developing a second malignancy was 31%. The likelihood of developing DM was 50% for FOM (N0-N1 = 3 of 12, N2-N3 = 8 of 10) and 21% for OT (N0-N1 = 4 of 21, N2-N3 = 1 of 8). This study highlights significant differences between FOM and OT cancers in response to combined surgery and RT. Future strategies should be directed at the enhancement of local control for OT and better systemic therapy for those with advanced N-stage FOM

  16. Recurrence of chromophobe pituitary adenomas after operation and postoperative radiotherapy

    International Nuclear Information System (INIS)

    Salmi, J.; Pelkonen, R.; Grahne, B.; Valtonen, S.

    1982-01-01

    The rate of recurrence is reported in a prospective study of 56 patients (28 men, 28 women) with large chromophobe pituitary adenoma (with or without hyperprolactinemia). The surgical approach was transfrontal in 44 and transseptospehnoidal in 12 patients. Cryoapplication was combined with the transsphenoidal operation. All but one patient received postopertive pituitary irradiation. Altogether, 11 (20 %) clinical relapses (10 men) occurred between 0.5 and 6 years after the transfrontal operation. Patients that relapsed had had larger tumors than those remaining in remission. Occurence of the tumors appeared with a deterioration of the visual field defect in 9 patients. There were no differences in the degrees of hypopituitarism in patients who relapsed as compared to patients remaining in remission. (author)

  17. Postoperative radiotherapy for patients with invasive cervical cancer following treatment with simple hysterectomy

    International Nuclear Information System (INIS)

    Chen Shangwen; Liang Jian; Yang Shihneng; Lin Fangjen

    2003-01-01

    This study aimed to investigate the survival and complications of patients who received adjuvant radiotherapy for invasive cervical cancer following inadvertent simple hysterectomy. From September 1992 through to December 1998, 54 patients who had received simple hysterectomies for benign lesions, but were incidentally found with invasive carcinoma of the cervix in the surgical specimen, were referred to our department for postoperative irradiation. They were categorized into two groups according to pathological findings. Group A consisted of 25 patients whose specimen showed microinvasion alone, with the depth of stromal invasion <5 mm. Group B consisted of 29 patients whose pathological findings included deep stromal invasion, tumor emboli in cervix, lymphovascular permeation, positive or close resection margin, endometrial or myometrial invasion and vaginal involvement. After external beam irradiation dose of 44 Gy in 22 fractions over 4-5 weeks to the whole pelvis, the radiation field was reduced to true pelvis for a further 10 Gy in five fractions. Brachytherapy was performed using an Ir-192 remote after-loading technique for 1-2 courses. The prescribed dose for each treatment was 7.5 Gy to the vaginal surface. A retrospective analysis was conducted to compare radiation-therapy outcomes for these 54 patients. After 37-102 months of follow-up (median, 58 months), 47 patients were alive without evidence of disease; five patients in Group B died of the disease (three with distant metastasis, one with local relapse, one with both). Two patients died of other concurrent diseases. The 5-year actuarial survival (AS) and disease-free survival (DFS) rates for all patients were 88 and 90%, respectively. The respective 5-year AS and DFS rates for Group A/B were 95/82% (P=0.07) and 100/83% (P=0.03). Ten patients (18.5%) developed Radiation Therapy Oncology Group (RTOG) Grade 1-4 rectal complications. Five patients (9.3%) developed RTOG Grade 3-4 bladder complications

  18. Outcomes of WHO Grade I Meningiomas Receiving Definitive or Postoperative Radiotherapy

    International Nuclear Information System (INIS)

    Tanzler, Emily; Morris, Christopher G.; Kirwan, Jessica M.; Amdur, Robert J.; Mendenhall, William M.

    2011-01-01

    Purpose: We analyzed long-term local control and complications in patients with either pathologically confirmed or clinical World Health Organization Grade I meningiomas treated with definitive or postoperative radiotherapy (RT) at the University of Florida. Methods: Between 1984 and 2006, 146 patients were treated with definitive (n = 88) or postoperative RT after subtotal resection (n = 57) or gross total resection (n = 1). Patients were treated with conventional (n = 41), stereotactic (n = 103), or intensity-modulated RT (n = 2) to a median dose of 52.7 Gy and followed for a median of 7.3 years (range, 0.6-22.0 years) Results: The local control rates at 5 and 10 years were as follows: definitive RT, 99% and 99%; postoperative RT, 96% and 93%; and overall, 97% and 96%, respectively. The 5- and 10-year cause-specific survival rates were as follows: definitive RT 94% and 94%, postoperative RT, 100% and 96%; and overall, 96% and 95%, respectively. The 5- and 10-year overall survival rates were as follows: definitive RT, 81% and 75%; postoperative RT, 96% and 85%; and overall, 87% and 79%, respectively. Severe RT complications occurred in 6.8% of patients; severe surgery-related complications occurred in 10 (17%) of 58 patients treated surgically. Conclusions: The likelihood of cure after definitive RT or following subtotal resection is excellent. However, a small population of patients experience severe complications, even at the moderate dose used for this disease.

  19. Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer

    International Nuclear Information System (INIS)

    Pinkawa, Michael; Schubert, Carolin; Escobar-Corral, Nuria; Holy, Richard; Eble, Michael J.

    2015-01-01

    In contrast to primary radiotherapy, no reports are available for a hydrogel spacer application in postoperative salvage radiotherapy for prostate cancer. A 77-year-old patient presented 20 years after radical prostatectomy with a digitally palpable local recurrence at the urethrovesical anastomosis (PSA 5.5 ng/ml). The hydrogel spacer (10 ml, SpaceOAR trademark) was injected between the local recurrence and rectal wall under transrectal ultrasound guidance. Treatment planning was performed with an intensity-modulated technique up to a total dose of 76 Gy in 2-Gy fractions. The same planning was performed based on computed tomography before spacer injection for comparison. The local recurrence, initially directly on the rectal wall, could be displaced more than 1 cm from the rectal wall after hydrogel injection. With a mean total dose of 76 Gy to the planning target volume, rectal wall volumes included in the 70 Gy, 60 Gy, 50 Gy isodoses were 0 cm 3 , 0 cm 3 , and 0.4 cm 3 with a spacer and 2.9 cm 3 , 4.5 cm 3 , and 6.2 cm 3 without a spacer, respectively. The patient reported rectal urgency during radiotherapy, completely resolving after the end of treatment. The PSA level was 5.4 ng/ml a week before the end of radiotherapy and dropped to 0.9 ng/ml 5 months after radiotherapy. A hydrogel spacer was successfully applied for dose-escalated radiotherapy in a patient with macroscopic local prostate cancer recurrence at the urethrovesical anastomosis to decrease the dose at the rectal wall. This option can be considered in specifically selected patients. (orig.) [de

  20. Symptom resolution, tumor control, and side effects following postoperative radiotherapy for pituitary macroadenomas

    International Nuclear Information System (INIS)

    Rush, Stephen; Cooper, Paul R.

    1997-01-01

    This study reports the outcome of 70 patients who were treated by a consistent treatment plan of surgery and postoperative radiotherapy (RT) for pituitary macroadenomas in the modern era [computed tomographic scan or magnetic resonance imaging (MRI), dopamine agonist therapy (DA) added as indicated, and immunohistochemical staining]. Sixty-two patients underwent transsphenoidal surgery (vs. transcranial surgery) and 61 received 45-Gy/25 fractions postoperatively (vs. other dose fractionation schemes). Twenty-four patients received DA for prolactin-secreting tumors. With a median follow-up of 8 years (range 2-15), 68 patients have experienced continuous control of their tumors. Most symptoms related to mass effect abated, while physiologic symptoms such as amenorrhea from markedly elevated prolactin levels tended to persist. Treatment-induced hypopituitarism occurred in 42% of the patients at risk. No patients in this series have died as a result of their pituitary tumor. No gross neuropsychologic dysfunction after treatment has been noted. While it is possible at this time with serial MRI to withhold postoperative RT and observe some patients who have had a 'gross total' resection of a macroadenoma, the therapeutic ratio for surgery and adjuvant radiotherapy for patients with nonfunctional tumors as well as select patients with secretory macroadenomas is favorable

  1. Postoperative complications following intraoperative radiotherapy in abdominopelvic malignancy: A single institution analysis of 113 consecutive patients.

    Science.gov (United States)

    Abdelfatah, Eihab; Page, Andrew; Sacks, Justin; Pierorazio, Phillip; Bivalacqua, Trinity; Efron, Jonathan; Terezakis, Stephanie; Gearhart, Susan; Fang, Sandy; Safar, Bashar; Pawlik, Timothy M; Armour, Elwood; Hacker-Prietz, Amy; Herman, Joseph; Ahuja, Nita

    2017-06-01

    Intraoperative radiotherapy (IORT) has advantages over external beam radiation therapy (EBRT). Few studies have described side effects associated with its addition. We evaluated our institution's experience with abdominopelvic IORT to assess safety by postoperative complication rates. Prospectively collected IRB-approved database of all patients receiving abdominopelvic IORT (via high dose rate brachytherapy) at Johns Hopkins Hospital between November 2006 and May 2014 was reviewed. Patients were discussed in multidisciplinary conferences. Those selected for IORT were patients for whom curative intent resection was planned for which IORT could improve margin-negative resection and optimize locoregional control. Perioperative complications were classified via Clavien-Dindo scale for postoperative surgical complications. A total of 113 patients were evaluated. Most common diagnosis was sarcoma (50/113, 44%) followed by colorectal cancer (45/113, 40%), most of which were recurrent (84%). There were no perioperative deaths. A total of 57% of patients experienced a complication Grade II or higher: 24% (27/113) Grade II; 27% (30/113) Grade III; 7% (8/113) Grade IV. Wound complications were most common (38%), then gastrointestinal (25%). No radiotherapy variables were significantly associated with complications on uni/multi-variate analysis. Our institution's experience with IORT demonstrated historically expected postoperative complication rates. IORT is safe, with acceptable perioperative morbidity. © 2017 Wiley Periodicals, Inc.

  2. Postoperative radiotherapy for stage I/II seminoma: results for 212 patients

    International Nuclear Information System (INIS)

    Bauman, Glenn S.; Venkatesan, Varagur M.; Ago, C. Tetteh; Radwan, John S.; Dar, A. Rashid; Winquist, Eric W.

    1998-01-01

    Purpose: A retrospective review of patients with Stage I and II seminoma treated at a regional cancer center was performed to assess the long term efficacy and toxicity associated with post operative radiotherapy. Methods and Materials: Between 1950 and 1995, 212 patients seen at the London Regional Cancer Centre received adjuvant radiotherapy following orchiectomy for Stage I (169) and II (43) seminoma. Median follow-up for the group was 7.5 years. Results: Progression free, cause specific, and overall survival were 95%, 98%, and 95% at 5 years, and 94%, 98%, and 94% at 10 years respectively. An increased risk of failure was noted among patients with bulky Stage II disease. No other prognostic factors for relapse were identified. Late toxicity was uncommon with only 12/212 (6%) developing any late GI toxicity potentially attributable to radiotherapy. The incidence of second malignancies (excluding second testicular tumors) was 6/212 (actuarial:1%, 1%, 6% at 5,10,15 years respectively). There was a trend toward increased acute complications for patients treated with larger volumes of radiation. No prognostic factors associated with increased risk of late toxicity or second malignancy were identified, likely a consequence of the small number of these events. Conclusion: Survival and toxicity were comparable to that reported in the literature. Post-operative radiotherapy remains a safe and efficacious adjuvant treatment for Stage I and early Stage II seminoma

  3. Conformity Index and Homogeneity Index of the Postoperative Whole Breast Radiotherapy.

    Science.gov (United States)

    Petrova, Deva; Smickovska, Snezana; Lazarevska, Emilija

    2017-10-15

    The treatment of breast cancer involves a multidisciplinary approach in which radiotherapy plays a key role. The conformity index and the homogeneity index are two analysis tools of a treatment plan using conformal radiotherapy. The purpose of this article is an analysis of these two parameters in the assessment of the treatment plans in 58 patients undergoing postoperative radiotherapy of the whole breast. All 58 patients participating in the study had a conservatively treated early-stage breast cancer. The treatment was performed using a standard regimen of fractionation in 25 fractions up to a total dose of 50 Gy. Dose-volume histograms were generated for both plans with and without segmental fields. Pair samples t-test was used. The technique with segmental fields allowed us more homogeneity distribution when compared to standard two tangential field techniques. The HI values were 1.08 ± 0.01 and 1.09 ± 0.01 for segment and technique with two tangential fields (p conformity and the homogeneity index are important tools in the analysis of the treatment plans during radiation therapy in patients with early-stage breast cancer. Adding segment fields in the administration of radiotherapy in patients with conservatively treated breast cancer can lead to improved dosage homogeneity and conformity.

  4. Combined modality treatment including intraoperative radiotherapy in locally advanced and recurrent rectal cancer

    International Nuclear Information System (INIS)

    Tveit, Kjell Maque; Wiig, Johan N.; Olsen, Dag Rune; Storaas, Andreas; Poulsen, Jan Peter; Giercksky, Karl-Erik

    1997-01-01

    Background: Treatment of locally advanced and recurrent rectal cancer usually has a high local recurrence rate and poor survival. Promising results have been reported by combined external radiotherapy, extensive surgery and intraoperative radiotherapy (IORT). Methods: One hundred fifteen patients with locally advanced rectal cancers fixed to the pelvic wall or locally recurrent rectal cancers underwent preoperative external radiotherapy with 46-50 Gy. Six to 8 weeks later radical pelvic surgery was attempted, and was combined with intraoperative electron beam radiotherapy (15-20 Gy) in 66 patients. The patients were followed closely to evaluate complication rate, local and distant recurrence rate and survival. Results: Surgery with no macroscopic tumour remaining was obtained in 65% of the patients with no postoperative deaths. Pelvic infection was the major complication (21%). Although the observation time is short (3-60 months), the local recurrence rate seems low (22%) and survival seems promising (about 60% at 4 years) in patients with complete tumour resection, in contrast to patients with residual tumour (none living at 4 years). Conclusions: The combined modality treatment with preoperative external radiotherapy and extensive pelvic surgery with IORT is sufficiently promising to start a randomized trial on the clinical value of IORT as a boost treatment in the multidisciplinary approach to this disease

  5. Indications of elective neck dissection and postoperative radiotherapy for parotid cancers

    International Nuclear Information System (INIS)

    Shibata, Tomohisa; Yonezawa, Kouichiro; Morimoto, Koichi; Yamashita, Daisuke; Otsuki, Naoki; Nishimura, Hideki; Sasaki, Ryohei; Nibu, Ken-ichi

    2011-01-01

    Regional lymph node metastases significantly influence the prognosis of patients with parotid cancer. To assess our indications of elective neck dissection and postoperative radiotherapy for parotid cancer, a retrospective chart review was performed. Between 2001 and 2009, 35 patients with parotid cancer were initially treated at our department. The median follow-up was 30 months (range, 10-90 months). Out of all patients, 31 (89%) patients were preoperatively diagnosed as malignant, while 4 (11%) patients were initially diagnosed as benign. Mucoepidermoid carcinoma was the most common histological type (10 patients). Twenty-two tumors (63%) were pathologically diagnosed as high-grade. The numbers of patients with Stages I, II, III, and IVA were 3, 10, 7, and 15, respectively. Ipsilateral neck dissection (Level II-V) was performed in seven patients with clinically positive neck metastasis (cN+), and in ten patients without lymph node metastasis who had T4 disease, high-grade malignancy, or positive neck (Level II) metastasis during intraoperative evaluation. Postoperative radiotherapy was performed in 24 patients with pathological T4, high-grade malignancy, positive surgical margin, multiple neck metastasis and/or extranodal extension (ENI). Seven of 28 (25%) patients with clinically N0 had pathologically positive neck metastasis (pN+). Regional recurrence developed in one patient with high-grade malignancy and ENI (T4N2b). Disease-specific survival rates for Stages I, II, III, and IVA at 3 years were 100%, 73%, 100%, and 37%, respectively. Loco-regional control rates for pN0 (21 patients) and pN+ (14 patients) at 3 years were 90% and 95%, respectively. Our present favorable loco-regional control supported our current indications of elective neck dissection and postoperative radiotherapy. We also recommend intraoperative biopsy of level IIB nodes to study the need for elective neck dissection. (author)

  6. Osteosarcoma in the anterior chest wall that developed 20 years after postoperative radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Murata, Mariko; Shoji, Tsuyoshi; Nakayama, Ei; Bando, Toru

    2008-01-01

    Sarcomas are a rare complication of radiotherapy for breast cancer and such patients have a poor prognosis. We report resection of an osteosarcoma in the chest wall that developed 20 years after postoperative radiotherapy for breast cancer. A 57-year-old woman was referred to our department for examination and treatment of an anterior chest wall tumor in April 2007. In September 1986, she had undergone a radical mastectomy and postoperative irradiation and chemotherapy for right breast cancer. In December 2003, she underwent chemotherapy for recurrence of breast cancer which was pointed out on computed tomography involving the pleura and left superior clavicular lymph nodes. In March 2006, follow-up computed tomography of the chest demonstrated the destruction of the sternum, which was diagnosed as recurrence and she was followed with chemotherapy for breast cancer continuously thereafter. In April 2007, because of the developing sternal tumor, excisional biopsy was performed and histopathology indicated sarcoma. In May 2007, resection of the chest wall tumor with the sternum, bilateral clavicles, bilateral first and second ribs, and right partial lung (upper and middle lobe) were performed, and the chest wall defect was reconstructed with a rectus abdominis musculocutaneous free flap. Histopathologically, the tumor was osteosarcoma with margin free. Adjuvant radiotherapy to the breast plays a significant role in preventing local disease recurrence in women treated for breast cancer. However, radiotherapy can induce malignant sarcoma after a latency period of several years. The risk is extremely low for the individual patient, but this disease is aggressive and associated with a poor overall prognosis. Therefore, early detection is necessary for optimal treatment and incisional biopsy is necessary for accurate diagnosis. (author)

  7. Effects from postoperative radiotherapy of parasellar ademonas of the pituitary gland

    International Nuclear Information System (INIS)

    Buchfelder, M.

    1984-01-01

    In this study, the effects from postoperative radiotherapy of parasellar or suprasellar adenomas of the pituitary were analysed to provide more detailed information about the value of radiation treatment, when used as a secondary measure after surgery or even in the primary treatment of pituitary adenomas. The analysis was based on 75 patients showing parasellar or suprasellar tumours of the pituitary. Radiation was in most cases preceded by surgery and carried out in the Radiological Department of Munich's University Hospital after the year 1975, when computed tomography had been made available to the Neurosurgical Department of this clinic. (orig./MG) [de

  8. Objective assessment of dermatitis following post-operative radiotherapy in patients with breast cancer treated with breast-conserving treatment

    International Nuclear Information System (INIS)

    Yoshida, Ken; Takenaka, Tadashi; Tanaka, Eiichi; Kuriyama, Keiko; Yoshida, Mineo; Yamazaki, Hideya; Nishimura, Tsunehiko; Kotsuma, Tadayuki; Fujita, Yuka; Masuda, Norikazu

    2010-01-01

    To evaluate radiation dermatitis objectively in patients with breast cancer who had undergone post-operative radiotherapy after breast-conserving surgery. Skin color (L * , a * , and b * values) and moisture analyses were performed for both breasts (before, after, 1 month, 6 months, and 1 year after radiotherapy) to examine irradiated and non-irradiated skin divided into four quadrants in 118 patients. These patients underwent breast conservative surgery followed by 50 Gy/25 fractions (median) of radiotherapy with or without boost irradiation (10 Gy/5 fractions). L * , a * , and moisture values were changed by irradiation and maximized at completion or 1 month after radiotherapy. One year after radiotherapy, the skin color had returned to the range observed prior to radiotherapy. However, moisture did not return to previous values even 1 year after treatment. The lateral upper side (quadrant C) showed greater changes than other quadrants in the L * value (darker) at the end of radiotherapy. The Common Toxicity Criteria version 3 scores were found to correlate well with a * and L * values at the completion and 1 month after radiotherapy. Boost radiotherapy intensified reddish and darker color changes at the completion of radiotherapy, while chemotherapy did not intensify the skin reaction caused by radiotherapy. Moisture impairment as a result of irradiation lasts longer than color alterations. Objective assessments are useful for analyzing radiation dermatitis. (orig.)

  9. Postoperative Prostate-Specific Antigen Velocity Independently Predicts for Failure of Salvage Radiotherapy After Prostatectomy

    International Nuclear Information System (INIS)

    King, Christopher R.; Presti, Joseph C.; Brooks, James D.; Gill, Harcharan; Spiotto, Michael T.

    2008-01-01

    Purpose: Identification of patients most likely to benefit from salvage radiotherapy (RT) using postoperative (postop) prostate-specific antigen (PSA) kinetics. Methods and Materials: From 1984 to 2004, 81 patients who fit the following criteria formed the study population: undetectable PSA after radical prostatectomy (RP); pathologically negative nodes; biochemical relapse defined as a persistently detectable PSA; salvage RT; and two or more postop PSAs available before salvage RT. Salvage RT included the whole pelvic nodes in 55 patients and 4 months of total androgen suppression in 56 patients. The median follow-up was >5 years. All relapses were defined as a persistently detectable PSA. Kaplan-Meier and Cox proportional hazards multivariable analysis were performed for all clinical, pathological, and treatment factors predicting for biochemical relapse-free survival (bRFS). Results: There were 37 biochemical relapses observed after salvage RT. The 5-year bRFS after salvage RT for patients with postop prostate-specific antigen velocity ≤1 vs. >1 ng/ml/yr was 59% vs. 29%, p = 0.002. In multivariate analysis, only postop PSAV (p = 0.0036), pre-RT PSA level ≤1 (p = 0.037) and interval-to-relapse >10 months (p = 0.012) remained significant, whereas pelvic RT, hormone therapy, and RT dose showed a trend (p = ∼0.06). PSAV, but not prostate-specific antigen doubling time, predicted successful salvage RT, suggesting an association of zero-order kinetics with locally recurrent disease. Conclusions: Postoperative PSA velocity independently predicts for the failure of salvage RT and can be considered in addition to high-risk features when selecting patients in need of systemic therapy following biochemical failure after RP. For well-selected patients, salvage RT can achieve high cure rates

  10. Primary radiotherapy or postoperative radiotherapy in patients with head and neck cancer. Comparative analysis of inflammation-based prognostic scoring systems

    International Nuclear Information System (INIS)

    Selzer, Edgar; Grah, Anja; Heiduschka, Gregor; Thurnher, Dietmar; Kornek, Gabriela

    2015-01-01

    Inflammation-based scoring systems have potential value in evaluating the prognosis of cancer patients; however, detailed comparative analyses in well-characterized head and neck cancer patient collectives are missing. We analyzed overall survival (OS) in locally advanced head and neck cancer patients who were treated with curative intent by primary radiotherapy (RT) alone, by RT in combination with cetuximab (RIT) or with cisplatin (RCHT), and by primary surgery followed by postoperative radiotherapy (PORT). The primary RT collective (N = 170) was analyzed separately from the surgery plus RT group (N = 148). OS was estimated using the Kaplan-Meyer method. Cox proportional-hazard regression models were applied to compare the risk of death among patients stratified according to risk factors and the inflammation-based Glasgow Prognostic Score (GPS), the modified GPS (mGPS), the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the prognostic index (PI). A prognostic relevance of the scoring systems for OS was observed in the primarily irradiated, but not in the PORT collective. OS was 35.5, 18.8, and 15.4 months, respectively, according to GPS 0, 1, and 2. OS according to mGPS 0-2 was identical. The PLR scoring system was not of prognostic relevance, while OS was 27.3 months in the NLR 0 group and 17.3 months in the NLR 1 group. OS was 35.5 months in PI 0, 16.1 months in PI 1, and 22.6 months in PI 2. GPS/mGPS scoring systems are able to discriminate between three risk groups in primarily, but not postoperatively irradiated locally advanced head and neck cancer patients. (orig.) [de

  11. Radiotherapy of bronchogenic carcinoma

    International Nuclear Information System (INIS)

    Heilmann, H.P.

    1982-01-01

    Radiotherapy of branchogenic carcinoma comprises; palliative treatment, postoperative or pre-operative radiotherapy, radiotherapy as part of a combination of chemotherapy and radiotherapy of small cell carcinoma and curative radiotherapy of non-operable non-small cell carcinoma. Atelectasis and obstruction are indications for palliative radiotherapy. Postoperative radiotherapy is given only in cases of incomplete resection or mediastinal metastases. In the treatment of small cell carcinoma by combined irradiation and chemotherapy the mediastinum and primary tumour are irradiated, generally after chemotherapy, and the C.N.S. receives prophylactic radiotherapy. Curative radiotherapy is indicated in cases of non-operable small cell carcinoma. Irradiation with doses of 60-70 Gy produced 5-years-survival rates of 10-14% in cases classified as T 1 -T 2 N 0 M 0 . (orig.) [de

  12. Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group

    International Nuclear Information System (INIS)

    Poortmans, Philip; Bossi, Alberto; Vandeputte, Katia; Bosset, Mathieu; Miralbell, Raymond; Maingon, Philippe; Boehmer, Dirk; Budiharto, Tom; Symon, Zvi; Bergh, Alfons C.M. van den; Scrase, Christopher; Poppel, Hendrik van; Bolla, Michel

    2007-01-01

    The appropriate application of 3-D conformal radiotherapy, intensity modulated radiotherapy or image guided radiotherapy for patients undergoing post-operative radiotherapy for prostate cancer requires a standardisation of the target volume definition and delineation as well as standardisation of the clinical quality assurance procedures. Recommendations for this are presented on behalf of the European Organisation for Research and Treatment of Cancer (EORTC) Radiation Oncology Group and in addition to the already published guidelines for radiotherapy as the primary treatment

  13. Outcome of postoperative radiotherapy following radical prostatectomy: a single institutional experience

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sea Won; Chung, Mi Joo; Jeong, Song Mi; Kim, Sung Hwan; Lee, Jong Hoon [Dept.of Radiation Oncology, St. Vincent' s Hospital, The Catholic University of Korea College of Medicine, Suwon (Korea, Republic of); Hwang, Tae Kon; Hong, Sung Hoo; Lee, Ji Youl; Jang, Hong Seok [Seoul St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Seoul (Korea, Republic of); Yoon, Sei Chul [Dept.of Radiation Oncology, Bucheon St. Mary' s Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of)

    2014-09-15

    This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.

  14. A case of angiosarcoma that developed 10 years after postoperative radiotherapy for tongue cancer

    International Nuclear Information System (INIS)

    Sagae, Hitomi; Watanabe, Yoshihiro; Ozawa, Hiroyuki; Ogawa, Kaoru

    2017-01-01

    Angiosarcoma is a rare disease that accounts for about 1%-2% of all soft-tissue sarcomas and is a highly malignant tumor with a poor prognosis. Albeit not very common, in some cases, angiosarcomas can be induced by irradiation. In this study, we report the case of a patient who developed angiosarcoma at the site of previous postoperative radiotherapy for tongue cancer. The patient was a 63-year-old woman who had undergone surgery for tongue cancer (T4aN2cM0) and received irradiation (50 Gy in total) to the cervical region. The postoperative course had been uneventful, without recurrence. However, 10 years after the surgery, she began to develop a dark-red tumor in the right lower jaw, which was diagnosed as angiosarcoma by biopsy. Because imaging revealed evidence of neither lymph node metastasis nor distant metastasis, tumorectomy with reconstructive surgery using a pectoralis major myocutaneous flap was performed. She then received postoperative adjuvant chemotherapy. Thereafter, she has had an uneventful course, without any evidence of recurrence until date. This case serves to underscore the fact that exposure to radiation can result in new malignant tumor formation. Therefore, such patients need to be explained about the possibility of development of radiation-induced tumor and about the need for long-term follow-up after radiotherapy; they should also receive instructions to visit a medical facility in case they notice any abnormality at the site of previous irradiation. In the event a patient develops any abnormality, such as redness and/or swelling, at the site of previous irradiation, he/she a patient should immediately be worked up under the assumption of not only recurrence of the primary disease, but also possible radiation-induced tumor. The diagnosis must be established by methods such as biopsy. (author)

  15. Prophylactic beclomethasone spray to the skin during postoperative radiotherapy of carcinoma breast: a prospective randomized study

    International Nuclear Information System (INIS)

    Shukla, P.N.; Gairola, M.; Mohanti, B.K.; Rath, G.K.

    2006-01-01

    Background and aims: Radiation induced wet desquamation of skin in carcinoma breast patients is a painful condition. In this study topical beclomethasone dipropionate spray was used as prophylaxis with the purpose of reducing risk of the wet desquamation of skin in irradiated field. Materials and methods: sixty patients of carcinoma breast were planned for postoperative loco regional radiotherapy (50 Gy in 25 fraction over five weeks) were prospectively randomized into two groups (1) steroid group-patients were advised to use beclomethasone dipropionate spray in irradiated axilla from day one of radiotherapy, (2) control group-patients were not allowed to use any topical agent in irradiated area. Radiation induced skin reaction was noted in terms of erythema, dry desquamation and wet desquamation weekly till end of prescribed 50Gy dose of the radiation therapy. Statistical method: Chi-square test was used to see the statistical significance of the difference in wet desquamation between two arms of the study. Chi-square value and P-value was calculated for the difference of wet desquamation in two study arms. Result: In steroid group 4/30 (13.33%) patients developed wet desquamation of the axillary skin at the end of the radiotherapy. For the control group, this figure was 11/30 (36.66%). The difference in wet desquamation of the axillary skin in the two groups was statistically significant (P-value=0.0369). Conclusion: Topical steroid (beclomethasone dipropionate spray) for skin during radiotherapy significantly reduces the risk of wet desquamation of the skin. (author)

  16. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L.; Carde, P.; Mauch, P.

    1992-01-01

    be reduced, and that the stress of experiencing a relapse is avoided in many patients. The major argument against the use of chemotherapy up front is: that by careful staging and selection of patients and by careful radiotherapy techniques the number of patients exposed to potentially toxic chemotherapy may...... metaanalysis of these trials indicate that we still do not definitively know whether or not the addition of prophylactic chemotherapy up front improves survival. Arguments in favour of the addition of chemotherapy up front are: that laparotomy may be avoided, that radiation fields and doses may perhaps...

  17. Radiotherapy versus combined modality in early stages

    DEFF Research Database (Denmark)

    Specht, L; Carde, P; Mauch, P

    1992-01-01

    metaanalysis of these trials indicate that we still do not definitively know whether or not the addition of prophylactic chemotherapy up front improves survival. Arguments in favour of the addition of chemotherapy up front are: that laparotomy may be avoided, that radiation fields and doses may perhaps...... be reduced, and that the stress of experiencing a relapse is avoided in many patients. The major argument against the use of chemotherapy up front is: that by careful staging and selection of patients and by careful radiotherapy techniques the number of patients exposed to potentially toxic chemotherapy may...

  18. Multimodal treatment combining chemotherapy, hyperthermia and radiotherapy for ovarian cancer

    International Nuclear Information System (INIS)

    Nagashima, Kei

    1992-01-01

    There has been increasing interest in the use of heat in the treatment of cancer. Theoretically cells are the most sensitive to ionizing radiation at mitosis, whereas the cycle phase that is the most resistant to ionizing radiation namely late in the DNA. Synthetic phase (late S) is the most sensitive to hyperthermia. Hyperthermia has been reported to enhance the cytocidal effects of several active chemotherapeutic agents. When thermal potentiation of chemotherapeutic agents against malignant cells is contemplated, normal tissues have a relatively high ambient blood flow which increases in response to thermal stress, thereby dissipating heat, compared to tumors. Tumors, with relatively poor blood flow and a responsive neovasculature, are in capable of augmenting flow and acting as a heat reservoir. This is the phenomenon of a heat reservoir which is one factor to enhance the cytocidal effects of several active anticancer agents for enhancing the uptake in tumor. The importance is in the adjuvant chemotherapy treated for post operative, advanced and recurrent ovarian cancer. Heating enhances the effects of radiotherapy and chemotherapy. Thirty patients with ovarian cancer were subjected to the multidisciplinary treatment with combination of hyperthermochemotherapy and radiation. The 30 patients consisted of 18 with endometrioid adenocarcinoma and 7 with serious post operative or recurrent status. Two types of equipments with rediofrequencies of 70 MHz (BSD-1000) or 434 MHZ (TAG MED·HS 434) were used for hyperthermia. Chemotherapeutic agents such as adriamycin, cis DDP, cyclophosphamide and etoposide were injected intravenously. Arterial infusion with reservoir was very effective in advanced stage of ovarian cancer. No severe or fatal side effects were observed. Hyperthermochemotherapy is useful and effective for the postoperative management or the treatment of recurrent cancer of the ovary. (J.P.N.)

  19. Brain abnormalities on MRI in non-functioning pituitary adenoma patients treated with or without postoperative radiotherapy

    NARCIS (Netherlands)

    Sattler, Margriet G. A.; Meiners, Linda C.; Sluiter, Wim J.; van den Berg, Gerrit; Langendijk, Johannes A.; Wolffenbuttel, Bruce H. R.; van den Bergh, Alphons C. M.; van Beek, Andre P.

    Background and purpose: To assess and compare brain abnormalities on Magnetic Resonance Imaging (MRI) in non-functioning pituitary macro-adenoma (NFA) patients treated with or without postoperative radiotherapy (RT). Material and methods: In 86 NFA patients, treated between 1987 and 2008 at the

  20. Contribution of radiotherapy to the treatment of malignant tumors, 3. Combined drugs and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Niibe, Hideo; Takahashi, Iku; Tamaki, Yoshio (Gunma Univ., Maebashi (Japan). School of Medicine)

    1984-09-01

    Effects of cytotoxic agent, hormone, hypoxic cell sensitizer, and radiation protector combined with radiation therapy in cancer management were analysed. The results were as follows: 1) An increase in response was seen in 25% or more of tumor nodules given radiotherapy combined with misonidazole, anoxic cell sensitizer, compared with radiotherpy alone. But the drug was also found to be neurotoxic and peripheral neuropathy. 2) Evidence has been given that Amifostine may protect the mucosal damage from radiation when Amifostine prior to irradiation was administrated to patients with tumor in the head and neck or in the pelvis. 3) There were no difference between five year survival of radiotherapy alone and with chemotherapy for patients with stage I Non-Hodgkin lymphoma. Chemotherapy following radiotherapy for patients with stage II was more effective treatment method than radiotherapy alone. 4) Radiotherapy for patients with prostate cancer was performed to control only primary site. The success rates of local control were over 80%. The near future holds extensive promise for a combination of radiation therapy, cytotoxic chemotherapy, hormone therapy, hypoxic cell sensitizer, and radiation protectors. All of these when used in the appropriate circumstances may yield significant improvements in the therapeutic ratio and in the long-tern control of tumors.

  1. Postoperative radiotherapy improves local control and survival in patients with uterine leiomyosarcoma

    International Nuclear Information System (INIS)

    Wong, Philip; Han, Kathy; Sykes, Jenna; Catton, Charles; Laframboise, Stephane; Fyles, Anthony; Manchul, Lee; Levin, Wilfred; Milosevic, Michael

    2013-01-01

    To examine the role of radiotherapy (RT) in uterine leiomyosarcomas (LMS) and to determine the patient population who may benefit from RT. From 1998–2008, 69 patients with primary uterine LMS underwent hysterectomy with or without pelvic radiotherapy to a median dose of 45 Gy. Univariate analysis was performed using the Kaplan-Meier method and cumulative-incidence function, and multivariate analyses using Fine and Gray or Cox proportional hazard models. Following surgery, 32 out of 69 patients received RT. There was no evidence of any correlation between patient, disease and treatment characteristics and the use of RT. Median follow-up was 57 months. RT was associated with reduced local recurrence (3y LR 19% vs. 39%; Gray’s p = 0.019) and improved overall survival (3y OS 69% vs. 35%; log-rank p = 0.025) on univariate analysis. Multivariate analysis demonstrated that RT reduced LR (HR: 0.28, CI: 0.11-0.69, p = 0.006) and increased OS (HR: 0.44, CI: 0.23-0.85, p = 0.014) independent of other clinical and pathologic factors. Positive surgical margins increased the odds of LR (HR: 5.6, CI: 2.3-13.4, p = 0.00012). Large tumor size and advanced stage (II-IV) were associated with the development of distant metastases and inferior OS. Postoperative pelvic RT reduces LR and improves OS of patients with uterine LMS

  2. Breast cancer patients receiving postoperative radiotherapy: Distress, depressive symptoms and unmet needs of psychosocial support

    International Nuclear Information System (INIS)

    Luutonen, Sinikka; Vahlberg, Tero; Eloranta, Sini; Hyvaeri, Heidi; Salminen, Eeva

    2011-01-01

    Background and purpose: The diagnosis and treatment of breast cancer can cause considerable psychological consequences, which may remain unrecognized and untreated. In this study, the prevalence of depressive symptoms and distress, and unmet needs for psychosocial support were assessed among breast cancer patients receiving postoperative radiotherapy. Material and methods: Out of 389 consecutive patients, 276 responded and comprised the final study group. Depressive symptoms were assessed with the Beck Depression Inventory. Distress was measured with the Distress Thermometer. Hospital records of the patients were examined for additional information. Results: Nearly one third of patients (32.1%) displayed depressive symptoms, and more than a quarter of patients (28.4%) experienced distress. Younger age (p = 0.001) and negative hormone receptor status (p = 0.008) were independent factors associated with distress. One quarter of the patients expressed an unmet need for psychosocial support, which was independently associated with depressive symptoms and/or distress (p = 0.001) and younger age (p = 0.006). Conclusions: During radiotherapy for breast cancer, the staff should have awareness of the higher risk of depression and distress in their patients and should consider screening tools to recognise distress and depressive symptoms. Special attention should be paid to younger patients.

  3. Clinical research on cancer treatment with combined radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Fuwa, Nobukazu; Ito, Yoshiyuki; Kato, Eriko; Koyama, Kazuyuki; Morita, Kozo

    1993-01-01

    There are two purposes of using combined chemotherapy and radiotherapy in the treatment of cancers. One is to suppress distant metastasis, especially micrometastasis; the other is to improve localized control. As a trial of the utility of the former, systemic chemotherapy with CDDP and 5 FU was given successively with radiotherapy to treat nasopharyngeal cancer. The survival rate was significantly improved compared with historical control cases. The main reason for this effectiveness was the improvement of localized control. The suppression of distant metastasis is the subject of future research. As a trial of the utility of the latter, a super-selective intraarterial chemotherapy with CBDCA combined with radiotherapy was used to head and neck localized progressive cancers. The control of localized cancer was remarkably effective. This treatment is considered to be especially suitable for locally advanced tongue cancer and cancer of the root of the tongue. (author)

  4. Combined modalities: chemotherapy/radiotherapy. Meeting summary

    International Nuclear Information System (INIS)

    Phillips, T.L.

    1979-01-01

    The effects of combined modalities, the standardization of terminology, the mechanisms of chemotherapeutic interactions with radiation and responses of normal and tumor systems are summarized from information presented at the Conference on Combined Modalities

  5. Experimental study on combination of chemotherapy and radiotherapy

    International Nuclear Information System (INIS)

    Tanaka, Juichi

    1986-01-01

    Recently, by applying multidrug therapy using cisplatin and bleomycin to the treatment of head and neck cancer, the response rate of chemotherapy has been markedly increased and thus, chemotherapy has taken an important part in the treatment of head and neck cancer. In this paper a clinical application of chemotherapy in combination with radiotherapy was evaluated from the point of the cure rate and also preservation of the structures and the functions of the head and neck region. In order to test the advantage or usefulness of initial chemotherapy followed by radiotherapy (= pre-radiation chemotherapy), the experimental study on combination of chemotherapy and radiotherapy was designed by using ICR mice and Ehrlich solid carcinoma. Cisplatin and peplomycin, a newly developed derivative of bleomycin, were used as chemotherapeutic agents. Tumor growth delay rate was chosen as a parameter to indicate the effectiveness. Results obtained are as follows. 1. Combination chemotherapy of cisplatin and peplomycin was more effective than each single agent on Ehrlich solid carcinoma. Synergistic effect was obtained by higher dose. So, the combination of cisplatin and peplomycin was proved to be eligible for pre-radiation chemotherapy. 2. Synergistic effect of chemotherapy and radiotherapy was observed when chemotherapy was used prior to radiotherapy on Ehrlich solid carcinoma. 3. Even their additional effect was not recognized when radiotherapy preceded to chemotherapy on Ehrlich solid carcinoma. 4. No severe toxic effect was seen in the mice. The experimental results made it clear that pre-radiation chemotherapy is beneficial to the treatment of head and neck cancer. (author)

  6. Intensity-Modulated Radiotherapy in Postoperative Treatment of Oral Cavity Cancers

    International Nuclear Information System (INIS)

    Gomez, Daniel R.; Zhung, Joanne E.; Gomez, Jennifer; Chan, Kelvin; Wu, Abraham J.; Wolden, Suzanne L.; Pfister, David G.; Shaha, Ashok; Shah, Jatin P.; Kraus, Dennis H.; Wong, Richard J.; Lee, Nancy Y.

    2009-01-01

    Purpose: To present our single-institution experience of intensity-modulated radiotherapy (IMRT) for oral cavity cancer. Methods and Materials: Between September 2000 and December 2006, 35 patients with histologically confirmed squamous cell carcinoma of the oral cavity underwent surgery followed by postoperative IMRT. The sites included were buccal mucosa in 8, oral tongue in 11, floor of the mouth in 9, gingiva in 4, hard palate in 2, and retromolar trigone in 1. Most patients had Stage III-IV disease (80%). Ten patients (29%) also received concurrent postoperative chemotherapy with IMRT. The median prescribed radiation dose was 60 Gy. Results: The median follow-up for surviving patients was 28.1 months (range, 11.9-85.1). Treatment failure occurred in 11 cases as follows: local in 4, regional in 2, and distant metastases in 5. Of the 5 patients with distant metastases, 2 presented with dermal metastases. The 2- and 3-year estimates of locoregional progression-free survival, distant metastasis-free survival, disease-free survival, and overall survival were 84% and 77%, 85% and 85%, 70% and 64%, and 74% and 74%, respectively. Acute Grade 2 or greater dermatitis, mucositis, and esophageal reactions were experienced by 54%, 66%, and 40% of the patients, respectively. Documented late complications included trismus (17%) and osteoradionecrosis (5%). Conclusion: IMRT as an adjuvant treatment after surgical resection for oral cavity tumors is feasible and effective, with promising results and acceptable toxicity

  7. Health-related quality of life outcome for oral cancer survivors after surgery and postoperative radiotherapy

    International Nuclear Information System (INIS)

    Fang, Fu-Min; Chien, Chih-Yen; Wang, Chong-Jong; Tsai, Wen-Ling; Chiu, Herng-Chia

    2004-01-01

    Health-related quality of life (HRQL) data are becoming an important supplement to information pertaining to treatment outcome for cancer patients. The purpose of this study was to evaluate the HRQL outcome for oral cancer survivors after surgery plus postoperative radiotherapy (RT) and to investigate the variables associated with their HRQL. Sixty-six oral cancer patients with cancer-free survival after surgery plus postoperative RT of >2 years were enrolled. The Short Form-36 (SF-36) questionnaire in the Taiwan Chinese version was self-reported by all participants at the clinics. The linear regression model was used to analyze the socio-demographic and medical-related variables correlated with the physical component summary (PCS) and mental component summary (MCS) in SF-36. The mean scores of the eight functional domains in the SF-36 were markedly lower for oral cancer survivors compared with the Taiwanese and US norms. Those with older age, lower annual family income, more advanced cancer stage and flap reconstruction had significantly worse PCS, and those with lower annual family income, unemployment and more advanced cancer stage reported significantly worse MCS. This model accounts for 63% of variance in PCS, and 51% in MCS. These results provided patient-reported evidence that oral cancer survivors lived with a worse HRQL compared with the general Taiwanese population. Socio-economic factors and cancer stage were important factors correlated with their HRQL. (authors)

  8. Role of postoperative radiotherapy for celiac lymph node metastasis from gastric cancer: analysis on 63 patients

    International Nuclear Information System (INIS)

    Sun Jing; Sun Yihong; Qin Xinyu; Zeng Mengsu; Wang Minhua; Zeng Zhaochong

    2007-01-01

    Objective: To evaluate the role of postoperative radiotherapy for celiac lymph node (LN) metastasis from gastric cancer in the past 6 years. Methods: Sixty-three patients with abdominal LN metastasis after curative resection for gastric cancer were retrospectively analyzed. Clinical characteristics was colleeted including age, gender, status of primary tumor of stomach (size, location and grade), and the number of LN dissected and involved. Of the 63 patients, 36 received local external beam radiotherapy (EBRT) as salvage therapy and were classified as the EBRT group. The irradiation target was local-regional LN. The radiation dose ranged from 40 to 60 Gy in daily 1.8-2.0 Gy fractions, 5 times weekly. The other 27 patients who received chemotherapy were classified as the non-EBRT group. The Kaplan-Meier method was used to evaluate the survival rates, and the Cox regression model was used to identify the predictors of prognosis. Results: After EBRT, complete response and partial response were observed in 31% and 58% of patients, respectively. The clinical obstruction symptoms induced by LN pressure in 18 patients were completely relieved after EBRT. The median survival was 339 clays for the EBRT group and 136 days for the non- EBRT group, the survival rate at 1 and 2 years for patients treated with EBRT vs. without EBRT was 40% vs. 17% and 20% vs. 6%, respectively (P=0.004). Multivariate analysis showed that the level of relative risk (RR) in the EBRT group was reduced to 0.299 (P=0.002). The incidence of death resulting from LN-related complications was lower in the EBRT group. The main cause of death in both groups was distant metastasis. The gastro-intestinal toxicities were the most common side effects during and after EBRT. The RTOG grade 0,1,2 and 3 toxicities were found in 7,17,11 and 1 patients, respectively. No hematologic and hepatic toxicities were observed. Conclusions: Postoperative lymph node metastasis from gastric cancer is sensitive to external beam

  9. Postoperative Radiotherapy in Prostate Cancer: The Case of the Missing Target

    International Nuclear Information System (INIS)

    Croke, Jennifer; Malone, Shawn; Roustan Delatour, Nicolas; Belanger, Eric; Avruch, Leonard; Morash, Christopher; Kayser, Cathleen; Underhill, Kathryn; Spaans, Johanna

    2012-01-01

    Purpose: Postoperative radiotherapy (XRT) increases survival in high-risk prostate cancer patients. Approximately 50% of patients on long-term follow-up relapse despite adjuvant XRT and the predominant site of failure remains local. Four consensus guidelines define postoperative clinical target volume (CTV) in prostate cancer. We explore the possibility that inadequate CTV coverage is an important cause of local failure. This study evaluates the utility of preoperative magnetic resonance imaging (MRI) in defining prostate bed CTV. Methods and Materials: Twenty prostate cancer patients treated with postoperative XRT who also had preoperative staging MRI were included. The four guidelines were applied and the CTVs were expanded to create planning target volumes (PTVs). Preoperative MRIs were fused with postoperative planning CT scans. MRI-based prostate and gross visible tumors were contoured. Three-dimensional (3D) conformal four- and six-field XRT plans were developed and dose–volume histograms analyzed. Subtraction analysis was conducted to assess the adequacy of prostate/gross tumor coverage. Results: Gross tumor was visible in 18 cases. In all 20 cases, the consensus CTVs did not fully cover the MRI-defined prostate. On average, 35% of the prostate volume and 32% of the gross tumor volume were missed using six-field 3D treatment plans. The entire MRI-defined gross tumor volume was completely covered in only two cases (six-field plans). The expanded PTVs did not cover the entire prostate bed in 50% of cases. Prostate base and mid-zones were the predominant site of inadequate coverage. Conclusions: Current postoperative CTV guidelines do not adequately cover the prostate bed and/or gross tumor based on preoperative MRI imaging. Additionally, expanded PTVs do not fully cover the prostate bed in 50% of cases. Inadequate CTV definition is likely a major contributing factor for the high risk of relapse despite adjuvant XRT. Preoperative imaging may lead to more

  10. Locally Advanced Rectal Carcinoma: Curative Surgery Alone vs. postoperative Radiotherapy and Chemotherapy

    International Nuclear Information System (INIS)

    Ahn, Seung Do; Choi, Eun Kyung; Kim, Jin Cheon; Kim, Sang Hee

    1995-01-01

    Purpose : To evaluate the effects of postoperative radiotherapy and chemotherapy on the pattern of failure and survival for locally advanced rectal carcinoma, we analyzed the two groups of patients who received curative resection only and who received postoperative radiochemotherapy retrospectively. Materials and Methods : From June 1989 to December 1992, ninety nine patients with rectal cancer were treated by curative resection and staged as B2-3 or C. Group I(25) patients received curative resection only and group II(74) patients postoperative adjuvant therapy. Postoperative adjuvant group received radiation therapy (4500 cGy/ 25fx to whole pelvis)with 5-FU (500 mg/m 2 , day 1-3 IV infusion) as radiosensitizer and maintenance chemotherapy with 5-FU(400mg/m 2 for 5 days) and leucovorin (20mg/m 2 for 5 days) for 6 cycles. Results : The patients in group I and group II were comparable in terms of age, sex, performance status, but in group II 74% of patients showed stage C compared with 56% of group I. All patients were flowed from 6 to 60 months with a median follow up of 29 months. Three year overall survival rates and disease free survival rates were 68%, 64% respectively in group I and 64%, 61%, respectively in group II. There was no statistical difference between the two treatment groups in overall survival rate and disease free survival rate. Local recurrences occurred in 28% of group I, 21% of group II (p>.05) and distant metastases occurred in 20% of group I, 27% of group II(p>.05). The prognostic value of several variables other that treatment modality was assessed. In multivariate analysis for prognostic factors stage and histologic grade showed statistically significant effect on local recurrences, and lymphatic or vessel invasion on distant metastasis. Conclusion : This retrospective study showed no statistical difference between two groups on the pattern of failure and survival. But considering that group II had more advanced stage and poor prognostic

  11. Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses: treatment results for 47 patients

    International Nuclear Information System (INIS)

    Claus, Filip; Boterberg, Tom; Ost, Piet; Huys, John; Vermeersch, Hubert; Braems, Sabine; Bonte, Katrien; Moerman, Mieke; Verhoye, Christoph; Neve, Wilfried de

    2002-01-01

    Purpose: Ethmoid sinus cancer is a rare malignancy. Treatment results are mostly reported together with other sinonasal tumors, grouping a wide range of different histologies and treatment approaches. This study reports on the treatment outcome of 47 patients diagnosed with adenocarcinoma of the ethmoid sinuses and treated with surgery and high-dose postoperative radiation therapy. Methods and Materials: Between September 1985 and October 2001, 51 patients with adenocarcinoma of the ethmoid sinuses were referred to the Ghent University Hospital. Four patients were treated with low-dose palliative radiation because of very extended inoperable disease or distant metastasis at the time of diagnosis. They were not included in this analysis. The other 47 patients, all staged as N0M0, were treated with surgery and postoperative high-dose radiation therapy. The median follow-up was 32 months. The T-stages were T1 for 2, T2 for 17, T3 for 11, and T4 for 17 patients. All 47 patients were staged as N0M0. Results: The 3-year, 5-year, and 7-year overall survival are respectively 71%, 60%, and 38%. The 3-year and 5-year disease-free survival are respectively 62% and 36%. The 3-year and 5-year disease-free survival for T1-T2 stages are respectively 87% and 55%, for T3 stages 57% and 28%, and for T4 stages 41% and 25%. The locoregional tumor control was 70% and 59% at respectively 3 and 5 years. Patients presenting with intracranial tumor invasion at the time of diagnosis relapsed within 7 months after the end of radiotherapy. Radiation-induced severe dry eye syndrome and optic neuropathy was observed in respectively 7 and 2 of the 47 cases. Conclusion: Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses is associated with good local control rates. Crucial for a favorable prognosis is the absence of intracranial invasion. The rarity of these tumors makes it difficult to evaluate new therapeutic advances

  12. Ipsilateral Irradiation for Oral and Oropharyngeal Carcinoma Treated With Primary Surgery and Postoperative Radiotherapy

    International Nuclear Information System (INIS)

    Vergeer, Marije R.; Doornaert, Patricia; Jonkman, Anja; Kaanders, Johannes H.A.M.; Ende, Piet L.A. van den; Jong, Martin A. de; Leemans, C. Rene; Slotman, Ben J.; Langendijk, Johannes A.

    2010-01-01

    Purpose: The purpose was to evaluate the contralateral nodal control (CLNC) in postoperative patients with oral and oropharyngeal cancer treated with ipsilateral irradiation of the neck and primary site. Late radiation-induced morbidity was also evaluated. Methods and Materials: The study included 123 patients with well-lateralized squamous cell carcinomas treated with surgery and unilateral postoperative irradiation. Most patients had tumors of the gingiva (41%) or buccal mucosa (21%). The majority of patients underwent surgery of the ipsilateral neck (n = 102 [83%]). The N classification was N0 in 73 cases (59%), N1 or N2a in 23 (19%), and N2b in 27 cases (22%). Results: Contralateral metastases developed in 7 patients (6%). The 5-year actuarial CLNC was 92%. The number of lymph node metastases was the only significant prognostic factor with regard to CLNC. The 5-year CLNC was 99% in N0 cases, 88% in N1 or N2a cases, and 73% in N2b cases (p = 0.008). Borderline significance (p = 0.06) was found for extranodal spread. Successful salvage could be performed in 71% of patients with contralateral metastases. The prevalence of Grade 2 or higher xerostomia was 2.6% at 5 years. Conclusions: Selected patients with oral or oropharyngeal carcinoma treated with primary surgery and postoperative ipsilateral radiotherapy have a very high CLNC with a high probability of successful salvage in case of contralateral metastases. However, bilateral irradiation should be applied in case of multiple lymph node metastases in the ipsilateral neck, particularly in the presence of extranodal spread. The incidence of radiation-induced morbidity is considerably lower as observed after bilateral irradiation.

  13. Clinical efficacy of radiotherapy combined with sodium glycididazole ...

    African Journals Online (AJOL)

    Purpose: To assess the clinical efficacy and side effects of radiotherapy combined with sodium glycididazole in the treatment of recurrent esophageal carcinoma. Methods: Ninety patients with locally recurrent oesophageal carcinoma who were admitted to the Oncology Department at Taian City Central Hospital, Shandong, ...

  14. Clinical Studies on conformal radiotherapy combined with epidermal ...

    African Journals Online (AJOL)

    Purpose: To study the effect of conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in the second-line treatment of non-small cell lung cancer (NSCLC). Methods: A total of 316 patients attending Shanghai Pulmonary Hospital affiliated to Tongji University, were divided ...

  15. Long-term impact of postoperative radiotherapy in carcinoma of the vulva FIGO I/II

    International Nuclear Information System (INIS)

    Busch, Martin; Wagener, Birgit; Schaffer, Moshe; Duehmke, Eckhart

    2000-01-01

    Purpose: Between 1953 and 1978, postoperative radiotherapy was used as an adjuvant therapy for carcinoma of the vulva that had not been treated with radical vulvectomy. We evaluated long-term results and possible prognostic factors. Methods and Materials: Ninety-two patients were treated. Surgical procedures were simple vulvectomy, electrocoagulation, or local excision. Radiotherapy doses to the vulva ranged from 0 to 90 Gy. All patients received radiotherapy to the inguinal lymph nodes, ranging from 30 to 60 Gy. Thirty-year retrospective follow-up was done evaluating the records and statistical survival rates. Results: Five-year actuarial survival rates in T1 patients were 71% (77% cause-specific survival rate), for T2 patients 43% (48% cause-specific survival rate). The difference between T1 and T2 patients was significant (p < 0.05). Patients with tumors of the labia minora had a significantly higher survival rate than those with different sites affected. Doses of 45 Gy or more to the vulva were sufficient to increase the 5-year cause-specific survival rate from 55% to 88%. The results in three subgroups were analyzed, group 1 having received electrocoagulation, but no radiotherapy of the vulva; group 2, local excision and doses of 40 Gy to the vulva; group 3, local excision and doses of 60 Gy to the vulva. There was a significant effect on 10-year cause-specific survival rates: 48% in group 1, 11% in group 2, and 88% in group 3. In multivariate analysis, the significant independent factors were T classification, tumor sites and--with only marginal significance--radiation doses to the vulva. Conclusions: The prognosis in early vulva carcinoma after nonradical surgery primarily depends on T classification and the site of the primary tumor. With univariate analyses, the dose has a significant effect on survival. In multivariate analyses the dose is a marginal independent factor in the whole group of patients. After nonradical surgery of early vulva carcinoma, the

  16. Radiotherapy

    International Nuclear Information System (INIS)

    Zedgenidze, G.A.; Kulikov, V.A.; Mardynskij, Yu.S.

    1984-01-01

    The technique for roentgenotopometric and medicamentous preparation of patients for radiotherapy has been reported in detail. The features of planning and performing of remote, intracavitary and combined therapy in urinary bladder cancer are considered. The more effective methods of radiotherapy have been proposed taking into account own experience as well as literature data. The comparative evaluation of treatment results and prognosis are given. Radiation pathomorphism of tumors and tissues of urinary bladder is considered in detail. The problems of diagnosis, prophylaxis and treatment of complications following radiodiagnosis and radiotherapy in patients with urinary bladder cancer are illustrated widely

  17. Intraoperative radiotherapy in combined treatment of sinonasal malignant tumors

    Science.gov (United States)

    Novikov, V. A.; Gribova, O. V.; Vasiljev, R. V.; Choynzonov, E. L.; Shtin, V. I.; Shiianova, A. A.; Surkova, P. V.; Starceva, Zh. A.; Shilova, O. G.

    2017-09-01

    Obvious advantage of IORT (intraoperative radiotherapy) is that the radiation source is delivered directly to the bed of the tumor during surgery, thus avoiding the negative impact on the skin, subcutaneous tissue and reducing the risk of fibrosis. Sinonasal tumors—a convenient object for intraoperative radiotherapy application (surface location, relatively small size tumors, good operational access). The surface location and comparatively small size of neoplasms, good operational access provide an efficient and accurate transfer of the electron beam to the postoperative cavity to increase the irradiation dose in the areas of the most probable recurrence, which makes the tumors of this localization a convenient object for the use of the intraoperative radiation therapy. The treatment was conducted using a mobile compact betatron (MIB-6E), 10-12 Gy single dose. IORT session extends surgery period by 30 min. There were no pathological clinical and laboratory reactions on IORT in the early postoperative period. Carrying out the procedure is possible in various standard operating rooms. It does not require special security measures for the patients and the staff. IORT with the help of electron beam allows avoiding post-radiation reactions and achieving a 5-year—disease-free survival of 66% of the patients. IORT session is possible through a minimal incision during organ preservation surgeries. Evident economic feasibility provides the prospects of applying IORT in the clinical practice.

  18. Surgical excision and immediate postoperative radiotherapy versus cryotherapy and intralesional steroids in the management of keloids: a prospective clinical trial.

    Science.gov (United States)

    Emad, Maryam; Omidvari, Shapour; Dastgheib, Ladan; Mortazavi, Afshin; Ghaem, Haleh

    2010-01-01

    To compare the efficacy and tolerability of surgical excision and radiotherapy with those of cryotherapy and intralesional steroid treatment of keloids. Twenty-six patients with a total of 76 keloids were enrolled in this study. Nineteen patients with 44 keloids underwent surgical excision combined with immediate 12-Gy irradiation (group A) while the remaining 9 patients with 32 keloids received multiple sessions of intralesional steroid treatment after cryotherapy which continued until flattening of lesion(s) occurred (group B). Two patients were included in both treatment groups. All patients were followed up at regular intervals for at least 1 year. In both treatment groups, keloids responded well without any major side effect. While patients of group A were all satisfied, those of group B (with a mean number of treatment sessions of 5.84 +/- 2.51) experienced more side effects, a more prolonged course, a higher recurrence rate and less satisfaction. This study showed that surgery plus immediate postoperative irradiation was an effective and relatively safe choice for treatment of keloids. Although cryotherapy combined with intralesional steroids was associated with more side effects and higher relapse rates, it could be a good choice for small and newly formed keloids. Copyright 2010 S. Karger AG, Basel.

  19. Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min [Chosun University College of Medicine, Gwangju (Korea, Republic of)

    2006-12-15

    A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

  20. Clinical application of radiotherapy combined with chemotherapy

    International Nuclear Information System (INIS)

    Morita, Kozo

    1978-01-01

    In clinical application of radiation therapy combined with chemotherapy, it is important to gain the maximal therapeutic benefit. At present we have no agents that improve the therapeutic ratio by enhancing the effect of radiation on the tumor cell selectively. Therefore, it is necessary to use combining some or all of following procedures: (1) the intraarterial infusion of the agents, (2) the selective localization by reason of the biological affinity of the agents, (3) the surgical removal of the non-sensitized tumor residue and (4) the selective sensitization of the tumor due to its shorter cell cycle. (author)

  1. Combined modality treatment with radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Tannock, I.F.; Toronto Univ., ON

    1989-01-01

    The present paper discusses some of the methodological issues which can confound the interpretation of clinical trials of combined modality treatment. It reviews some of the larger randomized trials which have evaluated combined modality treatment in cancers of the head and neck, lung, gastrointestinal tract and bladder. It concludes that adequate trials have yet to be performed in many of thses sites, but that at present, evidence for long-term benefit from adjunctivechemotherapy is meagre. Finally, it suggests some possible mechanisms which might heve limited the benefit of chemotherapy when added to radiation treatment. (Author). 87 refs.; 4 figs.; 4 tabs

  2. Postoperative radiotherapy for endometrial carcinoma. A retrospective analysis of 541 cases

    International Nuclear Information System (INIS)

    Haensgen, G.; Nagel, M.; Dunst, J.; Enke, H.

    1999-01-01

    Purpose: This retrospective study was designed to evaluate the role of adjuvant radiotherapy for surgically treated endometrial carcinoma. Patients and methods: From 1980 through 1988, 541 patients were treated with either intravaginal cuff irradiation with a high-dose-rate (HDR) Iridium-192 remote afterloading technique (n=294) or with combined HDR-brachytherapy and additional external pelvic irradiation to 54 Gy (n=247) after surgery for endometrical cancer. Afterloading irradiation was administered in 4 fractions 4 to 6 weeks after surgery. A dose of 30 Gy was delivered at a depth of 0,5 cm from the vaginal mucosa. Results: Patients with HDR-brachytherapy alone showed a 5-year survival of 94.3% for Stage I and 73.6% for Stage II (p=0.0007). Patients who received both brachytherapy and additional pelvic irradiation had a 5-year survival of 94.1% for Stage I, 81.1% for Stage II, 70.4% for Stage III and 46.9% for Stage IV (p=0.0001). The main predictors for survival in a multivariate analysis were stage and grading. Patients with combined readiotherapy had a local recurrence rate of 3.2%, whereas patients with brachytherapy alone who were better selected and had more favorable prognostic factors showed a recurrence rate of 2%. Low-risk patients (Stage I, Grade 1, low infiltration) in the HDR-brachytherapy group had 6 relapses, mainly caused by insufficient treatment on the basis of papillary histology. High-risk patients with poorly differential tumors, which infiltrate more than half the myometrial wall might benefit from additional external radiotherapy in terms of reduction of local recurrence and better survival. Five-year actuarial survival rate was 93.6% after combined radiotherapy vs 86.7% after brachytherapy alone. Complications were graded according to the RTOG scoring system. Severe late complications were fistulas of bladder and/or bowel, which occurred in 2.8% in the combined radiotherapy group, and 0.7% in the HDR brachytherapy group. (orig.) [de

  3. Postoperative Radiotherapy for Maxillary Sinus Cancer: Long-Term Outcomes and Toxicities of Treatment

    International Nuclear Information System (INIS)

    Bristol, Ian J.; Ahamad, Anesa; Garden, Adam S.; Morrison, William H.; Hanna, Ehab Y.; Papadimitrakopoulou, Vassiliki A.; Rosenthal, David I.; Ang, K. Kian

    2007-01-01

    Purpose: To determine the effects of three changes in radiotherapy technique on the outcomes for patients irradiated postoperatively for maxillary sinus cancer. Methods and Materials: The data of 146 patients treated between 1969 and 2002 were reviewed. The patients were separated into two groups according to the date of treatment. Group 1 included 90 patients treated before 1991 and Group 2 included 56 patients treated after 1991, when the three changes were implemented. The outcomes were compared between the two groups. Results: No differences were found in the 5-year overall survival, recurrence-free survival, local control, nodal control, or distant metastasis rates between the two groups (51% vs. 62%, 51% vs. 57%, 76% vs. 70%, 82% vs. 83%, and 28% vs. 17% for Groups 1 and 2, respectively). The three changes were to increase the portals to cover the base of the skull in patients with perineural invasion, reducing their risk of local recurrence; the addition of elective neck irradiation in patients with squamous or undifferentiated histologic features, improving the nodal control, distant metastasis, and recurrence-free survival rates (64% vs. 93%, 20% vs. 3%, and 45% vs. 67%, respectively; p < 0.05 for all comparisons); and improving the dose distributions within the target volume, reducing the late Grade 3-4 complication rates (34% in Group 1 vs. 8% in Group 2, p = 0.014). Multivariate analysis revealed advancing age, the need for enucleation, and positive margins as independent predictors of worse overall survival. The need for enucleation also predicted for worse local control. Conclusion: The three changes in radiotherapy technique improved the outcomes for select patients as predicted. Despite these changes, little demonstrable overall improvement occurred in local control or survival for these patients and additional work must be done

  4. Radiotherapy of esophageal cancer in combination with chemotherapy

    International Nuclear Information System (INIS)

    Jinnouchi, Shoshi; Koga, Kenji; Nishikawa, Kiyoshi; Kihara, Yasushi; Kusuhara, Toshiyuki; Watanabe, Katuji

    1983-01-01

    The significance of combination of chemotherapy in radiotherapy for esophageal cancer was evaluated in 32 patients. They were irradiated routinely in 5 times a weeks with a fraction dose of 200 rad by 10MV-X-ray linear accelerator. Combined drugs consist of Bleomycin or Pepleomycin in two-third and 5FU or FT-207 in one-third. There was statistically no significance between the results of radiation alone and combined chemotherapy, and the improvement of survival rate could not be obtained by combining chemotherapy. Some discussion on the causes of this unimprovement were made. (author)

  5. Biology-based combined-modality radiotherapy: workshop report

    International Nuclear Information System (INIS)

    Mason, Kathryn A.; Komaki, Ritsuko; Cox, James D.; Milas, Luka

    2001-01-01

    Purpose: The purpose of this workshop summary is to provide an overview of preclinical and clinical data on combined-modality radiotherapy. Methods and Materials: The 8th Annual Radiation Workshop at Round Top was held April 13-16, 2000 at the International Festival Institute (Round Top, TX). Results: Presentations by 30 speakers (from Germany, Netherlands, Australia, England, and France along with U.S. participants and M. D. Anderson Cancer Center faculty) formed the framework for discussions on the current status and future perspectives of biology-based combined-modality radiotherapy. Conclusion: Cellular and molecular pathways available for radiation modification by chemical and biologic agents are numerous, providing new opportunities for translational research in radiation oncology and for more effective combined-modality treatment of cancer

  6. Combination radiotherapy and chemotherapy for primary lung cancer

    International Nuclear Information System (INIS)

    Nishikawa, Kiyoshi; Koga, Kenji; Kusuhara, Toshiyuki; Kodama, Takao; Takeuchi, Midori; Watanabe, Katsushi

    1984-01-01

    Fifty-six patients with carcinoma of the lung treated with radiotherapy alone or combination of chemotherapy were reviewed. Radiation was given with a 10MV photon beam by a linear accelerator. A fraction dose of 2Gy (200 rad) was given routinely 5 times a week. Combined durgs consist of 5FU or FT-207 in monochemotherapy and METT, MFC, or METVFC in combination chemotherapy. 5 year survival rate of all patients was 3.8%. As for the stage classification, 5 year survival rate is 30% in Stage I and II cancer, but there was no 3 year survivor in Stage III cancer and 2 year survivor in Stage IV cancer. As for the cell types, cases of adenocarcinoma had worse prognosis than them of squamous cell carcinoma and small cell carcinoma. The prognosis of patients treated with combination of radiotherapy and chemotherapy was similar to that of patients treated with radiotherapy alone. These results suggest that combined chemotherapy did not influence tumor control. Some discussion on the treatment modality of chemotherapy are made, emphasizing untoward effect of chemotherapy on immunopotency. (author)

  7. Postoperative re-irradiation using stereotactic body radiotherapy for metastatic epidural spinal cord compression.

    Science.gov (United States)

    Ito, Kei; Nihei, Keiji; Shimizuguchi, Takuya; Ogawa, Hiroaki; Furuya, Tomohisa; Sugita, Shurei; Hozumi, Takahiro; Keisuke Sasai; Karasawa, Katsuyuki

    2018-06-15

    OBJECTIVE This study aimed to clarify the outcomes of postoperative re-irradiation using stereotactic body radiotherapy (SBRT) for metastatic epidural spinal cord compression (MESCC) in the authors' institution and to identify factors correlated with local control. METHODS Cases in which patients with previously irradiated MESCC underwent decompression surgery followed by spine SBRT as re-irradiation between April 2013 and May 2017 were retrospectively reviewed. The surgical procedures were mainly performed by the posterior approach and included decompression and fixation. The prescribed dose for spine SBRT was 24 Gy in 2 fractions. The primary outcome was local control, which was defined as elimination, shrinkage, or no change of the tumor on CT or MRI obtained approximately every 3 months after SBRT. In addition, various patient-, treatment-, and tumor-specific factors were evaluated to determine their predictive value for local control. RESULTS Twenty-eight cases were identified in the authors' institutional databases as meeting the inclusion criteria. The histology of the primary disease was thyroid cancer in 7 cases, lung cancer in 6, renal cancer in 3, colorectal cancer in 3, and other cancers in 9. The most common previous radiation dose was 30 Gy in 10 fractions (15 cases). The mean interval since the most recent irradiation was 16 months (range 5-132 months). The median duration of follow-up after SBRT was 13 months (range 4-38 months). The 1-year local control rate was 70%. In the analysis of factors related to local control, Bilsky grade, number of vertebral levels in the treatment target, the interval between the latest radiotherapy and SBRT, recursive partitioning analysis (RPA), the prognostic index for spinal metastases (PRISM), and the revised Tokuhashi score were not significantly correlated with local control. The favorable group classified by the Rades prognostic score achieved a significantly higher 1-year local control rate than the unfavorable

  8. The prognostic value of age for 1030 patients with early stage breast cancer after postoperative radiotherapy

    International Nuclear Information System (INIS)

    Xu Liming; Li Ruiying; Wang Ping; Xu Liang; Hao Jianlei; Liu Xiaobin; Pang Qingsong; Zhu Li; Cui Yong

    2010-01-01

    Objective: To analyze the prognostic value of age in patients with early stage breast cancer. Methods: The clinical characteristics of 1030 patients with early stage breast cancer (the number of positive axillary lymph nodes was less than 3) were retrospectively reviewed. Of all the patients, 468(stage I, n = 227; and stage II , n = 241) received breast conserving surgery (BCS) and 562 (stage I, n =184; and stage II, n= 378) received modified mastectomy. Patients were divided into young-age group (≤35, 136 patients), middle-age group (> 35-≤60,738 patients) and old-age group (> 60, 156 patients). The number of patients without postoperative radiation therapy after BCS is 16, 60 and 39 in the three groups, respectively. Two-dimensional conventional fractionated radiotherapy was administered. The prognostic value of the tumor size, status of axillary lymph nodes or hormonal receptors, postoperative radiation therapy were analyzed. Results: The follow-up rate was 97.86%. Of 795 patients followed up more than 5 years, 110, 569 and 116 patients were devided into the three groups, respectively. There were 40, 202 and 87 patients without radiation therapy in the three groups. The 5-year recurrence rates of the three groups were 6.2%, 8.7% and 10.4% (χ 2 = 1.14, P= 0.567). The 5-year distant metastasis rates were 4.3% , 9.5 % and 2. 5% (χ 2 = 5.31 , P = 0.070) . The 5 - year survival rates were 91.2% , 92.6% and 82.1% (χ 2 = 6. 83, P = 0.033). The young-age group had more tumors smaller than 2. 0 cm (65.4%), less positive axillary lymph nodes (13.2%), poorer differential tumor and less positive hormone acceptors (48.0%). Of patients with tumor larger than 2. 0 cm who had no radiotherapy after BCS, the 5-year survival rates were 94%, 87% and 71% (χ 2 = 20.69, P= 0.000) in the three groups. The corresponding recurrence rates were 23%, 18% ,7%, (χ 2 = 9.97, P = 0.007), and distant metastasis rates were 23%, 25% and 10% (χ 2 =8.51, P=0.014). Conclusions: The age is

  9. Extent of postoperative prophylactic radiotherapy after radical surgery of thoracic esophageal squamous cell carcinoma

    International Nuclear Information System (INIS)

    Lu Jincheng; Tao Hua; Zha Wenwu; Xu Kangxiong

    2007-01-01

    Objective: To determine the extent of postoperative prophylactic radiotherapy after radical surgery of thoracic esophageal squamous cell carcinoma. Should the entire mediastinum (M), bilateral supraclavicular areas(S) and the left gastric area(L) be all included in the irradiation field. Methods The clinical data of 204 such patients treated from 1996 through 1999 were retrospectively reviewed. They were classified into four groups: group A, 26 patients given irradiation to the mediastinum M alone; group B, 139 patients given irradiation to the mediastinum and bilateral supraclavicular areas M + S; group C, 10 patients irradiation to the mediastinum plus left gastric area M + L; and group D, 29 patients irradiation to all these three areas ( M + S + L). The overall and disease-free survival rates were calculated using the Kaplan- Meier method and comparison of these groups was done with the Logrank test. Prognostic variables were entered into a Cox regression model controlling the age, gender, length, site, pT, pN, and treatment received. Results: The 1-, 3- and 5-year overall and disease-free survival rates of all 204 patients were 83.8%, 53.2%, 34.1% and 77.8%, 51.6%, 33.8% , respectively. The 5-year disease-free survival rates for patients in group A, group B, group C, and group D were 36.3%, 30.7%, 40.0% and 43.6% (χ 2 = 3.05, P=0.385), respectively. Multivariate analysis showed that the pT and pN were independent risk factors for disease-free survival rate, whereas treatment arm gave no significant difference (χ 2 =2.77, P=0.096). None of the 43 patents without irradiation to the L had abdominal lymph node metastasis from lesions in the upper and upper-middle third (located middle third but invasion to the upper third) thoracic esophagus. The data of supraclavicular lymph node metastasis between patients with and without irradiation showed that S in lesion in the lower and middle-lower third (located middle third but invasion to the lower third) thoracic

  10. Methodological approaches and postoperative morbidity of intraoperative radiotherapy for soft-tissue sarcomas; Heidelberg series 6/91-9/92. Methodik, technische Voraussetzungen und postoperative Morbiditaet der intraoperativen Radiotherapie (IORT) bei Weichteilsarkomen; Heidelberger Krankengut 6/91-9/92

    Energy Technology Data Exchange (ETDEWEB)

    Eble, M.J. (Abt. Klinische Radiologie, Radiologische Universitaetsklinik, Heidelberg (Germany)); Quentmeier, A. (Chirurgische Universitaetsklinik, Heidelberg (Germany)); Ewerbeck, V. (Orthopaedische Universitaetsklinik, Heidelberg (Germany)); Herfarth, C. (Chirurgische Universitaetsklinik, Heidelberg (Germany)); Wannenmacher, M. (Abt. Klinische Radiologie, Radiologische Universitaetsklinik, Heidelberg (Germany))

    1993-09-01

    From June 1991 to 9/92 a total of 28 patients suffering from peripheral (n=20) or centrally (n=8) located soft tissue sarcomas were treated. Tumor resection with negative margins was performed in 20 patients, positive margins remained in 5 patients, and gross macroscopic residual disease in 3 patients. Combined intraoperative and external beam radiotherapy was applied in 22 patients, using IORT doses of 10-20 Gy and an external beam dose of 26-50 Gy. Three patients were irradiated intraoperatively twice with a time interval of 24 h. After a median follow-up of 9.9 months, 20 patients are disease free. Two patients died 4 and 5 months after the end of the therapy with rapidly progressive distant metastases. So far, there have been no IORT infield failures. Mild sensory neuropathy occurred in 1 patient 7 months after treatment. Overall only mild and reversible postoperative and posttherapeutic complications were seen. Based on the retrospective analysis of the target volumes chosen during this working period, a set of horse-shoe-shaped cones was designed, which permitted circular and longitudinal target volumes with a homogeneous dose to be delivered as well. With this dedicated IORT facility simple and safe application of a high boost dose is possible. Further, a clear definition of the target volume, followed by an exact verification and at least integration of this target volume in a three-dimensional treatment plan, is necessary. (orig./Mg)

  11. Outcomes and xerostomia after postoperative radiotherapy for oral and oropharyngeal carcinoma.

    Science.gov (United States)

    Wang, Zhong-He; Yan, Chao; Zhang, Zhi-Yuan; Zhang, Chen-Ping; Hu, Hai-Sheng; Tu, Wen-Yong; Kirwan, Jessica; Mendenhall, William M

    2014-10-01

    We compared outcomes and xerostomia grade after postoperative intensity-modulated radiation therapy (IMRT) and conventional radiotherapy (RT) in patients with oral and oropharyngeal carcinoma. Eighty-eight patients with oral cavity (n = 77) and oropharyngeal (n = 11) carcinoma underwent postoperative IMRT (n = 44) or conventional RT (n = 44). Outcomes, failure patterns, volume, doses, salivary gland V30, and xerostomia grade were evaluated. The median follow-up was 53 months (range, 48-58 months). The median interval from surgery to RT was 4 weeks (range, 3-6 weeks). Twenty-one patients (7 and 14 for the IMRT and conventional RT groups, respectively) experienced local-regional failure. For the IMRT group, all 7 local-regional failures occurred in the high-dose target volumes. For the conventional RT group, there were 12 in-field failures, 1 at the margin, and 1 out-of-field. Nine patients experienced distant failure (5 and 4 for the IMRT and conventional RT groups, respectively). The 4-year local-regional control, disease-free survival (DFS), overall survival (OS), and distant-metastasis rates for the IMRT and conventional RT groups were 84.1% versus 68.2% (p = .055), 68.2% versus 52.3% (p = .091), 70.5% versus 56.8% (p = .124), and 11.4% versus 9.1% (p = .927), respectively. Xerostomia grade after RT was lower for IMRT compared to conventional RT (p xerostomia grade when compared to conventional RT. The predominant failure pattern was local. No differences were found in survival outcomes between both groups. There was a marginal difference in local-regional control. © 2014 Wiley Periodicals, Inc.

  12. Combining radiotherapy and immunotherapy: A revived partnership

    International Nuclear Information System (INIS)

    Demaria, Sandra; Bhardwaj, Nina; McBride, William H.; Formenti, Silvia C.

    2005-01-01

    Ionizing radiation therapy (RT) is an important local modality for the treatment of cancer. The current rationale for its use is based largely on the ability of RT to kill the cancer cells by a direct cytotoxic effect. Nevertheless, considerable evidence indicates that RT effects extend beyond the mere elimination of the more radiosensitive fraction of cancer cells present within a tumor at the time of radiation exposure. For instance, a large body of evidence is accumulating on the ability of RT to modify the tumor microenvironment and generate inflammation. This might have far-reaching consequences regarding the response of a patient to treatment, especially if radiation-induced tumor cell kill were to translate into the generation of effective antitumor immunity. Although much remains to be learned about how radiation can impact tumor immunogenicity, data from preclinical studies provide the proof of principle that different immunotherapeutic strategies can be combined with RT to enhance antitumor effects. Conversely, RT could be a useful tool to combine with immunotherapy. This article will briefly summarize what is known about the impact of RT on tumor immunity, including tumor-associated antigens, antigen-presenting cells, and effector mechanisms. In addition, the experimental evidence supporting the contention that RT can be used as a tool to induce antitumor immunity is discussed, and a new approach to radioimmunotherapy of cancer is proposed

  13. The effect of postoperative radiotherapy on leukocyte zinc, serum trace elements and nutritional status of breast cancer patients

    International Nuclear Information System (INIS)

    Antila, H.M.J.; Salo, M.S.; Kirvelae, O.; Nikkanen, V.

    1992-01-01

    Mononuclear (MNC) and polymorphonuclear cell (PMNC) zinc content was determined together with serum zinc, copper, selenium and iron concentrations in 24 operable breast cancer patients during and after postoperative radiotherapy. Anthropometric and biochemical indices of nutritional status were measured as background data. The measurements were carried out in the years 1987-1988. Nine patients used unconventional multivitamin or trace element preparations. A steady but statistically insignificant decrease in PMNC zinc was seen during treatment. No changes occurred in MNC zinc. Serum copper levels increased in five patients possibly due to tamoxifen treatment, but no other alterations occurred in serum trace element levels. Appetite was well maintained and nutritional status remained unaltered. Postoperative radiotherapy for breast carcinoma had thus no effect on either trace element or nutritional status. Patient-initiated alternative treatments did not significantly affect their trace element levels. This was probably due to small supplementation doses or irregular use of the preparations. (orig.)

  14. Postoperative modified stereotactic radiotherapy using a micro-multileaf collimator in patients with malignant glioma.

    Science.gov (United States)

    Isaka, Toshihiko; Nishiyama, Kinji; Nakagawa, Hidemitsu; Suzuki, Tsuyoshi; Wada, Kouichi

    2002-06-01

    To achieve local control of malignant glioma, we designed a postoperative stereotactic radiotherapy using a micro-multileaf collimator (micro-MLC). The purpose of this study was to clarify the feasibility of this treatment. The treatment was performed in six patients who met the following eligibility criteria: (1) supratentorial tumor, (2) residual tumor volume or = 70. The three planning target volumes (PTVs), which consisted of restricted PTV (RPTV), intermediate PTV (IPTV), and extended PTV (EPTV), defined as the residual tumor plus a 1 cm, 2 cm, and 3 cm margins, respectively, and total dose delivery of 60-68 Gy, 52-60 Gy, and 44-52 Gy to the isocenters of RPTV, IPTV, and EPTV, respectively, in 4 Gy per fraction at five fractions per week, were established. The beam arrangement and the conformal blockade with a micro-MLC for the optimal treatment plan were designed. The treatment plans showed the high dose conformation to EPTV, the appropriate dose gradients in the three PTVs with the high dose homogeneity to RPTV, and the tolerated dose to critical structures. Following the plans, treatment was performed. The clinical findings more than 12 months after the treatment supported its possible use. We conclude that this treatment is feasible at least in selected patients.

  15. Lymph node ratio predicts the benefit of post-operative radiotherapy in oral cavity cancer

    International Nuclear Information System (INIS)

    Urban, Damien; Gluck, Iris; Pfeffer, M. Raphael; Symon, Zvi; Lawrence, Yaacov R.

    2013-01-01

    Background: The standard treatment for non-metastatic oral cavity squamous cell carcinoma (OCSCC) is surgical resection followed by post-operative radiotherapy (PORT) with/without chemotherapy in high risk patients. Given the substantial toxicity of PORT we assessed lymph node ratio (LNR) as a predictor of PORT benefit. Design: By using the Surveillance, Epidemiology and End Results (SEER) database, we analyzed all node positive OCSCC patients diagnosed between 1988 and 2007 who underwent neck dissection. LNR was categorized into three groups: <6%, 6–12.5% and >12.5%. Results: In 3091 subjects identified, median survival was 32, 25 and 16 months for LNR Groups 1, 2 and 3, respectively. On multivariate analysis, survival was associated with age, race, grade, tumor size, nodal stage, extra-capsular extension, use of PORT and LNR. When stratified by LNR group, PORT was associated with a survival benefit only in Group 3 (LNR > 12.5%): 2 year survival 25% vs 37%. No benefit to PORT was seen when the LNR ⩽ 12.5%: 2 year survival 51% vs 54%. Conclusion: A low LNR is associated with extended survival in LN positive OCSCC. The survival benefit associated with PORT in this disease appears to be limited to those with a LNR > 12.5%. Validation is required prior to the clinical implementation of our findings

  16. Ear-lobe keloids: treatment by a protocol of surgical excision and immediate postoperative adjuvant radiotherapy.

    Science.gov (United States)

    Ragoowansi, R; Cornes, P G; Glees, J P; Powell, B W; Moss, A L

    2001-09-01

    There is no universally agreed policy for treating keloid scars of the ear lobe following piercing. We treated 35 patients (34 women) for high-risk ear-lobe keloids; the average age was 24 years (range: 16-44 years). All had failed to respond to prior treatment with massage and silicone, and corticosteroid injection. The keloids were excised extralesionally and the defects were closed with interrupted prolene sutures. The operative scar was covered with topical 2% lignocaine-0.25% chlorhexidine sterile lubricant gel under a transparent adhesive dressing. Adjuvant postoperative radiotherapy of 10 Gy, applied as 100 kV photons (4 mm high-voltage therapy (HVT) Al), was given within 24 h of surgery. All keloid scars were controlled at 4 weeks' follow-up. At 1 year, three out of 34 cases followed up had relapsed (probability of control: 91.2%). At 5 years, a further four out of the remaining 31 patients had relapsed (cumulative probability of control at 5 years: 79.4%). There were no cases of serious toxicity. Copyright 2001 The British Association of Plastic Surgeons.

  17. 3D-Conformal Versus Intensity-Modulated Postoperative Radiotherapy of Vaginal Vault: A Dosimetric Comparison

    International Nuclear Information System (INIS)

    Cilla, Savino; Macchia, Gabriella; Digesu, Cinzia; Deodato, Francesco; Romanella, Michele; Ferrandina, Gabriella; Padula, Gilbert; Picardi, Vincenzo; Scambia, Giovanni; Piermattei, Angelo; Morganti, Alessio Giuseppe

    2010-01-01

    We evaluated a step-and-shoot IMRT plan in the postoperative irradiation of the vaginal vault compared with equispaced beam arrangements (3-5) 3D-radiotherapy (RT) optimized plans. Twelve patients were included in this analysis. Four plans for each patient were compared in terms of dose-volume histograms, homogeneity index (HI), and conformity index (CI): (1) 3 equispaced beam arrangement 3D-RT; (2) 4 equispaced beam arrangement 3D-RT; (3) 5 equispaced beam arrangement 3D-RT; (4) step-and-shoot IMRT technique. CI showed a good discrimination between the four plans. The mean scores of CI were 0.58 (range: 0.38-0.67) for the 3F-CRT plan, 0.58 (range: 0.41-0.66) for 4F-CRT, 0.62 (range: 0.43-0.68) for 5F-CRT and 0.69 (range: 0.58-0.78) for the IMRT plan. A significant improvement of the conformity was reached by the IMRT plan (p mean , V90%, V95%, V100% was recorded for rectal and bladder irradiation with the IMRT plan. Surprisingly, IMRT supplied a significant dose reduction also for rectum and bladder V30% and V50%. A significant dosimetric advantage of IMRT over 3D-RT in the adjuvant treatment of vaginal vault alone in terms of treatment conformity and rectum and bladder sparing is shown.

  18. Primary radiotherapy or postoperative radiotherapy in patients with head and neck cancer. Comparative analysis of inflammation-based prognostic scoring systems

    Energy Technology Data Exchange (ETDEWEB)

    Selzer, Edgar; Grah, Anja [Medical University of Vienna, Department of Radiotherapy, Vienna (Austria); Heiduschka, Gregor; Thurnher, Dietmar [Medical University of Vienna, Otorhinolaryngology - Head and Neck Surgery, Vienna (Austria); Kornek, Gabriela [Medical University of Vienna, Medicine I - Division of Clinical Oncology, Vienna (Austria)

    2015-01-13

    Inflammation-based scoring systems have potential value in evaluating the prognosis of cancer patients; however, detailed comparative analyses in well-characterized head and neck cancer patient collectives are missing. We analyzed overall survival (OS) in locally advanced head and neck cancer patients who were treated with curative intent by primary radiotherapy (RT) alone, by RT in combination with cetuximab (RIT) or with cisplatin (RCHT), and by primary surgery followed by postoperative radiotherapy (PORT). The primary RT collective (N = 170) was analyzed separately from the surgery plus RT group (N = 148). OS was estimated using the Kaplan-Meyer method. Cox proportional-hazard regression models were applied to compare the risk of death among patients stratified according to risk factors and the inflammation-based Glasgow Prognostic Score (GPS), the modified GPS (mGPS), the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the prognostic index (PI). A prognostic relevance of the scoring systems for OS was observed in the primarily irradiated, but not in the PORT collective. OS was 35.5, 18.8, and 15.4 months, respectively, according to GPS 0, 1, and 2. OS according to mGPS 0-2 was identical. The PLR scoring system was not of prognostic relevance, while OS was 27.3 months in the NLR 0 group and 17.3 months in the NLR 1 group. OS was 35.5 months in PI 0, 16.1 months in PI 1, and 22.6 months in PI 2. GPS/mGPS scoring systems are able to discriminate between three risk groups in primarily, but not postoperatively irradiated locally advanced head and neck cancer patients. (orig.) [German] Entzuendungsbasierte Bewertungssysteme haben eine potenzielle Bedeutung fuer die Beurteilung der Prognose von Krebspatienten. Derzeit fehlen jedoch ausreichend detailliert durchgefuehrte Analysen in Kollektiven von Patienten mit Kopf-Hals-Tumoren. Untersucht wurde das Gesamtueberleben (''overall survival'', OS) von Patienten mit lokal

  19. Intensity Modulated Radiotherapy (IMRT) in the postoperative treatment of an adenocarcinoma of the endometrium complicated by a pelvic kidney

    OpenAIRE

    Castilho, Marcus S; Jacinto, Alexandre A; Viani, Gustavo A; Campana, Andre; Carvalho, Juliana; Ferrigno, Robson; Novaes, Paulo ERS; Fogaroli, Ricardo C; Salvajoli, Joao V

    2006-01-01

    Abstract Background Pelvic Radiotherapy (RT) as a postoperative treatment for endometrial cancer improves local regional control. Brachytherapy also improves vaginal control. Both treatments imply significant side effects that a fine RT technique can help avoiding. Intensity Modulated RT (IMRT) enables the treatment of the target volume while protecting normal tissue. It therefore reduces the incidence and severity of side effects. Case We report on a 50 year-old patient with a serous-papilif...

  20. The incidence of postoperative radiotherapy-induced acute dermatitis in breast cancer and its influencing factors for Chinese women

    Directory of Open Access Journals (Sweden)

    Ding J

    2018-03-01

    Full Text Available Jingxian Ding,1,2,* Yonghong Guo,3,* Qingge Li,1 Jun Chen,4 Pinghua Hu,4 Qiuming Liu,4 Yali Cao,4 Jiong Wu5,6 1Department of Radiation Oncology, The Third Hospital of Nanchang, Nanchang, China; 2Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China; 3Department of Radiation Oncology, The Fourth Affiliated Hospital of Nanchang University, Nanchang, China; 4Department of Breast Surgery, The Third Hospital of Nanchang, Nanchang, China; 5Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China; 6Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China *These authors contributed equally to this work Purpose: To investigate the incidence of skin acute reaction and its influencing factors in postoperative breast cancer radiotherapy patients. Methods: One hundred and seventy three cases of breast cancer patients treated with postoperative radiotherapy were consecutively enrolled from June 1, 2016 to July 31, 2017 in our breast cancer center. Irradiation technology includes conformal intensity-modulated radiotherapy and a conventional two-dimensional one with conventional fraction. Any acute radiation dermatitis was recorded and the influencing factors were analyzed at the end of the radiation treatment. Results: Radiotherapy-induced acute dermatitis in patients with breast-conserving surgery was relatively mild. Among the 173 patients, 33 cases had no obvious changes in the skin (grade 0; 121 cases had grade 1 skin reactions, manifested as local dark erythema and dry peeling; 29 cases had grade 2 skin reactions, characterized by edema, hyperemia, or erosion part; no grade 3 cases of skin reactions were observed. The incidence of grade 0, grade 1, and grade 2 reactions in all patients was 19.1%, 69.9%, and 11.0%, respectively. The severity of skin acute reaction is independent of the tumor sites, molecular subtypes, patients’ age, and irradiation modalities, but it

  1. Improving external beam radiotherapy by combination with internal irradiation.

    Science.gov (United States)

    Dietrich, A; Koi, L; Zöphel, K; Sihver, W; Kotzerke, J; Baumann, M; Krause, M

    2015-07-01

    The efficacy of external beam radiotherapy (EBRT) is dose dependent, but the dose that can be applied to solid tumour lesions is limited by the sensitivity of the surrounding tissue. The combination of EBRT with systemically applied radioimmunotherapy (RIT) is a promising approach to increase efficacy of radiotherapy. Toxicities of both treatment modalities of this combination of internal and external radiotherapy (CIERT) are not additive, as different organs at risk are in target. However, advantages of both single treatments are combined, for example, precise high dose delivery to the bulk tumour via standard EBRT, which can be increased by addition of RIT, and potential targeting of micrometastases by RIT. Eventually, theragnostic radionuclide pairs can be used to predict uptake of the radiotherapeutic drug prior to and during therapy and find individual patients who may benefit from this treatment. This review aims to highlight the outcome of pre-clinical studies on CIERT and resultant questions for translation into the clinic. Few clinical data are available until now and reasons as well as challenges for clinical implementation are discussed.

  2. Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

    International Nuclear Information System (INIS)

    Kim Ju Ree; Lee, Sang Hoon

    2012-01-01

    To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the fi nal Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

  3. Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

    Energy Technology Data Exchange (ETDEWEB)

    Kim Ju Ree; Lee, Sang Hoon [Cheil General Hospital and Women' s Healthcare Center, Kwandong University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the fi nal Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

  4. Transcatheter arterial chemoembolization combined with radiotherapy for the treatment of advanced cervical cancer

    International Nuclear Information System (INIS)

    Zhu Jun; Luo Jianjun; Zhang Wen; Huang Yong; Li Dengke; Cao Yueyong

    2010-01-01

    Objective: To discuss the clinical value of interventional transcatheter arterial chemoembolization (TACE) combined with subsequent pelvic radiotherapy in treating patients with advanced cervical cancer. Methods: According to the therapeutic scheme, 195 patients with phase IIb or beyond advanced cervical cancer were divided into two groups: (1) study group (n = 99), treated with TACE combined with subsequent pelvic radiotherapy (i.e. combination group); (2) control group(n = 96), treated with radiotherapy alone (i. e. radiotherapy alone group). The short-term and long-term clinical results as well as the occurrence of complications were compared between two groups. Results: Different degrees of the tumor shrinkage were found in patients of both groups after treatment. The short-term remission rate of the study group was significantly higher than that of the control group, and the difference between two groups was statistically significant (P = 0.012). After the procedure, the anaemia in patients of study group was markedly corrected. The difference in hemoglobin between preoperative levels and postoperative ones was significant (T-test, P < 0.01). Long-term follow-up for 3 years the survival rate of the study group was higher than that of the control group (P = 0.032). Both the recurrence rate and metastatic rate at one and three years after the therapy in the study group were distinctly lower than that in the control group (P < 0.05). No significant difference in one-year, five-year survival rate and in five-year recurrent rate existed between two groups. The main short-term complications included digestive untoward reaction, bone marrow depression, hepatic and renal toxicity, etc., which could be well relieved after active symptomatic medication. The long-term complications included radiodermatitis, radiocystitis and / or radioproctitis. The incidence of radiocystitis and radioproctitis in the study group was significantly lower than that in the control group (P

  5. Renal function and urological complications after radical hysterectomy with postoperative radiotherapy and platinum-based chemotherapy for cervical cancer.

    Science.gov (United States)

    Okadome, Masao; Saito, Toshiaki; Kitade, Shoko; Ariyoshi, Kazuya; Shimamoto, Kumi; Kawano, Hiroyuki; Minami, Kazuhito; Nakamura, Motonobu; Shimokawa, Mototsugu; Okushima, Kazuhiro; Kubo, Yuichiro; Kunitake, Naonobu

    2018-02-01

    We aimed to clarify renal functional changes long term and serious urological complications in women with cervical cancer who undergo radical hysterectomy followed by pelvic radiotherapy and/or platinum-based chemotherapy to treat the initial disease. Data on 380 women who underwent radical hysterectomy at the National Kyushu Cancer Center from January 1997 to December 2013 were reviewed. Main outcome measures were the estimated glomerular filtration rate (eGFR) and monitored abnormal urological findings. Postoperative eGFR was significantly lower than preoperative eGFR in 179 women with surgery alone and in 201 women with additional pelvic radiotherapy and/or chemotherapy (both P types of univariate analyses for eGFR reduction in women after treatment showed that older age, advanced stage, pelvic radiotherapy, and platinum-based chemotherapy were significant variables on both analyses. Two types of multivariate analyses showed that platinum-based chemotherapy or pelvic radiotherapy were associated with impaired renal function (odds ratio 1.96, 95% confidence interval 1.08-3.54 and odds ratio 2.85, 95% confidence interval 1.12-7.24, for the respective analyses). There was a higher rate of bladder wall thickening in women with pelvic radiotherapy had than those without it (17.4% vs. 2.7%, P chemotherapy and/or postoperative pelvic radiotherapy. Serious and life-threatening urological complications are rare, but surgeons should be aware of the possibility during the long follow-up. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Role of postoperative radiotherapy in the management of malignant pleural mesothelioma. A propensity score matching of the SEER database

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Rahman, Omar [Ain Shams University, Clinical Oncology department, Faculty of medicine, Cairo (Egypt)

    2017-04-15

    This study assessed the prognostic impact of postoperative radiotherapy in patients with surgically resected malignant pleural mesothelioma (MPM). MPM patients diagnosed between 2000 and 2013 were identified from the SEER (Surveillance, Epidemiology, and End Results) database. A propensity-matched analysis was performed considering baseline characteristics (age, gender, race, histology, TNM stage, and type of surgery). A total of 2166 patients were identified. The median age was 60 years (range 25-85 years), and 469 patients received postoperative radiotherapy. Both before and after propensity score matching, overall survival (P < 0.0001 and P = 0.012, respectively) was better in the postoperative radiotherapy group. When the overall survival was stratified by histology, postoperative radiotherapy did not improve the survival in sarcomatoid histology patients both before and after matching (P = 0.424 and P = 0.281, respectively). In multivariate analysis of the matched population, not receiving postoperative radiotherapy did not correlate with worse survival (hazard ratio: 1.175; P = 0.12). Factors associated with worse survival include sarcomatoid histology, nodal positivity, and age ≥70. Evidence from this analysis is insufficient on its own to routinely recommend postoperative radiotherapy for surgically resected MPM. However, large-scale prospective clinical trials are warranted to further evaluate this intervention in nonsarcomatoid histology. (orig.) [German] In der vorliegenden Studie wurde der prognostische Einfluss der postoperativen Strahlentherapie bei Patienten mit chirurgisch reseziertem malignem Pleuramesotheliom (MPM) untersucht. In der SEER-Datenbank (Surveillance, Epidemiology, and End Results) wurden Patienten ermittelt, bei denen zwischen 2000 und 2013 die Diagnose eines MPM gestellt worden war. Unter Beruecksichtigung der Ausgangsmerkmale (Alter, Geschlecht, Ethnizitaet, Histologie, TNM-Stadium und Art des chirurgischen Eingriffs) wurde eine

  7. The effect of radiotherapy, and radiotherapy combined with bisphosphonates or RANK ligand inhibitors on bone quality in bone metastases. A systematic review

    NARCIS (Netherlands)

    Groenen, K.H.J.; Pouw, M.H.; Hannink, G.; Hosman, A.J.; van der Linden, Y.M.; Verdonschot, Nicolaas Jacobus Joseph; Tanck, E.

    2016-01-01

    Purpose The role of radiotherapy in stabilizing metastatic bones is unclear. This systematic review assessed the effects of (1) radiotherapy, (2) radiotherapy combined with bisphosphonates, and (3) radiotherapy combined with RANK ligand (RANKL) inhibitors on bone quality and bone strength in bone

  8. The Role of Postoperative Radiotherapy on Stage N2 Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Fangfang DU

    2009-11-01

    Full Text Available Background and objective The clinical value of postoperative radiotherapy (PORT in stage N2 nonsmall-cell lung cancer (NSCLC is controversy. The aim of this study is to analyze the efficacy of PORT in subgroup of stage N2 NSCLC, which can help clinicians to choose proper patients for PORT. Methods Clinical data of 359 patients with stage N2 NSCLC treated with radical surgery between Mar. 2000 and Jul. 2005 were retrospectively reviewed. Two hundred and seven patients received adjuvant chemotherapy and one hundred and four patients received adjuvant radiotherapy. First, the group of patients were analyzed to evaluate the factors affecting the overall survival. The all patients were divided based on tumor size and the number of lymph node metastasis station (single station or multiple station so as to evaluate the role of PORT. The endpoint was overall survival (OS and local recurrence-free survival (LRFS. Kaplan-Meier method was used to calculate the OS, LRFS and Log-rank was used to compare the difference in OS and LRFS between different groups. Results The median duration of follow-up was 2.3 years. 224 patients died. The median survival was 1.5 years and 1, 3, 5-year survival were 78%, 38% and 26%. Univariate analysis showed tumor size, the number of lymph node metastasis station and PORT were correlated with OS. Among patients, 5-year survival rates in PORT and non-PORT were 29% and 24% (P=0.047 respectively. In subgroups, PORT was related with high survival in patients with multiple station N2 compared to non-PORT: 36% vs 20% (P=0.013 and 33% vs 15% (P=0.002 in patients in patients with tumor size > 3 cm. Also, it was related with low local recurrence compared to non-PORT: 65% vs 48% (P=0.006 and 62% vs 48% (P=0.033. Conclusion PORT can improve overall survival for N2 NSCLC, especially the patients with the factors as follows: tumor size > 3 cm and multiple station N2 can benefit from PORT more or less.

  9. Relationship between acute and late normal tissue injury after postoperative radiotherapy in endometrial cancer

    International Nuclear Information System (INIS)

    Jereczek-Fossa, Barbara A.; Jassem, Jacek; Badzio, Andrzej

    2002-01-01

    Purpose: To evaluate the relationship between acute and late normal tissue reactions in 317 consecutive endometrial cancer patients treated with surgery and adjuvant radiotherapy (RT). Methods: The data of 317 patients (staging according to the International Federation of Gynecology and Obstetrics) treated with postoperative RT were analyzed. Both low-dose-rate brachytherapy and external beam RT were applied in 247 patients (78%); brachytherapy only in 49 (15%) and external beam irradiation only in 21 (7%). The median follow-up was 7.3 years (range 4-21). The European Organization for Research and Treatment of Cancer, Radiation Therapy Oncology Group system with elements of the late effects of normal tissue, subjective, objective, management, analytic (LENT/SOMA) scale was used to score the RT reactions. The correlation between the occurrence and severity of acute and late bowel and bladder toxicity, as well as the relationship between the severity of acute effects and time to occurrence of late reactions, were assessed using linear and logistic regression analyses. Results: Of the 317 patients, 268 (85%) experienced acute RT reactions of any grade. Severe acute bowel reactions were observed in 15 patients (5%), urinary bladder complications in 1 patient (0.5%), cutaneous in 1 patient (0.5%), and vaginal in 1 patient (0.5%). Severe acute hematologic toxicity was seen in 3 patients (1%). A total of 158 patients (51%) experienced late RT reactions of any grade. Severe late bowel reactions were observed in 19 patients (6%), urinary bladder in 5 (2%), vaginal in 3 (1%), and bone in 10 (4%). When all toxic events were considered, there was a highly significant correlation between the acute and late bowel reactions (p <0.001), but the acute and late urinary bladder reactions did not correlate (p=0.64). The grade of acute toxicity was found to predict the grade of late toxicity for the bowel but not for the bladder (p<0.001 and p=0.47, respectively). The severity of acute

  10. 11C-CHO PET in optimization of target volume delineation and treatment regimens in postoperative radiotherapy for brain gliomas

    International Nuclear Information System (INIS)

    Li Fangming; Nie Qing; Wang Ruimin; Chang, Susan M.; Zhao Wenrui; Zhu Qi; Liang Yingkui; Yang Ping; Zhang Jun; Jia Haiwei; Fang Henghu

    2012-01-01

    Objective: We explored the clinical values of 11 C-choline ( 11 C-CHO) PET in optimization of target volume delineation and treatment regimens in postoperative radiotherapy for brain gliomas. Methods: Sixteen patients with the pathological confirmation of the diagnosis of gliomas prior to receiving radiotherapy (postoperative) were included, and on whom both MRI and CHO PET scans were performed at the same position for comparison of residual tumors with the two techniques. 11 C-CHO was used as the tracer in the PET scan. A plain T1-weighted, T2-weighted and contrast-enhanced T1-weighted imaging scans were performed in the MRI scan sequence. The gliomas' residual tumor volume was defined as the area with CHO-PET high-affinity uptake and metabolism (V CHO ) and one with MRI T1-weighted imaging high signal intensity (V Gd ), and was determined by a group of experienced professionals and clinicians. Results: (1) In CHO-PET images, the tumor target volume, i.e., the highly metabolic area with a high concentration of isotopes (SUV 1.016–4.21) and the corresponding contralateral normal brain tissues (SUV0.1–0.62), was well contrasted, and the boundary between lesions and surrounding normal brain tissues was better defined compared with MRI and 18 F-FDG PET images. (2) For patients with brain gliomas of WHO Grade II, the SUV was 1.016–2.5; for those with WHO Grades III and IV, SUVs were >26–4.2. (3) Both CHO PET and MRI were positive for 10 patients and negative for 2 patients. The residual tumor consistency between these two studies was 75%. Four of the 10 CHO-PET-positive patients were negative on MRI scans. The maximum distance between V Gd and V CHO margins was 1.8 cm. (4) The gross tumor volumes (GTVs) and the ensuing treatment regimens were changed for 31.3% (5/16) of patients based on the CHO-PET high-affinity uptake and metabolism, in which the change rate was 80% (4/5), 14.3 % (1/7) and 0% (0/4) for patients with WHO Grade II III, and IV gliomas

  11. The Prognostic Value of Hemoglobin Concentration in Postoperative Radiotherapy of 835 Patients With Laryngeal Cancer

    International Nuclear Information System (INIS)

    Rutkowski, Tomasz; Suwinski, Rafal; Idasiak, Adam

    2007-01-01

    Purpose: To investigate the prognostic value of hemoglobin (Hb) concentration in patients with laryngeal cancer treated with postoperative radiotherapy (pRT). Methods and Materials: The records of 835 patients who underwent pRT between 1980 and 2003 were reviewed. Most patients (526 of 835 patients; 63%) were in advanced clinical stages (T3-T4) and 371 of 835 patients (44%) were node positive. Total laryngectomy had been performed in 676 of 835 patients (81%). Median Hb concentration before (Hb0) and after pRT (Hb1) was the same (13.3 g/dl). However, individual differences between Hb1 and Hb0 (dHb) varied within a broad range (-8.8; 5.0 g/dl). Univariate and multivariate analyses were performed to identify variables significantly associated with locoregional control (LRC), metastases-free survival, and overall survival. Results: Patients with dHb greater than 0 had significantly improved 5-year LRC compared with those with dHb of 0 or less (80% vs. 72%, p = 0.01). Conversely, when categorized, neither Hb0 nor Hb1 had a significant influence on LRC. In multivariate analysis, dHb remained a prognostic factor for LRC (p = 0.01) among the other variables, which included overall radiation treatment time and nodal status. None of the Hb-related variables significantly influenced metastases-free or overall survival. Conclusion: Individual change in Hb concentration during the course of pRT (dHb) rather than Hb level before or after pRT appeared as an independent prognostic factor for LRC in this set of patients

  12. Role of adjuvant postoperative external beam radiotherapy for well differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Jeanny; Wu, Hong Gyun; Youn, Yeo Kyu; Lee, Kyu Eun; Kim, Kwang Hyun; Park, Do Joon [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-09-15

    To analyze the outcome of adjuvant postoperative external beam radiotherapy (EBRT) in well-differentiated thyroid cancer (WDTC). We identified 84 patients treated with EBRT for WDTC from February 1981 to December 2010. Among them, we analyzed 39 patients who received EBRT after initial radical surgery. Twenty-four females and 15 males were included. The median age was 49 years (range, 16 to 72 years). There were 34 papillary thyroid carcinomas and 5 follicular thyroid carcinomas. Most patients showed pathologic T3/T4 stage (54%/26%). Ten patients (25.6%) had gross residual tumors. Five patients (12.8%) had tumor cells at the margin. The median EBRT dose and fraction size were 62.6 Gy and 1.8 to 2.0 Gy, respectively. The median follow-up was 73 months (range, 21 to 372 months). The five-year overall survival (OS) and locoregional recurrence free survival (LRFS) were 97.4% and 86.9%, respectively. Locoregional failures occurred in 5 and all failure sites were the neck node area. In univariate analysis, OS was significantly influenced by invasion of the trachea (p = 0.016) or esophagus (p = 0.006). LRFS was significantly decreased by male (p = 0.020), gross residuum after resection (p = 0.002), close or positive tumor at surgical margin involvement (p = 0.044), and tracheal invasion (p = 0.040). No significant prognostic factor was identified in the multivariate analysis. No patient experienced the Radiation Therapy Oncology Group grade 3 or more toxicity. Our locoregional control rate of 87.2% is comparable to historical controls with surgery alone, even though our study had a large proportion of advanced stage. Adjuvant EBRT may an effective and safe treatment option in patients with WDTC.

  13. Radiotherapy

    International Nuclear Information System (INIS)

    Wannenmacher, M.; Debus, J.; Wenz, F.

    2006-01-01

    The book is focussed on the actual knowledge on the clinical radiotherapy and radio-oncology. Besides fundamental and general contributions specific organ systems are treated in detail. The book contains the following contributions: Basic principles, radiobiological fundamentals, physical background, radiation pathology, basics and technique of brachytherapy, methodology and technique of the stereotactic radiosurgery, whole-body irradiation, operative radiotherapy, hadron therapy, hpyerthermia, combined radio-chemo-therapy, biometric clinical studies, intensity modulated radiotherapy, side effects, oncological diagnostics; central nervous system and sense organs, head-neck carcinomas, breast cancer, thorax organs, esophagus carcinoma, stomach carcinoma, pancreas carcinoma, heptabiliary cancer and liver metastases, rectal carcinomas, kidney and urinary tract, prostate carcinoma, testicular carcinoma, female pelvis, lymphatic system carcinomas, soft tissue carcinoma, skin cancer, bone metastases, pediatric tumors, nonmalignant diseases, emergency in radio-oncology, supporting therapy, palliative therapy

  14. Optimal dose and volume for postoperative radiotherapy in brain oligometastases from lung cancer: a retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Yeun; Kim, Hye Ryun; Cho, Byoung Chul; Lee, Chang Geol; Suh, Chang Ok [Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of); Chang, Jong Hee [Dept. of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2017-06-15

    To evaluate intracranial control after surgical resection according to the adjuvant treatment received in order to assess the optimal radiotherapy (RT) dose and volume. Between 2003 and 2015, a total of 53 patients with brain oligometastases from non-small cell lung cancer (NSCLC) underwent metastasectomy. The patients were divided into three groups according to the adjuvant treatment received: whole brain radiotherapy (WBRT) ± boost (WBRT ± boost group, n = 26), local RT/Gamma Knife surgery (local RT group, n = 14), and the observation group (n = 13). The most commonly used dose schedule was WBRT (25 Gy in 10 fractions, equivalent dose in 2 Gy fractions [EQD2] 26.04 Gy) with tumor bed boost (15 Gy in 5 fractions, EQD2 16.25 Gy). The WBRT ± boost group showed the lowest 1-year intracranial recurrence rate of 30.4%, followed by the local RT and observation groups, at 66.7%, and 76.9%, respectively (p = 0.006). In the WBRT ± boost group, there was no significant increase in the 1-year new site recurrence rate of patients receiving a lower dose of WBRT (EQD2) <27 Gy compared to that in patients receiving a higher WBRT dose (p = 0.553). The 1-year initial tumor site recurrence rate was lower in patients receiving tumor bed dose (EQD2) of ≥42.3 Gy compared to those receiving <42.3 Gy, although the difference was not significant (p = 0.347). Adding WBRT after resection of brain oligometastases from NSCLC seems to enhance intracranial control. Furthermore, combining lower-dose WBRT with a tumor bed boost may be an attractive option.

  15. Combined external beam and intraluminal radiotherapy for irresectable Klatskin tumors

    Energy Technology Data Exchange (ETDEWEB)

    Schleicher, U.M. [Klinik fuer Strahlentherapie, Technische Hochschule Aachen (Germany); Staatz, G. [Klinik fuer Radiologische Diagnostik, Technische Hochschule Aachen (Germany); Alzen, G. [Klinik fuer Radiologische Diagnostik, Technische Hochschule Aachen (Germany); Abt. Kinderradiologie, Giessen Univ. (Germany); Andreopoulos, D. [Klinik fuer Strahlentherapie, Technische Hochschule Aachen (Germany); BOC Oncology Centre, Nikosia (Cyprus)

    2002-12-01

    Background: In most cases of proximal cholangiocarcinoma, curative surgery is not possible. Radiotherapy can be used for palliative treatment. We report our experience with combined external beam and intraluminal radiotherapy of advanced Klatskin's tumors. Patients and Methods: 30 patients were treated for extrahepatic proximal bile duct cancer. Our schedule consisted for external beam radiotherapy (median dose 30 Gy) and a high-dose-rate brachytherapy boost (median dose 40 Gy) delivered in four or five fractions, which could be applied completely in twelve of our patients. 15 patients in the brachytherapy and nine patients in the non-brachytherapy group received additional low-dose chemotherapy with 5-fluorouracil. Results: The brachytherapy boost dose improved the effect of external beam radiotherapy by increasing survival from a median of 3.9 months in the non-brachytherapy group to 9.1 months in the brachytherapy group. The effect was obvious in patients receiving a brachytherapy dose above 30 Gy, and in those without jaundice at the beginning of radiotherapy (p<0.05). Conclusions: The poor prognosis in patients with advanced Klatskin's tumors may be improved by combination therapy, with the role of brachytherapy and chemotherapy still to be defined. Our results suggest that patients without jaundice should be offered brachytherapy, and that a full dose of more than 30 Gy should be applied. (orig.) [German] Hintergrund: Bei den meisten Patienten mit proximalen Cholangiokarzinomen ist eine kurative Operation nicht mehr moeglich. Im Rahmen der Palliativbehandlung kann die Strahlentherapie eingesetzt werden. Wir berichten ueber unsere Erfahrungen mit der Kombination aus perkutaner und intraluminaler Strahlentherapie fortgeschrittener Klatskin-Tumoren. Patienten und Methode: 30 Patienten wurden wegen extrahepatischer proximaler Gallengangskarzinome behandelt. Unser Therapieschema umfasste eine perkutane Strahlentherapie (mediane Dosis: 30 Gy) sowie einen

  16. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-12-15

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

  17. Intractable radiation pericarditis and pleuritis developed 20 years after postoperative radiotherapy in a case with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tsuji, Misa; Shintani, Uichirou; Ohmoto, Yasuhiro; Isshiki, Noriyuki; Tanaka, Tsuyoshi; Kitamura, Masami; Kato, Shigetake; Misaki, Moriharu [Mie National Central Hospital, Hisai (Japan); Shouin, Hiroshi

    1999-01-01

    We reported a 64-year-old woman with radiation-related intractable pericarditis and pleuritis which developed 20 years after radiotherapy. She underwent a left total mastectomy for a breast cancer and 50 Gy of radiotherapy postoperatively at the age of 43. She was admitted to our hospital because of facial edema and dyspnea. A chest roentgenogram on admission showed massive bilateral pleural effusion and a echocardiography revealed massive pericardial effusion. Though the symptoms of heart failure subsided after the administration of moderate diuretics and cardiotonics, the pleural effusion and pericardial effusion persisted and, she became worse and died. The histological findings at autopsy, showed chronic fibrous pericarditis with marked pericardial thickening, fibrous pleuritis and myocarditis. These findings were compatible with those of previously reported radiation-induced heart disease. We reported a case of pleuritis and pericarditis probably caused by radiation therapy. A long term observation is necessary for the radiation-related heart disease. (author)

  18. Health-related quality of life after adjuvant and salvage postoperative radiotherapy for prostate cancer - A prospective analysis

    International Nuclear Information System (INIS)

    Pinkawa, Michael; Fischedick, Karin; Asadpour, Branka; Gagel, Bernd; Piroth, Marc D.; Holy, Richard; Krenkel, Barbara; Eble, Michael J.

    2008-01-01

    Background and purpose: The aim of the study was to analyze health-related quality of life changes after postoperative radiotherapy (RT) for prostate cancer. Materials and methods: A group of 101 patients has been surveyed prospectively before (time A), at the last day (B), two months after (C) and >1 year after (D) RT using a validated questionnaire (Expanded Prostate Cancer Index Composite) with urinary, bowel, sexual and hormonal domains. The prostatic fossa was treated with a four-field box technique up to a total dose of 66.6 Gy. Results: While median urinary scores reached baseline levels already two months after radiotherapy (function/bother scores at time A-B-C-D: 94/89-89/75-94/89-94/89; A vs. B: p 1 year, only minor HRQOL changes occurred in comparison to baseline scores

  19. Combined chemotherapy and radiotherapy in the treatment of lung cancer

    International Nuclear Information System (INIS)

    Wolf, M.

    1992-01-01

    In the past decade the prognosis of patients with locally advanced lung cancer has not been altered significantly. In both small and non-small cell lung cancer cure rates are poor and 5-year survival rate still has not exceeded the 5% borderline. Despite of initially high response rates, a vast majority of patients suffered from tumor progression within 2 years after the start of treatment. Sites of tumor progression are either the primary tumor or the occurrence of distant metastases. Therefore, improvements of both local and systemic tumor control are necessary to increase long-term survival rate in lung cancer. Combined chemo- and radiotherapy may be an appropriate treatment approach to reach these aims. In patients with locally advanced lung cancer combined chemo-radiotherapy aims at overcoming radio- and chemo-therapy resistance as a cause of local treatment failure and at early eradication of distant micrometastases as a cause of systemic treatment failure. (author). 29 refs., 2 figs., 6 tabs

  20. Postoperative Concurrent Chemoradiotherapy Versus Postoperative Radiotherapy in High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck: The Randomized Phase III TROG 05.01 Trial.

    Science.gov (United States)

    Porceddu, Sandro Virgilio; Bressel, Mathias; Poulsen, Michael Geoffrey; Stoneley, Adam; Veness, Michael John; Kenny, Lizbeth Moira; Wratten, Chris; Corry, June; Cooper, Stephen; Fogarty, Gerald Blaise; Collins, Marnie; Collins, Michael Kevin; Macann, Andrew Martin John; Milross, Christopher Gerard; Penniment, Michael Gordon; Liu, Howard Yu-Hao; King, Madeleine Trudy; Panizza, Benedict James; Rischin, Danny

    2018-05-01

    Purpose To report the results of the Trans Tasman Radiation Oncology Group randomized phase III trial designed to determine whether the addition of concurrent chemotherapy to postoperative radiotherapy (CRT) improved locoregional control in patients with high-risk cutaneous squamous cell carcinoma of the head and neck. Patients and Methods The primary objective was to determine whether there was a difference in freedom from locoregional relapse (FFLRR) between 60 or 66 Gy (6 to 6.5 weeks) with or without weekly carboplatin (area under the curve 2) after resection of gross disease. Secondary efficacy objectives were to compare disease-free survival and overall survival. Results Three hundred twenty-one patients were randomly assigned, with 310 patients commencing allocated treatment (radiotherapy [RT] alone, n = 157; CRT, n = 153). Two hundred thirty-eight patients (77%) had high-risk nodal disease, 59 (19%) had high-risk primary or in-transit disease, and 13 (4%) had both. Median follow-up was 60 months. Median RT dose was 60 Gy, with 84% of patients randomly assigned to CRT completing six cycles of carboplatin. The 2- and 5-year FFLRR rates were 88% (95% CI, 83% to 93%) and 83% (95% CI, 77% to 90%), respectively, for RT and 89% (95% CI, 84% to 94%) and 87% (95% CI, 81% to 93%; hazard ratio, 0.84; 95% CI, 0.46 to 1.55; P = .58), respectively, for CRT. There were no significant differences in disease-free or overall survival. Locoregional failure was the most common site of first treatment failure, with isolated distant metastases as the first site of failure seen in 7% of both arms. Treatment was well tolerated in both arms, with no observed enhancement of RT toxicity with carboplatin. Grade 3 or 4 late toxicities were infrequent. Conclusion Although surgery and postoperative RT provided excellent FFLRR, there was no observed benefit with the addition of weekly carboplatin.

  1. Recurrence pattern of squamous cell carcinoma in the midthoracic esophagus: implications for the clinical target volume design of postoperative radiotherapy

    Directory of Open Access Journals (Sweden)

    Wang X

    2016-10-01

    Full Text Available Xiaoli Wang,1,2,* Yijun Luo,1,2,* Minghuan Li,2 Hongjiang Yan,2 Mingping Sun,2 Tingyong Fan2 1School of Medicine and Life Sciences, Jinan University-Shandong Academy of Medical Sciences, Jinan, Shandong, People’s Republic of China; 2Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong, People’s Republic of China *These authors contributed equally to this work Background: Postoperative radiotherapy has shown positive efficacy in lowering the recurrence rate and improving the survival rate for patients with esophageal squamous cell carcinoma (ESCC. However, controversies still exist about the postoperative prophylactic radiation target volume. This study was designed to analyze the patterns of recurrence and to provide a reference for determination of the postoperative radiotherapy target volume for patients with midthoracic ESCC.Patients and methods: A total of 338 patients with recurrent or metastatic midthoracic ESCC after radical surgery were retrospectively examined. The patterns of recurrence including locoregional and distant metastasis were analyzed for these patients.Results: The rates of lymph node (LN metastasis were 28.4% supraclavicular, 77.2% upper mediastinal, 32.0% middle mediastinal, 50.0% lower mediastinal, and 19.5% abdominal LNs. In subgroup analyses, the rate of abdominal LN metastasis was significantly higher in patients with histological node-positive than that in patients with histological node-negative (P=0.033. Further analysis in patients with histological node-positive demonstrated that patients with three or more positive nodes are more prone to abdominal LN metastasis, compared with patients with one or two positive nodes (χ2=4.367, P=0.037. The length of tumor and histological differentiation were also the high-risk factors for abdominal LN metastasis.Conclusion: For midthoracic ESCC with histological node-negative, or one or two positive nodes, the supraclavicular and

  2. Inhibitory effect of sequential combined chemotherapy and radiotherapy on growth of implanted tumor in mice

    International Nuclear Information System (INIS)

    Okada, Kouji

    1983-01-01

    Sequential chemotherapy using FT-207, adriamycin and mitomycin C followed by radiotherapy was attempted to achieve effective inhibition against implanted tumor in C57BL/6 black mice bearing YM-12 tumors. Sequential combined chemotherapy was more effective than single drug chemotherapy or combined chemotherapy of other drugs. Addition of radiotherapy to the sequential combined chemotherapy was successful for enhancing therapeutic effect. (author)

  3. Long-term results of postoperative radiotherapy in adult patients with incompletely excised infratentorial low grade astrocytoma

    International Nuclear Information System (INIS)

    Pluta, E.; Glinski, B.; Szpytma, T.; Nowak-Sadzikowska, J.

    2002-01-01

    lnfratentorial low grade astrocytoma (ILGA) occurs rarely in adult patients and accounts for about 3% of all intracranial tumors.The basic method of treatment for ILGA is surgery. Complete resection results in high local control rate and the role of postoperative irradiation in management of partially resected tumors is not clearly determined. The aim of this study was to evaluate the efficacy of postoperative irradiation in adult patients with incompletely excised ILGA. Between 1975 and 1995, thirty one adult patients with incompletely excised ILGA received postoperative irradiation with curative intent. All patients were treated with megavoltage gamma rays ( 60C o). The total dose ranged from 50 to 60 Gy (mean; 54 Gy) and was delivered with daily fraction of 1.8-2 Gy. The treatment volume covered the tumor being area with a margin of 1-2 cm. Tolerance to treatment has been found to be good in 30 patients (97%). The overall 15-year actuarial survival rate was 62% in the entire group. Young patients, up to twenty years of age achieved a 15-year overall actuarial survival rate of 85%, older patients - 46%. This difference was statistically significant (p =0. 0205). Conventionally fractionated postoperative radiotherapy with doses of 50 to 60 Gy may improve long term results of adult patients with ILGA after uncomplete resection. Age is a significant prognostic factor - young patients, up to twenty years of age, show best survival. (author)

  4. Combined intraarterial chemotherapy and radiotherapy for invasive bladder cancer

    International Nuclear Information System (INIS)

    Koike, Hidekazu; Okamura, Keigo; Matsuo, Yasushige; Yajima, Hisanori

    2003-01-01

    A total of 9 patients with invasive bladder cancer (T2b, n=2; T3a, n=0; T3b, n=3; T4, n=4) were treated with intra-arterial cisplatin (CDDP) and pirarubicin (THP)-doxorubicin (ADM), in combination with external radiotherapy. Clinical response was as follows: complete response (CR) was obtained in 3 patients, partial response (PR) in 2 patients, no change (NC) in 3 patients and no progressive disease (PD). One patient died during the treatment because of pneumonia caused by myelosuppression and overall response rate was 62.5%. Total cystectomy was performed for 4 patients after chemo-radiotherapy. Overall survival rate was 75.0% for 1-year, 62.5% for 2-year, and 41.7% for 5-year. In group with cystectomy survival rate was 100% for 1-year, 100% for 2-year, and 50.0% for 5-year. In group without cystectomy, 50.0% for 1-year, and 25.0% for 2-year. Overall no recurrence rate was 87.5% for 6-months, 58.3% for 1-year, and 58.3% for 5-year. Main side effects were myelosuppression, appetite loss, diarrhea, thigh pain and contracted bladder. (author)

  5. Radiotherapy

    International Nuclear Information System (INIS)

    Pistenma, D.A.

    1980-01-01

    The need for radiotherapy research is exemplified by the 100,000 cancer patients who will fail treatment locally and/or regionally annually for the next several years but who would benefit from better local treatment modalities. Theoretically, all of the areas of investigation discussed in this projection paper have the potential to significantly improve local-regional treatment of cancer by radiotherapy alone or in combination with other modalities. In many of the areas of investigation discussed in this paper encouraging results have been obtained in cellular and animal tumor studies and in limited studies in humans as well. In the not too distant future the number of patients who would benefit from better local control may increase by tens of thousands if developments in chemotherapy and/or immunotherapy provide a means to eradicate disseminated microscopic foci of cancer. Thus the efforts to improve local-regional control take on even greater significance

  6. Treatment results and prognostic analysis of 47 patients with urethral transitional cell carcinoma treated with post-operative adjuvant radiotherapy

    International Nuclear Information System (INIS)

    He Ke; Hou Xiaorong; Shen Jie; Lian Xin; Sun Shuai; Zhang Fuquan

    2010-01-01

    Objective: To evaluate treatment results and prognostic factors of 47 patients with primary urethral transitional cell carcinoma treated with post-operative adjuvant radiotherapy. Methods: From October 1998 to October 2008, 47 patients with primary urethral transitional cell carcinoma received postoperative adjuvant radiotherapy. Thirty-one patients had stage T 3 /T 4 disease, 7 had lymph node metastasis. Thirty-nine patients had G3 tumor, 13 had stump-positive. The median radiotherapy dose was 60 Gy (36-64 Gy). 81% patients (38/47) were treated with regional irradiation. Results: The median follow-up time was 21 months (6 -88 months). The follow-up rate was 92%. The median overall survival time was 35 months (5 -88 months). The 2-and 5-year overall survival rates were 57% and 49%, respectively. In univariate analysis, the median overall survival time was better in patients with stage T 1 or T 2 compared with stage T 3 or T 4 tumor (42 months vs. 19 months, χ 2 =7.28, P=0.007), with age of ≤65 years compared with >65 years (28 mouths vs 18 months,χ 2 =8.23, P =0.004). There was no significant difference in the long term survival in patients with non-radical surgery compared with radical mastectomy (21 months vs. 20 months, χ 2 = 0.90, P = 0.344). In multivariate analysis, the stage T 3 or T 4 (χ 2 = 7.89, P =0.005), >65 years old (χ 2 = 4.85, P = 0.028), renal pelvis involvement (χ 2 = 5.65, P = 0.018), and tumor located in the mid or inferior segment (χ 2 =6.08,P =0.014) were factors associated with poorer prognosis. Conclusions: Postoperative adjuvant radiotherapy can improve the efficacy of patients with locally advanced urethral transitional cell carcinoma. Advanced T stage and > 65 years age are associated with poorer prognosis. (authors)

  7. Dosimetric comparison of the related parameters between simultaneous integrated boost intensity-modulated radiotherapy and sequential boost conformal radiotherapy for postoperative malignant glioma of the brain

    International Nuclear Information System (INIS)

    Shao Qian; Lu Jie; Li Jianbin; Sun Tao; Bai Tong; Liu Tonghai; Yin Yong

    2011-01-01

    Objective: To compare the dosimetric of different parameter of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) with sequential boost conformal radiotherapy (SB-CRT) for postoperative malignant glioma of the brain. Methods: Ten patients with malignant glioma of brain were selected to study. Each patient was simulated all by CT and MRI, and the imagings of CT and MRI were all sent to Pinnacle 3 planning system. The fusion technology with MR-CT imaging was used on Pinnacle 3 planning system. The target volume was delineated and defined based on MRI. The postoperative residual lesion and resection cavity were defined as gross tumor volume (GTV) and expanded GTV some scope was defined as clinical target volume (CTV). The margins of GTV expanded 10 mm and 25 mm were defined as CTV1 and CTV2 respectively. CTV1 and CTV2 all enlarged 5 mm were defined as PTV1 and PTV2 respectively. The plans of simultaneous integrated boost intensity-modulated radiotherapy and sequential boost conformal radiotherapy were respectively designed for each patient using Pinnacle 3 planning system and the dosimetric of different parameter was compared. The prescribe dose of SIB-IMRT was PTV1: 62.5 Gy/25 f, PTV2: 50.0 Gy/25 f; and SB-CRT was PTV1: 66.0 Gy/33 f, PTV2: 50.0 Gy/25 f. The dosimetries of different parameters of SIB-IMRT and SB-CRT were compared by using Paired-Samples T Test. Results: The maximum and mean dose of PTV1, PTV2, and brainstem were of significant difference (P 0.05). Conclusion: The SIB-IMRT plan is better than the SB-CRT plan. The CI and HI of SIB-IMRT are superior to SB-CRT. At the same time, it can preserve the important organs such as brainstem and reduce the mean dose of whole brain. On the other hand it can shorten the total period of therapy time. (authors)

  8. Effect of postoperative brachytherapy and external beam radiotherapy on functional outcomes of immediate facial nerve repair after radical parotidectomy.

    Science.gov (United States)

    Hontanilla, Bernardo; Qiu, Shan-Shan; Marré, Diego

    2014-01-01

    There is much controversy regarding the effect of radiotherapy on facial nerve regeneration. However, the effect of brachytherapy has not been studied. Fifty-three patients underwent total parotidectomy of which 13 were radical with immediate facial nerve repair with sural nerve grafts. Six patients (group 1) did not receive adjuvant treatment whereas 7 patients (group 2) received postoperative brachytherapy plus radiotherapy. Functional outcomes were compared using Facial Clima. Mean percentage of blink recovery was 92.6 ± 4.2 for group 1 and 90.7 ± 5.2 for group 2 (p = .37). Mean percentage of commissural excursion restoration was 78.1 ± 3.5 for group 1 and 74.9 ± 5.9 for group 2 (p = .17). Mean time from surgery to first movement was 5.7 ± 0.9 months for group 1 and 6.3 ± 0.5 months for group 2 (p = .15). Brachytherapy plus radiotherapy does not affect the functional outcomes of immediate facial nerve repair with nerve grafts. Copyright © 2013 Wiley Periodicals, Inc.

  9. Evaluation of the radiotherapy combined with surgery for extrahepatic bile duct cancer and pancreatoduodenal cancer

    International Nuclear Information System (INIS)

    Takezawa, Jiro

    1984-01-01

    Curative resection of extrahepatic bile duct cancer and pancreatoduodenal cancer is very difficult, and its long term result is pessimistic. Twenty patients with bile duct cancer (12 resected and 8 non-resected) and 23 patients with pancreatoduodenal cancer (10 resected and 13 non-resected) were treated with extracorporeal Cobalt-60 irradiation following the surgery. The just opposed anterior and posterior ports were used with the field size ranging from 6 x 6 cm to 13 x 14 cm. The delivered doses ranged from 46 to 60 Gy (70 - 108TDF) for bile duct cancer, and from 18 to 66 Gy (28 - 104TDF) for pancreatoduodenal cancer. On one of resected and 4 of non-resected patients with pancreatoduodenal cancer, the therapeutic schedule could not be pursued completely because of decreased leucocytes and emaciation. The postoperative survivals were compared between the cases with and without adjunctive radiotherapy. The longest and mean survivals of the patients with resected bile duct cancer were 41 mos. and 20 mos. respectively, in the irradiated v.s. 21 mos. and 14 mos. in the non-irradiated group. The mean survival of the patients without resection of bile duct cancer was 15 mos. in the irradiated v.s. 6 mos. in the non-irradiated group; one resected case has survived more than 61 mos. after radiotherapy and is still alive. The mean survival after resection of pancreatoduodenal cancer was 16 mos. in the irradiated v.s. 11 mos. in non-irradiated group, and 3 in the former are still alive, one having survived the longest 50 mos. The longest and mean survival of the patients without resection of pancreatoduodenal cancer were 22 mos. and 8 mos. respectively v.s. 7 mos. and 4 mos. of the non-irradiated patients. Advantageous effects of radiotherapy combined with surgery for bile duct cancer and pancreatoduodenal cancer were observed throughout this clinical study. (author)

  10. Combining Targeted Agents With Modern Radiotherapy in Soft Tissue Sarcomas

    Science.gov (United States)

    Wong, Philip; Houghton, Peter; Kirsch, David G.; Finkelstein, Steven E.; Monjazeb, Arta M.; Xu-Welliver, Meng; Dicker, Adam P.; Ahmed, Mansoor; Vikram, Bhadrasain; Teicher, Beverly A.; Coleman, C. Norman; Machtay, Mitchell; Curran, Walter J.

    2014-01-01

    Improved understanding of soft-tissue sarcoma (STS) biology has led to better distinction and subtyping of these diseases with the hope of exploiting the molecular characteristics of each subtype to develop appropriately targeted treatment regimens. In the care of patients with extremity STS, adjunctive radiation therapy (RT) is used to facilitate limb and function, preserving surgeries while maintaining five-year local control above 85%. In contrast, for STS originating from nonextremity anatomical sites, the rate of local recurrence is much higher (five-year local control is approximately 50%) and a major cause of death and morbidity in these patients. Incorporating novel technological advancements to administer accurate RT in combination with novel radiosensitizing agents could potentially improve local control and overall survival. RT efficacy in STS can be increased by modulating biological pathways such as angiogenesis, cell cycle regulation, cell survival signaling, and cancer-host immune interactions. Previous experiences, advancements, ongoing research, and current clinical trials combining RT with agents modulating one or more of the above pathways are reviewed. The standard clinical management of patients with STS with pretreatment biopsy, neoadjuvant treatment, and primary surgery provides an opportune disease model for interrogating translational hypotheses. The purpose of this review is to outline a strategic vision for clinical translation of preclinical findings and to identify appropriate targeted agents to combine with radiotherapy in the treatment of STS from different sites and/or different histology subtypes. PMID:25326640

  11. Radiotherapy in combination with vascular-targeted therapies

    International Nuclear Information System (INIS)

    Ciric, Eva; Sersa, Gregor

    2010-01-01

    Given the critical role of tumor vasculature in tumor development, considerable efforts have been spent on developing therapeutic strategies targeting the tumor vascular network. A variety of agents have been developed, with two general approaches being pursued. Antiangiogenic agents (AAs) aim to interfere with the process of angiogenesis, preventing new tumor blood vessel formation. Vascular-disrupting agents (VDAs) target existing tumor vessels causing tumor ischemia and necrosis. Despite their great therapeutic potential, it has become clear that their greatest clinical utility may lie in combination with conventional anticancer therapies. Radiotherapy is a widely used treatment modality for cancer with its distinct therapeutic challenges. Thus, combining the two approaches seems reasonable. Strong biological rationale exist for combining vascular-targeted therapies with radiation. AAs and VDAs were shown to alter the tumor microenvironment in such a way as to enhance responses to radiation. The results of preclinical and early clinical studies have confirmed the therapeutic potential of this new treatment strategy in the clinical setting. However, concerns about increased normal tissue toxicity, have been raised

  12. Development of radiation oncology learning system combined with multi-institutional radiotherapy database (ROGAD)

    International Nuclear Information System (INIS)

    Takemura, Akihiro; Iinuma, Masahiro; Kou, Hiroko; Harauchi, Hajime; Inamura, Kiyonari

    1999-01-01

    We have constructed and are operating a multi-institutional radiotherapy database ROGAD (Radiation Oncology Greater Area Database) since 1992. One of it's purpose is 'to optimize individual radiotherapy plans'. We developed Radiation oncology learning system combined with ROGAD' which conforms to that purpose. Several medical doctors evaluated our system. According to those evaluations, we are now confident that our system is able to contribute to improvement of radiotherapy results. Our final target is to generate a good cyclic relationship among three components: radiotherapy results according to ''Radiation oncology learning system combined with ROGAD.'; The growth of ROGAD; and radiation oncology learning system. (author)

  13. Timescale of evolution of late radiation injury after postoperative radiotherapy of breast cancer patients

    International Nuclear Information System (INIS)

    Johansson, Silvia; Svensson, Hans; Denekamp, Juliana

    2000-01-01

    Purpose: To evaluate the incidence and prevalence of various signs of late morbidity, their time of appearance and pattern of progression during an observation period up to 34 years in breast cancer patients treated with postoperative radiation therapy after radical mastectomy. Methods and Materials: A group of 71 breast cancer patients received in 1963-1965 aggressive postoperative telecobalt therapy to the parasternal, axillary, and supraclavicular lymph node regions after total mastectomy and axillary clearance. None of the patients received chemotherapy either prior to, or after the irradiation as part of their primary treatment. The prescribed dose to the three lymph node regions was 44 Gy in 11 fractions. Only two of the three fields were treated per day. This total dose was given in 16-17 fractions over 3-4 weeks. Because of the overlap of the supraclavicular and axillary fields, the dose received by the brachial plexus was not the dose that was prescribed. A retrospective dose calculation showed that the total dose to the brachial plexus was 57 Gy, delivered as a complex combination of 1.8 Gy, 3.4 Gy, and 5.2 Gy fractions. This cohort of patients has now been followed to 34 years and the late side effects of the treatment evaluated and scored. Results: This series is unique in the literature. There is no comparable report of a detailed long-term follow-up in a homogeneously treated group of patients with such a high survival, especially among the younger women, where it is almost 50% at 30 years. This is the reason that they were able to develop some of the very slowly evolving injuries. There was progression of many of the late effects in the period between 5 and 34 years. The more serious morbidities have increased progressively over the whole 34-year follow-up period. Ninety-two percent of the long-term survivors have paralysis of their arm. Other neurological findings included unilateral vocal cord paralysis among 5% of the patients, who developed the

  14. A combination of modified transnasal endoscopic maxillectomy via transnasal prelacrimal recess approach with or without radiotherapy for selected sinonasal malignancies.

    Science.gov (United States)

    He, Shuangba; Bakst, Richard L; Guo, Tao; Sun, Jingwu

    2015-10-01

    An external approach for resection of sinonasal tumors is associated with increased morbidity. Therefore, we employed a modified transnasal endoscopic maxillectomy combined with pre and/or postoperative radiotherapy for early stage maxillary carcinomas. It aims to evaluate our early experience with endoscopic resection of selected malignant sinonasal tumors. The medical and radiology records of patients who underwent endonasal endoscopic resection of malignant sinonasal tumors between 2008 and 2012 were retrospectively reviewed. Ten cases of selected malignant tumor were performed to resect by modified transnasal endoscopic maxillectomy. All the patients were without evidence of disease at a mean follow-up of 26.8 months. No major complications were recorded. The mean hospitalization stay was 6.6 days. In very carefully selected cases of malignant tumors, modified transnasal endoscopic maxillectomy is acceptable. The postoperative complication rate is low, cosmetic outcome is excellent and patients do not require a long hospitalization.

  15. Results of primary and postoperative radiotherapy of malignant tumours of the larynx and posterior pharynx

    International Nuclear Information System (INIS)

    Poppele, G.

    1980-01-01

    In a study on the epidemiology of laryngeal and pharyngeal tumours, a coincidence was found between established alcohol abuse and tumours of the two organs. The results of surgery followed by gammatron radiotherapy (laryngeal tumours) or betatron therapy (pharyngeal tumours) are prescuted and discussed. (APR) [de

  16. Effects of health education intervention on negative emotion and quality of life of patients with laryngeal cancer after postoperative radiotherapy.

    Science.gov (United States)

    Han, J; Nian, H; Zheng, Z-Y; Zhao, M-M; Xu, D; Wang, C

    2018-02-01

    The study aimed to explore and analyze the effects of health education intervention on patients with laryngeal cancer and evaluate negative emotions and quality of life after receiving postoperative radiotherapy. Furthermore the relationship between health education intervention methods and its correlation to complications and relapse rates require greater understanding. Patients with aryngeal cancer receiving surgery and postoperative radiotherapy were randomly divided into observation and control groups. A quality of life questionnaire was used to evaluate patients' current life quality as well as negative emotions experienced. The collected data was evaluated using the Self-rating Anxiety Scale (SAS) as well as the Self-rating Depression Scale (SDS). At the time of discharge, patients' satisfaction on nursing and perception of health knowledge was assessed. Three and six months after discharge, patients were given follow-up visits and questionnaire surveys to evaluate their rehabilitation. This was done in relation with the Morningside Rehabilitation Stats Scale (MRSS), incidence of complications and recurrence. The scores of negative emotions, exhibited during the study, were lower in the observation group than in the control group. A month after discharge had a positive correlation to improved quality of life. This was highlighted in the observation group in comparison with the control group. The data collected following discharge revealed an improvement in quality of life, compared with that at the time of admission. Compared with the control group, the SAS and SDS scores in the observation group were decreased a month after discharge. Compared with the scores on admission, the SAS and SDS scores in both groups were decreased one month after discharge. The observation group had a lower incidence of complications than that of the control group. Six months after discharge, in the observation group, the MRSS score was lower than before discharge while in the

  17. Radiotherapy combined with tegafur for inoperable advanced gastric carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, K; Asakawa, H; Otawa, H; Yamada, S [Miyagi Prefectural Adult Disease Center, Natori (Japan)

    1982-02-01

    A total of 58 cases with inoperable advanced gastric carcinomas were treated by radiotherapy combined with tegafur, and the result was analyzed mainly from the aspects of life expectancies and some prognostic factors. Median survival time of all cases was 8.9 months. Actuarial survival rates at one, two, three, four and five years were 45%, 22%, 14%, 14% and 11% respectively. Cancer type, histologic type, tumor size and radiation effect on the primary lesion were chosen as the prognostic factors, and examined using median survival time as a parameter. Borrmann IV type cancer showed an unequivocally poor prognosis, whereas no significant prognostic differences were seen among other types. Poorly differentiated adenocarcinoma gave a poor prognosis. Radiation effect on the primary lesion seemed to have a positive correlation with prognosis, while life expectancies became shorter with the increase of tumor size. It seems, from the present study, that this combination therapy contributes a great deal to life prolongation of patients with inoperable advanced gastric carcinomas.

  18. COMBINATION OF MORPHINE AND GABAPENTIN LEADS TO SYNERGISTIC EFFECTS IN A RAT MODEL OF POSTOPERATIVE PAIN

    DEFF Research Database (Denmark)

    Papathanasiou, Theodoros; Juul, Rasmus Vestergaard; Heegaard, Anne-Marie

    Postoperative pain is a complex clinical condition that is still inadequately managed. Opioids remain the first line agents for the management of postoperative pain despite their side effects. Combination treatment with non-opioid agents that act at different sites within the central and peripheral...... of hindpaw withdrawal thresholds, after subcutaneous administration of morphine (0, 1, 3 and 7 mg/kg), gabapentin (0, 10, 30 and 100 mg/kg) or their combination (9 combinations of the above doses) were obtained using an electronic von Frey device. Surface of synergistic interaction (SSI) analysis was used...

  19. Combined radiotherapy and chemotherapy for high-grade brain tumours

    Science.gov (United States)

    Barazzuol, Lara

    Glioblastoma (GBM) is the most common primary brain tumour in adults and among the most aggressive of all tumours. For several decades, the standard care of GBM was surgical resection followed by radiotherapy alone. In 2005, a landmark phase III clinical trial coordinated by the European Organization for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC) demonstrated the benefit of radiotherapy with concomitant and adjuvant temozolomide (TMZ) chemotherapy. With TMZ, the median life expectancy in optimally managed patients is still only 12-14 months, with only 25% surviving 24 months. There is an urgent need for new therapies in particular in those patients whose tumour has an unmethylated methylguanine methyltransferase gene (MGMT) promoter, which is a predictive factor of benefit from TMZ. In this dissertation, the nature of the interaction between TMZ and radiation is investigated using both a mathematical model, based on in vivo population statistics of survival, and in vitro experimentation on a panel of human GBM cell lines. The results show that TMZ has an additive effect in vitro and that the population-based model may be insufficient in predicting TMZ response. The combination of TMZ with particle therapy is also investigated. Very little preclinical data exists on the effects of charged particles on GBM cell lines as well as on the concomitant application of chemotherapy. In this study, human GBM cells are exposed to 3 MeV protons and 6 MeV alpha particles in concomitance with TMZ. The results suggest that the radiation quality does not affect the nature of the interaction between TMZ and radiation, showing reproducible additive cytotoxicity. Since TMZ and radiation cause DNA damage in cancer cells, there has been increased attention to the use of poly(ADP-ribose) polymerase (PARP) inhibitors. PARP is a family of enzymes that play a key role in the repair of DNA breaks. In this study, a novel PARP inhibitor, ABT-888

  20. Postoperative radiotherapy in the rectal cancers patterns of care study for the years of 1998 ∼ 1999

    International Nuclear Information System (INIS)

    Kim, Jong Hoon; Oh, Do Hoon; Kang, Ki Moon

    2005-01-01

    To conduct a nationwide survey on the principles in radiotherapy for rectal cancer, and produce a database of Korean Patterns of Care Study. We developed web-based Patterns of Care Study system and a national survey was conducted using random sampling based on power allocation methods. Eligible patients were who had postoperative radiotherapy for rectal cancer without gross residual tumor after surgical resection and without previous history of other cancer and radiotherapy to pelvis. Data of patients were inputted to the web based PCS system by each investigators in 19 institutions. Information on 309 patients with rectal cancer who received radiotherapy between 1998 and 1999 were collected. Male to female ratio was 59:41, and the most common location of tumor was lower rectum (46%). Preoperative CEA was checked in 79% of cases and its value was higher than 6 ng/ml in 32%. Pathologic stage were I in 1.6%, II in 32%, III in 63%, and IV in 1.6%. Low anterior resection was the most common type of surgery and complete resection was performed in 95% of cases. Distal resection margin was less than 2 cm in 30%, and number of lymph node dissected was less than 12 in 31%. Chemotherapy was performed in 91% and most common regiment was 5-FU and leucovorine (69%). The most common type of field arrangement used for the initial pelvic field was the four field box (Posterior-Right-Left) technique (65.0%), and there was no AP-PA parallel opposing field used. Patient position was prone in 81.2%, an the boost field was used in 61.8%. To displace bowel outward, pressure modulating devices or bladder filling was used in 40.1%. Radiation dose was prescribed to isocenter in 45.3% and to isodose line in 123 cases (39.8%). Percent delivered dose over 90% was achieved in 92.2%. We could find the Patterns of Care for the radiotherapy in Korean rectal cancer patients was similar to that of US national survey. The type of surgery and the regimen of chemotherapy were variable according to

  1. Intensity Modulated Radiotherapy (IMRT in the postoperative treatment of an adenocarcinoma of the endometrium complicated by a pelvic kidney

    Directory of Open Access Journals (Sweden)

    Novaes Paulo ERS

    2006-11-01

    Full Text Available Abstract Background Pelvic Radiotherapy (RT as a postoperative treatment for endometrial cancer improves local regional control. Brachytherapy also improves vaginal control. Both treatments imply significant side effects that a fine RT technique can help avoiding. Intensity Modulated RT (IMRT enables the treatment of the target volume while protecting normal tissue. It therefore reduces the incidence and severity of side effects. Case We report on a 50 year-old patient with a serous-papiliferous adenocarcinoma of the uterus who was submitted to surgical treatment without lymph node sampling followed by Brachytherapy, and Chemotherapy. The patient had a pelvic kidney, and was therefore treated with IMRT. So far, the patient has been free from relapse and with normal kidney function. Conclusion IMRT is a valid technique to prevent the kidney from radiation damage.

  2. Intensity Modulated Radiotherapy (IMRT) in the postoperative treatment of an adenocarcinoma of the endometrium complicated by a pelvic kidney

    International Nuclear Information System (INIS)

    Castilho, Marcus S; Jacinto, Alexandre A; Viani, Gustavo A; Campana, Andre; Carvalho, Juliana; Ferrigno, Robson; Novaes, Paulo ERS; Fogaroli, Ricardo C; Salvajoli, Joao V

    2006-01-01

    Pelvic Radiotherapy (RT) as a postoperative treatment for endometrial cancer improves local regional control. Brachytherapy also improves vaginal control. Both treatments imply significant side effects that a fine RT technique can help avoiding. Intensity Modulated RT (IMRT) enables the treatment of the target volume while protecting normal tissue. It therefore reduces the incidence and severity of side effects. We report on a 50 year-old patient with a serous-papiliferous adenocarcinoma of the uterus who was submitted to surgical treatment without lymph node sampling followed by Brachytherapy, and Chemotherapy. The patient had a pelvic kidney, and was therefore treated with IMRT. So far, the patient has been free from relapse and with normal kidney function. IMRT is a valid technique to prevent the kidney from radiation damage

  3. Prognostic analysis of uterine cervical cancer treated with postoperative radiotherapy: importance of positive or close parametrial resection margin

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Jun; Lee, Kyung Ja; Park, Kyung Ran [Dept. of Radiation Oncology, (Korea, Republic of); and others

    2015-06-15

    To analyze prognostic factors for locoregional recurrence (LRR), distant metastasis (DM), and overall survival (OS) in cervical cancer patients who underwent radical hysterectomy followed by postoperative radiotherapy (PORT) in a single institute. Clinicopathologic data of 135 patients with clinical stage IA2 to IIA2 cervical cancer treated with PORT from 2001 to 2012 were reviewed, retrospectively. Postoperative parametrial resection margin (PRM) and vaginal resection margin (VRM) were investigated separately. The median treatment dosage of external beam radiotherapy (EBRT) to the whole pelvis was 50.4 Gy in 1.8 Gy/fraction. High-dose-rate vaginal brachytherapy after EBRT was given to patients with positive or close VRMs. Concurrent platinum-based chemoradiotherapy (CCRT) was administered to 73 patients with positive resection margin, lymph node (LN) metastasis, or direct extension of parametrium. Kaplan-Meier method and log-rank test were used for analyzing LRR, DM, and OS; Cox regression was applied to analyze prognostic factors. The 5-year disease-free survival was 79% and 5-year OS was 91%. In univariate analysis, positive or close PRM, LN metastasis, direct extension of parametrium, lymphovascular invasion, histology of adenocarcinoma, and chemotherapy were related with more DM and poor OS. In multivariate analysis, PRM and LN metastasis remained independent prognostic factors for OS. PORT after radical hysterectomy in uterine cervical cancer showed excellent OS in this study. Positive or close PRM after radical hysterectomy in uterine cervical cancer correlates with poor prognosis even with CCRT. Therefore, additional treatments to improve local control such as radiation boosting need to be considered.

  4. Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients.

    Science.gov (United States)

    Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

    2015-01-09

    This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997-2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis.

  5. Pre-radiotherapy feeding tube identifies a poor prognostic subset of postoperative p16 positive oropharyngeal carcinoma patients

    International Nuclear Information System (INIS)

    Verma, Vivek; Liu, Jingxia; Eschen, Laura; Danieley, Jonathan; Spencer, Christopher; Lewis, James S Jr; Diaz, Jason; Piccirillo, Jay F; Adkins, Douglas R; Nussenbaum, Brian; Thorstad, Wade L; Gay, Hiram A

    2015-01-01

    This study explores variables associated with poor prognosis in postoperative p16 positive oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing adjuvant radiotherapy or chemoradiotherapy. Specifically, analysis was done related to timing of feeding tube insertion relative to radiotherapy. From 1997–2009, of 376 consecutive patients with OPSCC, 220 received adjuvant IMRT, and 97 were p16 positive and eligible. Of these, 23 had feeding tube placement before IMRT (B-FT), 32 during/after IMRT (DA-FT), and 42 had no feeding tube (NO-FT). Feeding tubes were not placed prophylactically. These three groups were analyzed for differential tumor, patient, treatment, and feeding tube characteristics, as well as differences in overall survival (OS), disease free survival (DFS), and distant metastasis free survival (DMFS). Pre-RT FT insertion was associated with higher tumor size and depth, T (but not N) and overall stage, comorbidities, presence of chemotherapy, and less use of transoral laser microsurgery/transoral bovie. Additionally, time from surgery to IMRT completion was also statistically longer in the B-FT group. The feeding tube was permanent in 52% of patients in the B-FT group versus 16% in the DA-FT group (p = 0.0075). The 5-year OS for the NO-FT, DA-FT, and B-FT groups was 90%, 86%, and 50%, respectively. The 5-year DFS for the NO-FT, DA-FT, and B-FT groups was 87.6%, 83.6%, and 42.7%, respectively. Multivariate analysis showed that for OS and DFS, feeding tube placement timing and smoking history were statistically significant. Due to the poor prognosis of early FT insertion, the presence of FTs at time of radiotherapy consultation can be used as an alternate marker to identify a subset of p16 positive OPSCC patients that have a poor prognosis

  6. Assessment of buprenorphine, carprofen, and their combination for postoperative analgesia in olive baboons (Papio anubis).

    Science.gov (United States)

    Allison, Sarah O; Halliday, Lisa C; French, Jeffrey A; Novikov, Dmitri D; Fortman, Jeffrey D

    2007-05-01

    This study compared the efficacy of buprenorphine, carprofen, and a combination of the 2 analgesics in female baboons. Physiologic and behavioral parameters were assessed at baseline and postoperatively for 6 d by use of continuous noninvasive physiologic monitoring and twice-daily videotaping. Prior to surgery, all animals received a pre-emptive dose of either 0.01 mg/kg buprenorphine intramuscularly, 2.2 mg/kg carprofen intramuscularly, or a combination of 0.01 mg/kg buprenorphine and 2.2 mg/kg carprofen intramuscularly. All animals in the carprofen (n = 4) and buprenorphine+carprofen (n = 4) treatment groups appeared to have sufficient analgesia. Three of 4 animals in the buprenorphine group had adequate analgesia. The fourth animal had an elevated heart rate and spent less time standing during the postoperative period. In this study, the use of carprofen or a combination of carprofen plus buprenorphine provided more reliable postoperative analgesia than buprenorphine alone.

  7. Super-selective interventional chemotherapy combined with systemic chemotherapy for the treatment of postoperative gliomas:a clinical study

    International Nuclear Information System (INIS)

    Chen Jian; Hu Qinglei; Sun Yanchun; Feng Lei; Liu Yunzhen; Liu Ju; Kong Ruifen

    2010-01-01

    Objective: To evaluate super-selective interventional chemotherapy combined with systemic chemotherapy in treating postoperative gliomas. Methods: During the period of 2005-2009, a total of 46 patients with glioma were encountered in our hospital. According to the principle of patient's free will the involved patients were divided into two groups. Study group (n = 25): after operation the patients received routine radiotherapy, which was followed by super-selective interventional chemotherapy combined simultaneously with systemic chemotherapy. Control group (n = 21): after operation the patients received routine radiotherapy, which was followed by systemic chemotherapy only. The patients were regularly followed up. Cranial CT checkups were made to determine the tumor size, and the results were evaluated with Karnofsky scores. The clinical data were analyzed and compared between two groups. Results: In the study group, the side-effects and complications included epileptic seizures (n = 3), eye pain (n = 5), headache (n = 9), nausea and vomiting (n = 8) and thrombopenia (n = 1). In the control group,the side-effects and complications were as follows: epileptic seizures (n = 1), headache (n = 7), nausea and vomiting (n = 6) and thrombopenia(n = 3). No death occurred in either of the two groups. The patients were followed up for an average period of 2.3 years. Before chemotherapy no statistically significant difference in tumor size existed between two groups (P > 0.05). One year after the chemotherapy, the tumor volume in study group was reduced by 67.11%, while it was 45.79% in control group. By using independent sample t test analysis, the difference between two groups was of statistical significance (P < 0.05). Wilcoxon rank sum test and Karnofsky prognostic score analysis indicated that the prognosis of study group was much better than that of control group (P < 0.05). Conclusion: In comparison with routine radiotherapy plus simple systemic chemotherapy, routine

  8. Combined chemo/radiotherapy of cancer: present state and prospects for use with high-LET radiotherapy

    International Nuclear Information System (INIS)

    Phillips, T.L.

    1979-01-01

    Cytotoxic chemotherapy added to low-LET radiotherapy has improved survival and in some cases local control. In some instances the combination has yielded increased normal tissue damage. Similar results can be expected, as confirmed by intestinal crypt cell experiments, with high-LET. Less interaction than with low-LET appears to occur with agents blocking sublethal damage repair or causing synchronization. (author)

  9. Histopathologic findings of radiotherapy combined with chemotherapy on head and neck cancer

    International Nuclear Information System (INIS)

    Sakaino, Koji; Matsumoto, Mitsuomi; Satake, Bunsuke; Takahashi, Keiichi; Makino, Sotaro

    1979-01-01

    We studied in this series about histopathologic changes in radiotherapy of squamous cell carcinoma of head and neck. Then we recognized that radiotherapy combined with chemotherapy is useful for radioresistant squamous cell carcinoma. In this series, we studied about cancer of the tongue as one of the keratinizing squamous cell carcinoma and used Bleomycin as a chemotherapeutic drug. We commented as follows: 1. Radiotherapy combined with chemotherapy had benefit decreasing of a period for radium therapy. 2. Severs complication was not occurred in this series, then this combined therapy was useful for aged or handicapped patient. (author)

  10. Radiotherapy

    International Nuclear Information System (INIS)

    Prosnitz, L.R.; Kapp, D.S.; Weissberg, J.B.

    1983-01-01

    This review highlights developments over the past decade in radiotherapy and attempts to summarize the state of the art in the management of the major diseases in which radiotherapy has a meaningful role. The equipment, radiobiology of radiotherapy and carcinoma of the lung, breast and intestines are highlighted

  11. Clinical efficacy of radiotherapy combined with sodium glycididazole ...

    African Journals Online (AJOL)

    treatment group (treated with radiotherapy and sodium glycididazole) and a control group (treated with ... Side effects in both groups included alopecia, headache, nausea, vomiting and ... hypoxic cells in a solid carcinoma to low linear ...

  12. Postoperative Irradiation of Gynecologic Malignancies: Improving Treatment Delivery Using Aperture-Based Intensity-Modulated Radiotherapy

    International Nuclear Information System (INIS)

    Nadeau, Sylvain; Bouchard, Myriam; Germain, Isabelle; Raymond, Paul-Emile; Beaulieu, Frederic; Beaulieu, Luc; Roy, Rene; Gingras, Luc

    2007-01-01

    Purpose: To evaluate dosimetric and treatment delivery advantages of aperture-based intensity-modulated radiotherapy (AB-IMRT) for the treatment of patients receiving whole pelvic radiotherapy for gynecologic malignancies. Methods and Materials: Nineteen patients undergoing pelvic radiotherapy after resection of endometrial cancers were selected. A 45-Gy dose was prescribed to the target volume delineated on a planning CT scan. An in-house inverse planning system, Ballista, was used to develop a treatment plan using aperture-based multileaf collimator segments. This approach was compared with conventional four-field, enlarged four-field, and static beamlet-based IMRT (BB-IMRT) techniques in terms of target coverage, dose-volume histogram statistics for surrounding normal tissues, and numbers of segments and monitor units (MU). Results: Three quarters (76.4%) of the planning target volume received the prescription dose with conventional four-field plans. With adequate target coverage, the Ballista plans significantly reduced the volume of bowel and bladder irradiated at the prescribed dose (p < 0.001), whereas the two approaches provided equivalent results for the rectum (p 0.5). On the other hand, AB-IMRT and BB-IMRT plans showed only small differences in dose-volume histogram statistics of unknown clinical impact, whereas Ballista plan delivery required on average 73% and 59% fewer segments and MU, respectively. Conclusion: With respect to conventional techniques, AB-IMRT for the treatment of gynecologic malignancies provides dosimetric advantages similar to those with BB-IMRT but with clear treatment delivery improvements

  13. Postoperative Radiotherapy for Prostate Cancer: A Comparison of Four Consensus Guidelines and Dosimetric Evaluation of 3D-CRT Versus Tomotherapy IMRT

    International Nuclear Information System (INIS)

    Malone, Shawn; Croke, Jennifer; Roustan-Delatour, Nicolas; Belanger, Eric; Avruch, Leonard; Malone, Colin; Morash, Christopher; Kayser, Cathleen; Underhill, Kathryn; Li Yan; Malone, Kyle; Nyiri, Balazs; Spaans, Johanna

    2012-01-01

    Purpose: Despite the benefits of adjuvant radiotherapy after radical prostatectomy, approximately one-half of patients relapse. Four consensus guidelines have been published (European Organization for Research and Treatment of Cancer, Faculty of Radiation Oncology Genito-Urinary Group, Princess Margaret Hospital, Radiation Therapy Oncology Group) with the aim of standardizing the clinical target volume (CTV) delineation and improve outcomes. To date, no attempt has been made to compare these guidelines in terms of treatment volumes or organ at risk (OAR) irradiation. The extent to which the guideline-derived plans meet the dosimetric constraints of present trials or of the Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) trial is also unknown. Our study also explored the dosimetric benefits of intensity-modulated radiotherapy (IMRT). Methods and Materials: A total of 20 patients treated with postoperative RT were included. The three-dimensional conformal radiotherapy (3D-CRT) plans were applied to cover the guideline-generated planning target volumes (66 Gy in 33 fractions). Dose–volume histograms (DVHs) were analyzed for CTV/planning target volume coverage and to evaluate OAR irradiation. The OAR DVHs were compared with the constraints proposed in the QUANTEC and Radiotherapy and Androgen Deprivation In Combination After Local Surgery (RADICALS) trials. 3D-CRT plans were compared with the tomotherapy plans for the Radiation Therapy Oncology Group planning target volume to evaluate the advantages of IMRT. Results: The CTV differed significantly between guidelines (p < 0.001). The European Organization for Research and Treatment of Cancer-CTVs were significantly smaller than the other CTVs (p < 0.001). Differences in prostate bed coverage superiorly accounted for the major volumetric differences between the guidelines. Using 3D-CRT, the DVHs rarely met the QUANTEC or RADICALS rectal constraints, independent of the guideline used. The RADICALS

  14. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

    Directory of Open Access Journals (Sweden)

    Choi Eun

    2010-05-01

    Full Text Available Abstract Background The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T1-2N0-1 oral tongue squamous cell carcinoma (OSCC and to evaluate survival and prognostic factors. Methods Retrospective analysis of 86 patients with T1-2N0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3% received postoperative radiotherapy (PORT. Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. Results The median follow-up was 45 months. The five-year overall survival (OS and disease-free survival (DFS rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth. In the risk group, there was no local failure in patients with postoperative radiotherapy. Conclusions In T1-2N0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features.

  15. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy

    International Nuclear Information System (INIS)

    Shim, Su Jung; Cha, Jihye; Koom, Woong Sub; Kim, Gwi Eon; Lee, Chang Geol; Choi, Eun Chang; Keum, Ki Chang

    2010-01-01

    The aim of this study was to assess the results of curative surgery with and without radiotherapy in patients with T 1-2 N 0-1 oral tongue squamous cell carcinoma (OSCC) and to evaluate survival and prognostic factors. Retrospective analysis of 86 patients with T 1-2 N 0-1 OSCC who received surgery between January 2000 and December 2006. Fourteen patients (16.3%) received postoperative radiotherapy (PORT). Patient characteristics, tumor characteristics, treatment modality, failure patterns, and survival rates were analyzed. The median follow-up was 45 months. The five-year overall survival (OS) and disease-free survival (DFS) rates were 80.8% and 80.2%, respectively. Higher tumor grade and invasion depth ≥ 0.5 cm were the significant prognostic factors affecting five-year OS and DFS (OS rate; 65% vs. 91%, p = 0.001 for grade; 66% vs. 92%, p = 0.01 for invasion depth: DFS rate; 69% vs. 88%, p = 0.005 for grade; 66% vs. 92%, p = 0.013 for invasion depth). In the risk group, there was no local failure in patients with postoperative radiotherapy. In T 1-2 N 0-1 OSCC, factors that affected prognosis after primary surgery were higher tumor grade and deep invasion depth over 0.5 cm. Postoperative radiotherapy should be considered in early oral tongue cancer patients with these high-risk pathologic features

  16. Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF).

    Science.gov (United States)

    Lucatelli, Pierleone; Sacconi, Beatrice; Cereatti, Fabrizio; Argirò, Renato; Corona, Mario; Bezzi, Mario; Fanelli, Fabrizio; Fiocca, Fausto; Saba, Luca; Catalano, Carlo

    2016-09-01

    Postoperative pancreatic fistula (POPF) with leakage of pancreatic juice is a rare, severe complication following pancreatic resection or, less commonly, splenectomy. Definitive treatment can require multidisciplinary approaches. We report a case of stenosis of the main pancreatic duct with distal tail GRADE C POPF, occurred after splenectomy for Hodgkin lymphoma, successfully treated with combined radiological-endoscopic approach.

  17. Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF)

    International Nuclear Information System (INIS)

    Lucatelli, Pierleone; Sacconi, Beatrice; Cereatti, Fabrizio; Argirò, Renato; Corona, Mario; Bezzi, Mario; Fanelli, Fabrizio; Fiocca, Fausto; Saba, Luca; Catalano, Carlo

    2016-01-01

    Postoperative pancreatic fistula (POPF) with leakage of pancreatic juice is a rare, severe complication following pancreatic resection or, less commonly, splenectomy. Definitive treatment can require multidisciplinary approaches. We report a case of stenosis of the main pancreatic duct with distal tail GRADE C POPF, occurred after splenectomy for Hodgkin lymphoma, successfully treated with combined radiological-endoscopic approach.

  18. Combined Endoscopic-Radiological Rendezvous for Distal Tail Postoperative Pancreatic Fistula (POPF)

    Energy Technology Data Exchange (ETDEWEB)

    Lucatelli, Pierleone, E-mail: pierleone.lucatelli@gmail.com; Sacconi, Beatrice, E-mail: beatrice.sacconi@fastwebnet.it [“Sapienza” University of Rome, Department of Radiological Sciences, Oncological and Anatomo-pathological Sciences, Vascular and Interventional Radiology Unit (Italy); Cereatti, Fabrizio, E-mail: fcereatti@yahoo.com [“Sapienza” University of Rome, Department of General Surgery Paride Stefanini, Interventional Endoscopy Unit (Italy); Argirò, Renato, E-mail: renato.argiro@gmail.com; Corona, Mario, E-mail: mario.corona68@gmail.com; Bezzi, Mario, E-mail: mario.bezzi@uniroma1.it; Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it [“Sapienza” University of Rome, Department of Radiological Sciences, Oncological and Anatomo-pathological Sciences, Vascular and Interventional Radiology Unit (Italy); Fiocca, Fausto, E-mail: fausto.fiocca@uniroma1.it [“Sapienza” University of Rome, Department of General Surgery Paride Stefanini, Interventional Endoscopy Unit (Italy); Saba, Luca, E-mail: lucasabamd@gmail.com [Azienda Ospedaliero Universitaria di Cagliari-Polo di Monserrato, Department of Radiology (Italy); Catalano, Carlo, E-mail: carlo.catalano@uniroma1.it [“Sapienza” University of Rome, Department of Radiological Sciences, Oncological and Anatomo-pathological Sciences, Vascular and Interventional Radiology Unit (Italy)

    2016-09-15

    Postoperative pancreatic fistula (POPF) with leakage of pancreatic juice is a rare, severe complication following pancreatic resection or, less commonly, splenectomy. Definitive treatment can require multidisciplinary approaches. We report a case of stenosis of the main pancreatic duct with distal tail GRADE C POPF, occurred after splenectomy for Hodgkin lymphoma, successfully treated with combined radiological-endoscopic approach.

  19. Rule of lymph node metastasis and proper target of postoperative radiotherapy for thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Xiao Zefen; Zhou Zongmei; Lv Jima; Liang Jun; Ou Guangfei; Jin Jing; Song Yongwen; Zhang Shiping; Yin Weibo

    2008-01-01

    Objective: To analyze the rule of lymph node metastasis in thoracic esophageal carcinoma, and to study the proper radiation target. Methods: From September 1986 to December 1997,549 patients with esophageal carcinoma who had undergone radical resection were divided into surgery alone group (S,275 patients) or surgery plus radiotherapy group(S + R,274 patients). Radiotherapy was begun 3 to 4 weeks after operation. The radiation target included both supra-clavicular areas and the entire mediastinum. The total dose was 50 Gy in 25 fractions over 5 weeks for the supra-clavicular areas and 60 Gy in 30 fractions over 6 weeks for the entire mediastinum. Results: The 5-year overall survival of patients with lymph node metastasis in one anatomic site and two anatomic sites was 31.5% and 13.9% (P=0.013), respectively. For patients with > 2 positive nodes metastasis receiving surgery alone, the corresponding 5-year survival was 24.8% and 4.9% (P=0.046), respectively. The median number of dissected lymph nodes of the upper-, middle-and lower-segment esophageal carcinoma was 13, 17 and 20, respectively. The rate of metastatic lymph node in the para-esophagus region was the highest(61.5%-64.9%), which was not different among the different primary sites (P=0.922). The anastomotic stoma recurrence rate of the upper-segment esophageal carcinoma was higher than that of the middle- or lower-segment carcinomas (16.7%, 3.1%, and 7.7%, χ 2 =9.02,P<0.05). Conclusions: For the thoracic esophageal carcinoma, the number of anatomic sites of lymph node metastasis is an important factor affecting the survival. The lower rate of lymph node metastasis of the upper segment esophageal carcinoma may be corrected with the less lymph node dissected. The rate of lymph node metastasis in para-esophageal region is not related with the lesion segment. The anastomotic stoma is an important radiotherapy target for upper segment esophageal carcinoma. (authors)

  20. Analysis of postoperative vaginal vault radiotherapy of stage I endometrial cancer with different radionuclides

    International Nuclear Information System (INIS)

    Ryberg, M.; Einhorn, N.; Hamed, A.F.A.; Ruden, B.I.; Nilsson, B.

    1998-01-01

    A total of 213 patients in stage I grade 1 endometrical cancer were treated postoperatively with either radium or caesium vaginal applicators. The rate of complication and the incidence of second malignancies were studied in both groups. The frequency of grades 2 and 3 vaginal complications was higher among patients treated with caesium applicators but not statistically significant. The observed number of second malignancies was significantly higher than expected in the radium-treated group, in which the observed number of second malignancies with distant location was also significantly higher than expected, which could not be found in the caesium group. (orig.)

  1. Virtual 3D tumor marking-exact intraoperative coordinate mapping improve post-operative radiotherapy

    International Nuclear Information System (INIS)

    Essig, Harald; Gellrich, Nils-Claudius; Rana, Majeed; Meyer, Andreas; Eckardt, André M; Kokemueller, Horst; See, Constantin von; Lindhorst, Daniel; Tavassol, Frank; Ruecker, Martin

    2011-01-01

    The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D) allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP) allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine) in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor) to oncologists, radiotherapists and pathologists

  2. Virtual 3D tumor marking-exact intraoperative coordinate mapping improve post-operative radiotherapy

    Directory of Open Access Journals (Sweden)

    Essig Harald

    2011-11-01

    Full Text Available Abstract The quality of the interdisciplinary interface in oncological treatment between surgery, pathology and radiotherapy is mainly dependent on reliable anatomical three-dimensional (3D allocation of specimen and their context sensitive interpretation which defines further treatment protocols. Computer-assisted preoperative planning (CAPP allows for outlining macroscopical tumor size and margins. A new technique facilitates the 3D virtual marking and mapping of frozen sections and resection margins or important surgical intraoperative information. These data could be stored in DICOM format (Digital Imaging and Communication in Medicine in terms of augmented reality and transferred to communicate patient's specific tumor information (invasion to vessels and nerves, non-resectable tumor to oncologists, radiotherapists and pathologists.

  3. A comparison of three antiemetic combinations for the prevention of postoperative nausea and vomiting.

    Science.gov (United States)

    Sanchez-Ledesma, M J; López-Olaondo, L; Pueyo, F J; Carrascosa, F; Ortega, A

    2002-12-01

    In this study we compared the efficacy and safety of three antiemetic combinations in the prevention of postoperative nausea and vomiting (PONV). Ninety ASA status I-II women, aged 18-65 yr, undergoing general anesthesia for major gynecological surgery, were included in a prospective, randomized, double-blinded study. A standardized anesthetic technique and postoperative analgesia (intrathecal morphine plus IV patient-controlled analgesia (PCA) with morphine) were used in all patients. Patients were randomly assigned to receive ondansetron 4 mg plus droperidol 1.25 mg after the induction of anesthesia and droperidol 1.25 mg 12 h later (Group 1, n = 30), dexamethasone 8 mg plus droperidol 1.25 mg after the induction of anesthesia and droperidol 1.25 mg 12 h later (Group 2, n = 30), or ondansetron 4 mg plus dexamethasone 8 mg after the induction of anesthesia and placebo 12 h later (Group 3, n = 30). A complete response, defined as no PONV in 48 h, occurred in 80% of patients in Group 1, 70% in Group 3, and 40% in Group 2 (P = 0.004 versus Groups 1 and 3). The incidences of side effects and other variables that could modify the incidence of PONV were similar among groups. In conclusion, ondansetron, in combination with droperidol or dexamethasone, is more effective than dexamethasone in combination with droperidol in women undergoing general anesthesia for major gynecological surgery with intrathecal morphine plus IV PCA with morphine for postoperative analgesia. The combination of ondansetron plus dexamethasone or droperidol was significantly better than the combination of dexamethasone plus droperidol in the prophylaxis of postoperative nausea and vomiting in women undergoing general anesthesia for major gynecological surgery, with intrathecal and IV morphine (patient-controlled analgesia) for management of postoperative pain.

  4. Outcome of 289 locally advanced non-small cell lung cancer treated with radiotherapy alone and radiotherapy combined with chemotherapy

    International Nuclear Information System (INIS)

    Ou Guangfei; Wang Lvhua; Zhang Hongxing; Chen Dongfu; Xiao Zefen; Feng Qinfu; Zhou Zongmei; Lv Jima; Liang Jun; Wang Mei; Yin Weibo

    2007-01-01

    Objective: To retrospectively analyze the outcome of locally advanced non-small cell lung cancer patients treated with radiotherapy and chemoradiotherapy. Methods: 289 patients who were treated either by radiotherapy alone (168 patients) or radiotherapy plus chemotherapy (121 patients) from Dec. 1999 to Dec. 2002 were entered into the database for analysis. Pathological types: squamous cancer (152), adenocarcinoma(74), squamoadenocarcinoma(2) and other types (2). 24 showed cancer unclassificable and 35 were diagnosed without pathological proof. Stages: 74 had III A and 215 III B stage disease. Among the 121 patients treated with combined modality, 24 were treated with concurrent chemoradiotherapy, 78 radiotherapy after chemotherapy(C + R), and 19 radiotherapy followed by chemotherapy(R + C). In patients treated by concurrent chemoradiotherapy or C + R, 38 received consolidation chemotherapy after induction treatment. Results: The 1-, 3-, 5-year overall survival, and the median survival were: 45% , 16% , 8%, and 16.2 months for all patients; 57%, 27%, 11%, and 21.7 months for stage IIIA; 41%, 12%, 7%, and 15.3 months for IIIB. By logrank test, clinical stage, KPS performance, tumor volume, hemoglobin level before treatment, consolidation chemotherapy, radiation dose, and response to treatment showed statistically dramatic impact on overall survival. The overall survival rate and median survival time were slightly higher in the combined group than in the radiotherapy alone group, but the difference is statistically insignificant. In Cox multivariable regression, stage and consolidation chemotherapy were independent prognostic factors; KPS performance, radiation dose, and response to treatment were at the margin of statistical significance. Esophagitis and pneumonitis of Grade II or higher were 24% and 8%, respectively. Failure sites included in the thorax(41%), outside of thorax(48%), and both in and outside the thorax(11%). There was no difference between the

  5. Histomorphological changes of vessel structure in head and neck vessels following preoperative or postoperative radiotherapy

    International Nuclear Information System (INIS)

    Schultze-Mosgau, S.; Wehrhan, F.; Wiltfang, J.; Grabenbauer, G.G.; Sauer, R.; Roedel, F.; Radespiel-Troeger, M.

    2002-01-01

    Patients and Methods: In 348 patients (October 1995-March 2002) receiving primarly or secondarily 356 microvascular hard- and soft tissue reconstruction, a total of 209 vessels were obtained from neck recipient vessels and transplant vessels during anastomosis. Three groups were analysed: group 1 (27 patients) treated with no radiotherapy or chemotherapy; group 2 (29 patients) treated with preoperative irradiation (40-50 Gy) and chemotherapy (800 mg/m 2 /day 5-FU and 20 mg/m 2 /day cisplatin) 1.5 months prior to surgery; group 3 (20 patients) treated with radiotherapy (60-70 Gy) (median interval 78.7 months; IQR: 31.3 months) prior to surgery. From each of the 209 vessel specimens, 3 sections were investigated histomorphometrically, qualitatively and quantitatively (ratio media area/total vessel area) by NIH-Image-digitized measurements. To evaluate these changes as a function of age, radiation dose and chemotherapy, a statistical analysis was performed using an analysis of covariance and χ 2 tests (p > 0.05, SPSS V10). Results: In group 3, qualitative changes (intima dehiscence, hyalinosis) were found in recipient arteries significantly more frequently than in groups 1 and 2. For group 3 recipient arteries, histomorphometry revealed a significant decrease in the ratio media area/total vessel area (median 0.51, IQR 0.10) in comparison with groups 1 (p = 0.02) (median 0.61, IQR 0.29) and 2 (p = 0.046) (median 0.58, IQR 0.19). No significant difference was found between the vessels of groups 1 and 2 (p = 0.48). There were no significant differences in transplant arteries and recipient or transplant veins between the groups. Age and chemotherapy did not appear to have a significant influence on vessel changes in this study (p > 0.05). Conclusions: Following irradiation with 60-70 Gy, significant qualitative and quantitative histological changes to the recipient arteries, but not to the recipient veins, could be observed. In contrast, irradiation at a dose of 40-50 Gy

  6. Protons Offer Reduced Normal-Tissue Exposure for Patients Receiving Postoperative Radiotherapy for Resected Pancreatic Head Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Romaine C., E-mail: rnichols@floridaproton.org [University of Florida Proton Therapy Institute, Jacksonsville, FL (United States); Huh, Soon N. [University of Florida Proton Therapy Institute, Jacksonsville, FL (United States); Prado, Karl L.; Yi, Byong Y.; Sharma, Navesh K. [Department of Radiation Oncology, University of Maryland, Baltimore, MD (United States); Ho, Meng W.; Hoppe, Bradford S.; Mendenhall, Nancy P.; Li, Zuofeng [University of Florida Proton Therapy Institute, Jacksonsville, FL (United States); Regine, William F. [Department of Radiation Oncology, University of Maryland, Baltimore, MD (United States)

    2012-05-01

    Purpose: To determine the potential role for adjuvant proton-based radiotherapy (PT) for resected pancreatic head cancer. Methods and Materials: Between June 2008 and November 2008, 8 consecutive patients with resected pancreatic head cancers underwent optimized intensity-modulated radiotherapy (IMRT) treatment planning. IMRT plans used between 10 and 18 fields and delivered 45 Gy to the initial planning target volume (PTV) and a 5.4 Gy boost to a reduced PTV. PTVs were defined according to the Radiation Therapy Oncology Group 9704 radiotherapy guidelines. Ninety-five percent of PTVs received 100% of the target dose and 100% of the PTVs received 95% of the target dose. Normal tissue constraints were as follows: right kidney V18 Gy to <70%; left kidney V18 Gy to <30%; small bowel/stomach V20 Gy to <50%, V45 Gy to <15%, V50 Gy to <10%, and V54 Gy to <5%; liver V30 Gy to <60%; and spinal cord maximum to 46 Gy. Optimized two- to three-field three-dimensional conformal proton plans were retrospectively generated on the same patients. The team generating the proton plans was blinded to the dose distributions achieved by the IMRT plans. The IMRT and proton plans were then compared. A Wilcoxon paired t-test was performed to compare various dosimetric points between the two plans for each patient. Results: All proton plans met all normal tissue constraints and were isoeffective with the corresponding IMRT plans in terms of PTV coverage. The proton plans offered significantly reduced normal-tissue exposure over the IMRT plans with respect to the following: median small bowel V20 Gy, 15.4% with protons versus 47.0% with IMRT (p = 0.0156); median gastric V20 Gy, 2.3% with protons versus 20.0% with IMRT (p = 0.0313); and median right kidney V18 Gy, 27.3% with protons versus 50.5% with IMRT (p = 0.0156). Conclusions: By reducing small bowel and stomach exposure, protons have the potential to reduce the acute and late toxicities of postoperative chemoradiation in this setting.

  7. Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting-the MSKCC experience

    International Nuclear Information System (INIS)

    Hoppe, Bradford S.; Stegman, Lauren D.; Zelefsky, Michael J.; Rosenzweig, Kenneth E.; Wolden, Suzanne L.; Patel, Snehal G.; Shah, Jatin P.; Kraus, Dennis H.; Lee, Nancy Y.

    2007-01-01

    Purpose: To perform a retrospective analysis of patients with paranasal sinus (PNS) cancer treated with postoperative radiotherapy (RT) at Memorial Sloan-Kettering Cancer Center. Methods and Materials: Between January 1987 and July 2005, 85 patients with PNS and nasal cavity cancer underwent postoperative RT. Most patients had squamous cell carcinoma (49%; n = 42), T4 tumors (52%; n = 36), and the maxillary sinus (53%; n = 45) as the primary disease site. The median radiation dose was 63 Gy. Of the 85 patients, 76 underwent CT simulation and 53 were treated with either three-dimensional conformal RT (27%; n = 23) or intensity-modulated RT (35%; n = 30). Acute and late toxicities were scored according to the Radiation Therapy Oncology Group radiation morbidity scoring criteria. Results: With a median follow-up for surviving patients of 60 months, the 5-year estimates of local progression-free, regional progression-free, distant metastasis-free, disease-free, and overall survival rates were 62%, 87%, 82%, 55%, and 67%, respectively. On multivariate analysis, squamous cell histology and cribriform plate involvement predicted for an increased likelihood of local recurrence, and squamous cell histologic features predicted for worse overall survival. None of the patients who underwent CT simulation and were treated with modern techniques developed a Grade 3-4 late complication of the eye. Conclusion: Complete surgical resection followed by adjuvant RT is an effective and safe approach in the treatment of PNS cancer. Emerging tools, such as three-dimensional conformal treatment and, in particular, intensity-modulated RT for PNS tumors, may minimize the occurrence of late complications associated with conventional RT techniques. Local recurrence remains a significant problem

  8. Clinical Studies on conformal radiotherapy combined with epidermal ...

    African Journals Online (AJOL)

    in second-line treatment of non-small cell lung cancer ... receptor-tyrosine kinase inhibitor (EGFR-TKI) in the second-line treatment of non-small cell ... were divided into two groups: 106 patients were treated with conformal ... Conformal radiotherapy, Targeted therapy, Survival rate .... regression model was used for survival.

  9. Results of postoperative 90Sr radiotherapy of keloids in view of patients' subjective assessment

    International Nuclear Information System (INIS)

    Fraunholz, I.B.; Gerstenhauer, A.; Boettcher, H.D.

    2005-01-01

    Background and Purpose: As treatment of keloids is mainly a cosmetic indication, the authors investigated, beyond the recurrence rate, the patients' satisfaction with the result and its correlation with objective medical findings. Patients and Methods: 83 keloids of 66 patients had been irradiated after excision by a uniform protocol with 4 x 5 Gy (strontium-90 [ 90 Sr] surface applicator). A questionnaire was developed and sent out in which, above all, the satisfaction with the therapeutic and cosmetic outcome was obtained. These results were correlated with objective parameters and medical findings which were ascertained during an extra follow-up examination. Results: Among 18 of the 41 patients (44%), who had answered the questionnaire, 19 of the 53 keloids treated (36%) had relapsed. 61% of the patients were extremely or mainly satisfied with the therapeutic outcome, 51% extremely or mainly satisfied with the cosmetic outcome. The relief from former keloid-caused symptoms (therapeutic outcome: p=0.0005; cosmetic outcome: p=0.0011), the ear as keloid localization (p=0.0008 and p=0.0197), and male gender (therapeutic outcome: p=0.0423) were significantly associated with higher satisfaction. The recurrence rate as well as the extent of radiation side effects had no significant influence on patients' assessment. Conclusion: Cosmetic aspects like the dermal side effects and the patients' satisfaction should be taken into account when evaluating the results of radiotherapy in keloids. (orig.)

  10. Outcomes after surgery and postoperative radiotherapy for perineural spread of head and neck cutaneous squamous cell carcinoma.

    Science.gov (United States)

    Warren, Timothy A; Panizza, Benedict; Porceddu, Sandro V; Gandhi, Mitesh; Patel, Parag; Wood, Martin; Nagle, Christina M; Redmond, Michael

    2016-06-01

    Queensland, Australia, has the highest rates of cutaneous squamous cell carcinoma (SCC). Perineural invasion (PNI) is associated with reduced local control and survival. A retrospective review of a prospective database of patients with clinical PNI from cutaneous SCC of the head and neck (SCCHN) treated with surgery and postoperative radiotherapy (PORT) between 2000 and 2011 and a minimum of 24 months follow-up. Patients were excluded if immunosuppressed, had non-SCC histology, or were treated palliatively. Fifty patients (mean age, 60 years) with median follow-up of 50 months were included in this study. A total of 54.8% of known primary tumors had incidental PNI. Ten percent had nodal disease at presentation. MRI neurogram was positive in 95.8%. Recurrence-free survival (RFS) at 5-years was 62%. Five-year disease-specific survival (DSS) and overall survival (OS) were 75% and 64%, respectively. There were no perioperative deaths. This report demonstrates that long-term survival is achievable in patients with clinical PNI from cutaneous SCCHN after surgery and PORT. © 2015 Wiley Periodicals, Inc. Head Neck 38: 824-831, 2016. © 2015 Wiley Periodicals, Inc.

  11. Setup errors and effectiveness of Optical Laser 3D Surface imaging system (Sentinel) in postoperative radiotherapy of breast cancer.

    Science.gov (United States)

    Wei, Xiaobo; Liu, Mengjiao; Ding, Yun; Li, Qilin; Cheng, Changhai; Zong, Xian; Yin, Wenming; Chen, Jie; Gu, Wendong

    2018-05-08

    Breast-conserving surgery (BCS) plus postoperative radiotherapy has become the standard treatment for early-stage breast cancer. The aim of this study was to compare the setup accuracy of optical surface imaging by the Sentinel system with cone-beam computerized tomography (CBCT) imaging currently used in our clinic for patients received BCS. Two optical surface scans were acquired before and immediately after couch movement correction. The correlation between the setup errors as determined by the initial optical surface scan and CBCT was analyzed. The deviation of the second optical surface scan from the reference planning CT was considered an estimate for the residual errors for the new method for patient setup correction. The consequences in terms for necessary planning target volume (PTV) margins for treatment sessions without setup correction applied. We analyzed 145 scans in 27 patients treated for early stage breast cancer. The setup errors of skin marker based patient alignment by optical surface scan and CBCT were correlated, and the residual setup errors as determined by the optical surface scan after couch movement correction were reduced. Optical surface imaging provides a convenient method for improving the setup accuracy for breast cancer patient without unnecessary imaging dose.

  12. Cardiopulmonary morbidity and quality of life in non-small cell lung cancer patients treated with or without postoperative radiotherapy

    International Nuclear Information System (INIS)

    Kepka, Lucyna; Bujko, Krzysztof; Orlowski, Tadeusz M.; Jagiello, Robert; Salata, Andrzej; Matecka-Nowak, Miroslawa; Janowski, Henryk; Rogowska, Danuta

    2011-01-01

    Aim: To prospectively assess the cardiopulmonary morbidity and quality of life in patients with non-small cell lung cancer (NSCLC) treated with postoperative radiotherapy (PORT) in comparison to those not receiving PORT. Materials and methods: From 2003 to 2007, 291 patients entered the study; 171 pN2 patients received 3D-planned PORT (PORT group), 120 pN1 patients (non-PORT group) did not. One month after surgery, all patients completed EORTC QLQ C-30 questionnaire and had pulmonary function tests (PFT); cardiopulmonary symptoms were assessed by modified LENT-SOM scale. Two years later, disease-free patients repeated the same examinations. The differences between baseline values and values recorded at two years in QLQ, LENT-SOM and the PFT of the two groups were compared. Results: In the whole cohort, the rate of non-cancer related deaths was 5.3% and 5.0% in PORT and non-PORT group, respectively. Ninety-five patients (47 - PORT group, 48 - non-PORT group) were included into the final analysis. The differences in the QLQ and cardiopulmonary function (LENT/SOM, PFT) between both groups were insignificant. The forced expiratory volume in one second was on average 12.2% and 1.3% better in the PORT and the non-PORT group, respectively, p = 0.2. Conclusions: Our findings support the hypothesis about insignificant morbidity of 3D-planned PORT.

  13. Target volume for postoperative radiotherapy in non-small cell lung cancer: Results from a prospective trial

    International Nuclear Information System (INIS)

    Kępka, Lucyna; Bujko, Krzysztof; Bujko, Magdalena; Matecka-Nowak, Mirosława; Salata, Andrzej; Janowski, Henryk; Rogowska, Danuta; Cieślak-Żerańska, Ewa; Komosińska, Katarzyna; Zawadzka, Anna

    2013-01-01

    Background and purpose: A previous prospective trial reported that three-dimensional conformal postoperative radiotherapy (PORT) for pN2 NSCLC patients using a limited clinical target volume (CTV) had a late morbidity rate and pulmonary function that did not differ from those observed in pN1 patients treated with surgery without PORT. The aim of this study was to assess locoregional control and localization of failure in patients treated with PORT. Materials and methods: The pattern of locoregional failure was evaluated retrospectively in 151 of 171 patients included in the PORT arm. The CTV included the involved lymph node stations and those with a risk of invasion >10%. Competing risk analysis was used to assess the incidence of locoregional failure and its location outside the CTV. Results: Overall survival at 5 years was 27.1% with a median follow-up of 67 months for 40 living patients. The 5-year cumulative incidence of locoregional failure was 19.4% (95% CI: 18.2–20.5%) including a failure rate of 2% (95% CI: 0–17%) in locations outside or at the border of the CTV. Conclusions: The use of limited CTV was associated with acceptable risk of geographic miss. Overall locoregional control was similar to that reported by other studies using PORT for pN2 patients

  14. Development of radiation oncology learning system combined with multi-institutional radiotherapy database (ROGAD)

    Energy Technology Data Exchange (ETDEWEB)

    Takemura, Akihiro; Iinuma, Masahiro; Kou, Hiroko [Kanazawa Univ. (Japan). School of Medicine; Harauchi, Hajime; Inamura, Kiyonari

    1999-09-01

    We have constructed and are operating a multi-institutional radiotherapy database ROGAD (Radiation Oncology Greater Area Database) since 1992. One of it's purpose is 'to optimize individual radiotherapy plans'. We developed Radiation oncology learning system combined with ROGAD' which conforms to that purpose. Several medical doctors evaluated our system. According to those evaluations, we are now confident that our system is able to contribute to improvement of radiotherapy results. Our final target is to generate a good cyclic relationship among three components: radiotherapy results according to ''Radiation oncology learning system combined with ROGAD.'; The growth of ROGAD; and radiation oncology learning system. (author)

  15. Impact of postoperative radiotherapy and HER2/new overexpression in salivary duct carcinoma. A monocentric clinicopathologic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Haderlein, Marlen; Semrau, Sabine; Lettmaier, Sebastian; Hecht, Markus; Fietkau, Rainer [University Hospital of Erlangen, Department of Radiation Oncology, Erlangen (Germany); Scherl, Claudia; Iro, Heinrich [University Hospital of Erlangen, Department of Otorhinolaryngology, Erlangen (Germany); Erber, Ramona; Agaimy, Abbas [University Hospital of Erlangen, Institute of Pathology, Erlangen (Germany)

    2017-11-15

    Retrospective Investigation of the prognostic relevance of clinicopathologic parameters in patients with salivary duct carcinoma (SDC). An experienced pathologist reviewed 67 patients with de novo SDC or SDC ex pleomorphic adenoma. Paraffin-embedded tumor samples were examined by immunohistochemistry for expression of HER2/neu, androgen (AR), progesterone (PR), estrogen (ER), epidermal growth factor (EGFR) and programmed death ligand 1 (PD-L1-R) receptor. In 45 patients who had cM0 and follow-up data available, survival rates were calculated (Kaplan-Meier method) and prognostic variables were analyzed (univariate analysis: log-rank test; multivariate analysis: Cox-regression analysis). Overexpression of HER2/neu, AR, ER, PR, EGFR, PD-L1-R was found in 25.4%, 84%, 0%, 0%, 17.9%, 16.4% of patients. Overall (OS), disease-free (DFS), distant-metastases-free survival (DMFS) and locoregional control (LRC) were 92.3/72.4/56.9%, 78.2/58.1/58.1%, 85.4/65.2/65.2% and 89.7/81.9/81.9% after 1/3/5 years (medial follow-up 26 months). In univariate analysis a positive resection margin (p = 0.008) and no postoperative radiotherapy (p = 0.001) predict an increased locoregional recurrence rate. In multivariate analysis only postoperative radiotherapy is statistically significant (p = 0.004). Presence of lymph node metastases, a lymph node density >4 and HER2/neu overexpression predict decreased DFS and DMFS. In multivariate HER2/neu overexpression was the only significant predictor for reduced DFS (p = 0.04) and DMFS (p = 0.02). Postoperative radiotherapy is the only significant predictor for LRC. HER2/neu receptor expression is an independent prognostic factor for decreased DFS and DMFS in patients with SDC. In addition to radio(chemo)therapy, intensified first-line treatment regimens should also be evaluated in the future. (orig.) [German] In dieser retrospektiven Auswertung wurde der Einfluss klinisch-pathologischer Parameter auf die Prognose von Patienten mit

  16. Veliparib in combination with radiotherapy for the treatment of MGMT unmethylated glioblastoma

    OpenAIRE

    Jue, Toni Rose; Nozue, Kyoko; Lester, Ashleigh J.; Joshi, Swapna; Schroder, Lisette B. W.; Whittaker, Shane P.; Nixdorf, Sheri; Rapkins, Robert W.; Khasraw, Mustafa; McDonald, Kerrie L.

    2017-01-01

    Background The O 6 -methylguanine methyltransferase (MGMT) gene is frequently unmethylated in patients with glioblastoma (GBM), rendering them non-responsive to the standard treatment regime of surgery followed by concurrent radiotherapy (RT) and temozolomide. Here, we investigate the efficacy of adding a PARP inhibitor, veliparib, to radiotherapy to treat MGMT unmethylated GBM. Methods The inhibition of PARP with veliparib (ABT-888), a potent and orally bioavailable inhibitor in combination ...

  17. The effect of granisetron dexamethasone combination on postoperative nausea and vomiting in gynecological operations

    Directory of Open Access Journals (Sweden)

    Ziya Kaya

    2010-06-01

    Full Text Available Objectives: Postoperative nausea and vomiting (PONV is one of the most frequent adverse effects of anesthesia. PONV postpones hospital stays and also delays recover and getting better, of the patients. The objective of the current study is to compare efficacy of prophylactic granisetron(40 μ/kg + dexamethasone (4 mg combination against PONV in different anesthesia models.Materials and Methods: 72 patients with an age range of 18-72 years and ASA 1 or 2 were enrolled in the present study. The patients were assigned as group 1 propofol-remifentanil (P-R, group 2 propofol- nitrous oxide (P-N2O, group 3 sevoflurane- nitrous oxide (S-N2O and group 4 sevoflurane-remifentanyl-air (S-R+H. Inductions of the patients in all groups were made with intravenous 2-3 mg/kg propofol, 1μ/kg remifentanil and 0.2 mg/kg cis-atracurium. 4 mg of dexamethasone by bolus and 40 μ/kg of granisetron by infusion were administered to the patients in all groups after induction. During the last 10 minutes of the operation, 1mg/kg tramadol was administered.Postoperative nausea and vomiting, VAS scores, and additional antiemetic needs were recorded during postoperative 48 hours.Results: Postoperative 48 hours follow up revealed that PONV was seen 27%, 16%, 38%, 48% frequencies in (P+R, (P+ N2O, (S+ N2O, (S+R+H groups, respectively.While antiemetic requirement was not observed in (P+ N2O and (S+ N2O groups, the patients in (P+R and (S+R+H groups needed additional antiemetic drugs with a frequency of 5.5% and 11% respectively.Conclusion: Granisetron, dexamethasone combination in different anesthetic models did not reveal significant difference in terms of postoperative nausea, vomiting, and additional antiemetic usage.

  18. Complications of combined radical hysterectomy-postoperative radiation therapy in women with early stage cervical cancer

    International Nuclear Information System (INIS)

    Barter, J.F.; Soong, S.J.; Shingleton, H.M.; Hatch, K.D.; Orr, J.W. Jr.

    1989-01-01

    Fifty patients with cervical cancer were treated with radical hysterectomy and lymphadenectomy followed by postoperative radiation therapy for high risk factors (nodal metastases, lymphvascular space invasion, close or involved margins) at the University of Alabama at Birmingham Medical Center from 1969 to 1984. Fifteen (30%) of the patients treated had serious complications, 8 (16%) requiring an operation, and 1 (2%) dying as a result of treatment-related problems. This combined modality approach is associated with significant complications

  19. Effects of postoperative adjuvant chemotherapy and radiotherapy on ovarian function in women undergoing treatment for soft tissue sarcoma

    International Nuclear Information System (INIS)

    Shamberger, R.C.; Sherins, R.J.; Ziegler, J.L.; Glatstein, E.; Rosenberg, S.A.

    1981-01-01

    Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD) [follicle-stimulating hormone (FSH), 10 +/- 15 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml] and 17 β-estradiol (E 2 ) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developd persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 109 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E 2 (19 +/- 8 pg/ml). Two additional women (ages 21 and 39 yr) who received radiation (7000 rad) to the pelvis plus chemotherapy developed prompt cessation of menses and became functional castrates (FSH, 77 and 80mlU/ml; LH, 40 and 58 mlU/ml; E 2 , 10 and 19 pg/ml). However, this result would be expected from the radiation dose alone. The data demonstrated that ovarian dysfunction may follow the use of doxorubicin, cyclophosphamide, and high doses of methotrexate and that the injury is age related

  20. Effects of postoperative adjuvant chemotherapy and radiotherapy on ovarian function in women undergoing treatment for soft tissue sarcoma

    International Nuclear Information System (INIS)

    Shamberger, R.C.; Sherins, R.J.; Ziegler, J.L.; Glatstein, E.; Rosenberg, S.A.

    1981-01-01

    Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD [follicle-stimulating hormone (FSH), 10 +/- 5 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml] and 17 beta-estradiol (E2) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developed persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 108 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E2 (19 +/- 8 pg/ml). Two additional women (ages 21 and 39 yr) who received radiation (7,000 rad) to the pelvis plus chemotherapy developed prompt cessation of menses and became functional castrates (FSH, 77 and 80 mlU/ml; LH, 40 and 58 mlU/ml; E2, 10 and 19 pg/ml). However, this result would be expected from the radiation dose alone. The data demonstrated that ovarian dysfunction may follow the use of doxorubicin, cyclophosphamide, and high doses of methotrexate and that the injury is age related

  1. Effects of postoperative adjuvant chemotherapy and radiotherapy on ovarian function in women undergoing treatment for soft tissue sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Shamberger, R.C.; Sherins, R.J.; Ziegler, J.L.; Glatstein, E.; Rosenberg, S.A.

    1981-12-01

    Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD (follicle-stimulating hormone (FSH), 10 +/- 5 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 beta-estradiol (E2) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developed persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 108 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E2 (19 +/- 8 pg/ml). Two additional women (ages 21 and 39 yr) who received radiation (7,000 rad) to the pelvis plus chemotherapy developed prompt cessation of menses and became functional castrates (FSH, 77 and 80 mlU/ml; LH, 40 and 58 mlU/ml; E2, 10 and 19 pg/ml). However, this result would be expected from the radiation dose alone. The data demonstrated that ovarian dysfunction may follow the use of doxorubicin, cyclophosphamide, and high doses of methotrexate and that the injury is age related.

  2. Nedaplatin and 5-fluorouracil combined with radiotherapy for advanced esophageal cancer

    International Nuclear Information System (INIS)

    Nakamura, Tsutomu; Ide, Hiroko; Eguchi, Reiki; Hayashi, Kazuhiko; Ota, Masaho; Narumiya, Kosuke; Takasaki, Ken

    2003-01-01

    We conducted a pilot study of nedaplatin+5-fluorouracil (5-FU) combined with radiotherapy for 29 patients with primary advanced (stage IV) esophageal cancer. A complete remission (CR) was obtained in 4 (14%) and a partial response in 13 patients (response rate: 59%). The median survival time and one-year survival rate were 238 days and 34.5%, respectively. Of the 29 patients, 24 (83%) completed the treatment schedule and toxicity of stomatitis and the like was infrequent. In conclusion, these results suggest that the efficacy of nedaplatin+5-FU combined with radiotherapy might not differ from that of cisplatin+5-FU combined with radiotherapy. Clearly, the usefulness of this combined therapy needs to be assessed in multicenter phase III trials. (author)

  3. Combination of chemotherapy, radiotherapy and surgery in the treatment of oral cancer

    International Nuclear Information System (INIS)

    Ayyagiri, S.; Gupta, B.D.; Dutta, T.K.

    1980-01-01

    In locally advanced oral cancer, the main modalities of treatment, e.g. surgery and radiotherapy, most often fail to control the disease when used singly. A combination policy of surgery and radiotherapy achieves adequate control of the disease. In order to improve the results in advanced oral cancer, chemotherapy given prior to and during radiation treatment and judicious combination of surgery offer the best possible approach in the management. The experience in the combination policy in the treatment of oral cancer in Northern India is dealt with. (auth.)

  4. Postoperative radiotherapy for invasive micropapillary carcinoma of the breast: an analysis of Surveillance, Epidemiology, and End Results database

    Directory of Open Access Journals (Sweden)

    Wu SG

    2017-10-01

    Full Text Available San-Gang Wu,1,* Wen-Wen Zhang,2,* Jia-Yuan Sun,2 Feng-Yan Li,2 Yong-Xiong Chen,3 Zhen-Yu He2 1Department of Radiation Oncology, Xiamen Cancer Hospital, The First Affiliated Hospital of Xiamen University, Xiamen, 2Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, 3Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Medical College, Xiamen University, Xiamen, People’s Republic of China *These authors contributed equally to this work Introduction: Invasive micropapillary carcinoma (IMPC of the breast poses a high risk of locoregional recurrence, and postoperative radiotherapy (PORT may be beneficial in IMPC. Hence, we determined the clinical value of PORT in IMPC patients. Patients and methods: We assessed clinicopathological factors extracted from the Surveillance, Epidemiology, and End Results database (2004–2013. Univariate and multivariate Cox proportional hazards regressions were performed to assess the independent prognostic factors on breast cancer-specific survival (BCSS and overall survival (OS. Results: Of the 881 study patients, 444 (50.4% and 437 (49.6% underwent breast-conserving surgery (BCS and mastectomy (MAST, respectively, of whom 357 (80.4% and 153 (35.0% underwent PORT, respectively. Patients with young age, large tumor size, or advanced nodal stage were more likely to undergo MAST and PORT compared with MAST alone. Patients with progesterone receptor-positive disease were more likely to receive BCS and PORT compared with BCS alone. The 5-year BCSS and OS were 95.7% and 90.9%, respectively. On multivariate analyses, tumor size, histological grade, and estrogen receptor status were independent predictors of BCSS and OS. The types of surgical procedures (MAST vs. BCS were not an independent predictor of survival outcomes. Patients who

  5. Tramadol-Paracetamol Combination for Postoperative Pain Relief in Elective Single-level Microdisectomy Surgery.

    Science.gov (United States)

    Dogar, Samie A; Khan, Fauzia A

    2017-04-01

    The tramadol and paracetamol combination is used frequently for postoperative pain management. The literature on the use of this combination for vertebral surgery is limited. Our objective was to compare a combination of paracetamol 1 g and a lower dose of tramadol (1 mg/kg: group 1T) with a combination of paracetamol 1 g and a higher dose of tramadol (1.5 mg/kg: group 1.5T) for postoperative pain after microdisectomy surgery. Our main outcome measure was Visual Analogue Scale pain scores for 4 hours postoperatively. This prospective randomized triple-blind clinical trial was conducted at Aga Khan University Hospital, Karachi. Ninety-four patients aged between 18 and 50 years scheduled for elective single-level microdisectomy were allocated randomly into 1 of 2 groups. Twenty minutes before the end of the surgery, patients received the study drugs. There was no significant demographic difference between groups. None of the patients experienced severe pain (VAS>6). There was no significant difference in the mean pain score between groups. The mean score at 4 hours was 2.17 (1.38) in group 1.5T and 1.74 (1.37) in group 1T. The difference was not statistically significant (P=0.14). In group 1.5T, 13 patients reported having nausea and vomiting compared with 2 patients in group 1T. This was a statistically significant difference (P=0.004). The sedation score was similar between groups. The combination of low-dose tramadol (1 mg/kg) and paracetamol has comparable analgesia and a decreased incidence of nausea and vomiting compared with the higher dose of tramadol (1.5 mg/kg) and paracetamol combination.

  6. Role of antioxidant therapy in ameliorating the side effects of post-operative radiotherapy on genetic material of cancer cervix patients

    International Nuclear Information System (INIS)

    Korraa, S.; Elmaghraby, T.; Arian, F.; Mahfouz, M.

    2003-01-01

    The oxidative stress found in cancer patients and radiotherapy was resulted from the increased production of oxidants in the body and the inefficiency of endogenous antioxidant system to eliminate such oxidants. The present study was carried out to investigated whether supplementation of cancer cervix patients during radiotherapy with antioxidants can ameliorate the damaging effects of radiation on DNA of circulating lymphocytes or not. Accordingly, apoptosis, DNA-fragmentation, lipid peroxidation and the frequency of micronuclei among cancer cervix patient undergoing post-operative radiotherapy (n=40) were measured with and without the administration course of antioxidant antox (including 60 mg vitamin C 10 mg vitamin E, 1000 U I vitamin A and 50 mg selenium). Patients were divided into 2 groups each of 20 patients. The first group was administered the antioxidant antox, 200 mg per day, during radiotherapy and one week more post-cessation of radiotherapy , while the second group did not supplemented with antox. All parameters were investigated in a control group of 20 normal healthy women and in the 40 patient ones

  7. Postoperative radiotherapy appeared to improve the disease free survival rate of patients with extrahepatic bile duct cancer at high risk of loco-regional recurrence

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Kim, Jin Hee; Kim, Yong Hoon [Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of); Byun, Sang Jun [Dept. of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2016-12-15

    To investigate the outcomes of postoperative radiotherapy (RT), in patients with extrahepatic bile duct (EHBD) cancer by comparing the survival rate between patients undergoing surgery alone or surgery plus postoperative RT, and to identify the prognostic factors affecting survival. Between 2000 and 2013, 52 patients with EHBD cancer underwent surgical resection. Of these, 33 patients did not receive postoperative RT (group I), and 19 patients did (group II). R1 resection was significantly more frequent in group II. The median radiation dose was 5,040 cGy. The 3-year overall survival (OS) rate for group I and group II was 38% and 56%, respectively (p = 0.274). The 3-year disease free survival (DFS) rate for group I and group II was 20% and 31%, respectively (p = 0.049), and the 3-year loco-regional recurrence free survival (LRFS) rates were 19% and 58%, respectively (p = 0.002). Multivariate analyses showed that postoperative RT and lymphovascular invasion were independent prognostic factors for DFS and LRFS. Overall, 42 patients (80%) experienced treatment failure. Distant metastasis was the predominant pattern of failure in group II. Postoperative RT after surgical resection appeared to improve the loco-regional control and DFS rate. More effort is needed to reduce distant metastasis, the major pattern of failure, in patients who receive postoperative RT.

  8. Postoperative pain

    DEFF Research Database (Denmark)

    Kehlet, H; Dahl, J B

    1993-01-01

    also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

  9. Postoperative radiotherapy for completely resected Masaoka stage III thymoma: a retrospective study of 65 cases from a single institution

    International Nuclear Information System (INIS)

    Fan, Chengcheng; Hui, Zhouguang; Liang, Jun; Lv, Jima; Mao, Yousheng; Wang, Luhua; He, Jie; Feng, Qinfu; Chen, Yidong; Zhai, Yirui; Zhou, Zongmei; Chen, Dongfu; Xiao, Zefen; Zhang, Hongxing; Li, Jian

    2013-01-01

    The role of adjuvant radiotherapy (RT) for patients with stage III thymoma after complete resection is not definite. Some authors have advocated postoperative RT after complete tumor resection, but some others suggested observation. In this study, we retrospectively evaluated the effect of postoperative RT on survival as well as tumor control in patients with Masaoka stage III thymoma. Between June 1982 and December 2010, 65 patients who underwent complete resection of stage III thymoma entered the study. Fifty-three patients had adjuvant RT after surgery (S + R) and 12 had surgery only (S alone). Of patients who had adjuvant RT, 28 had three-dimensional conformal RT (3D-CRT)/intensity modulated RT (IMRT) and 25 had conventional RT. A median prescribed dose of 56 Gy (range, 28–60 Gy) was given. The median follow-up time was 50 months (range, 5–360 months). Five- and 10-year overall survival (OS) rates were 91.7% and 71.6%, respectively, for S + R and 81.5% and 65.2% for S alone (P = 0.5), respectively. In the subgroup analysis, patients with 3D-CRT/IMRT showed a trend of improved 5-year OS rate compared with conventional RT (100% vs. 86.9%, P =0.12). Compared with S alone, the 5-year OS rate was significantly improved (100% vs. 81.5%, P = 0.049). Relapses occurred in 15 patients (23.1%). There was a trend of lower crude local recurrence rates for S + R (3.8%) compared with S alone (16.7%) (P = 0.09), whereas the crude regional recurrence rates were similar (P = 0.9). No clear dose–response relationship was found according to prescribed doses. Adjuvant 3D-CRT/IMRT showed potential advantages in improving survival and reducing relapse in patients with stage III thymoma after complete resection, whereas adjuvant RT did not significantly improve survival or reduce recurrence for the cohort as a whole. Doses of ≤ 50 Gy may be effective and could be prescribed for adjuvant RT. To confirm the role of adjuvant 3D-CRT/IMRT in patients who undergo a complete

  10. Comparative effect of paracetamol, NSAIDs or their combination in postoperative pain management: a qualitative review

    DEFF Research Database (Denmark)

    Hyllested, M; Jones, S; Pedersen, J L

    2002-01-01

    BACKGROUND: Quantitative reviews of postoperative pain management have demonstrated that the number of patients needed to treat for one patient to achieve at least 50% pain relief (NNT) is 2.7 for ibuprofen (400 mg) and 4.6 for paracetamol (1000 mg), both compared with placebo. However, direct...... comparisons between paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) have not been extensively reviewed. The aims of this review are (i) to compare the analgesic and adverse effects of paracetamol with those of other NSAIDs in postoperative pain, (ii) to compare the effects of combined...... paracetamol and NSAID with those of either drug alone, and (iii) to discuss whether the adverse effects of NSAIDs in short-term use are justified by their analgesic effects, compared with paracetamol. METHODS: Medline (1966 to January 2001) and the Cochrane Library (January 2001) were used to perform...

  11. Preoperative Intensity-Modulated Radiotherapy Combined with Temozolomide for Locally Advanced Soft-Tissue Sarcoma

    International Nuclear Information System (INIS)

    Jakob, Jens; Wenz, Frederik; Dinter, Dietmar J.; Stroebel, Philipp; Hohenberger, Peter

    2009-01-01

    Purpose: To evaluate the toxicity and efficacy of preoperative intensity-modulated radiotherapy (IMRT) combined with temozolomide to improve local tumor control in soft-tissue sarcoma (STS). Patients and Methods: A cohort of 15 consecutive patients with nonmetastasized, primary high-grade or locally recurrent Stage III (n = 14) or IIb (n = 1) STS not amenable to surgical resection without significant organ or extremity function loss was prospectively investigated. Median tumor size was 9.8 cm, and most tumors were non-extremity sarcomas. Patients preoperatively received 50 mg/m 2 of temozolomide during IMRT (50.4 Gy). Resection was intended 6 weeks thereafter. Toxicity was assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0, and response was assessed by Response Evaluation Criteria in Solid Tumors. Results: Of 15 patients, 14 completed preoperative treatment. No Grade 4 toxicities occurred. Nausea and vomiting were the most frequent Grade 3 toxicities. The most frequent toxicities of any grade were dermatologic, gastrointestinal, and hematologic. Response was partial response in 5, stable disease in 7, and progressive disease in 2 patients. Ten patients underwent surgery: 7 were resected with clear margins (R0), and 2 patients had an R1 resection; in 1 patient the tumor was not resectable. Postoperative complications occurred in 4 patients. Five patients did not undergo surgery because of intercurrent metastatic disease, unresectable disease, or refusal. Conclusions: Preoperative chemoradiation with temozolomide and IMRT can be administered safely and with promising efficacy in patients with locally advanced STS.

  12. PP22. PROGRESSING RADIOTHERAPY-DRUG COMBINATIONS TOWARDS EARLY PHASE CLINICAL TRIALS

    Science.gov (United States)

    Jones, Dr Hazel; Stock, Dr Julie; Chalmers, Prof Anthony

    2017-01-01

    Abstract The Radiotherapy-Drug Combinations consortium (RaDCom) works with UK-based investigators to design and deliver high quality preclinical projects evaluating specific radiotherapy-drug combinations. We have several collaborations with industry, from in vitro projects to understand the novel agent in the context of radiobiology, through to preclinical studies that will generate data to support the development of radiotherapy combination trials. RaDCom facilitates the coordination of industry interactions, triage new proposals, monitor active projects, and engages with the radiotherapy community to promote collaboration and networking (via a capability map). The CRUK New Agents Committee Preclinical Combination Grant scheme provides one of the funding options for these studies, with the potential to feed into early phase clinical trials via the ECMC Combinations Alliance. RaDCom also supports broader radiotherapy research initiatives, by working to improve preclinical quality assurance and identifying a route to registration for radiotherapy-drug treatments. These activities will place the UK at the forefront of radiotherapy-drug preclinical research and provide a significant incentive for pharmaceutical companies to invest in this area and utilise the RaDCom network. Further information can be found on our webpage: http://ctrad.ncri.org.uk/research-support/radiation-drug-combinations-radcom Successful projects from RaDCom can then move into early phase combinations trials within the Combinations Alliance. The Combinations Alliance supports early phase combination studies in the UK via the ECMC (Experimental Cancer Medicine Centres) network. It focuses on translational research, and enables clinical project teams to work with disease experts to set up investigator led trials. The CRUK Centre of Drug Development (CDD) supports these studies with further management and coordination ensuring more robust timelines and delivery. The Combinations Alliance framework

  13. Keratinocyte Growth Factor Combined with a Sodium Hyaluronate Gel Inhibits Postoperative Intra-Abdominal Adhesions

    Directory of Open Access Journals (Sweden)

    Guangbing Wei

    2016-09-01

    Full Text Available Postoperative intra-abdominal adhesion is a very common complication after abdominal surgery. One clinical problem that remains to be solved is to identify an ideal strategy to prevent abdominal adhesions. Keratinocyte growth factor (KGF has been proven to improve the proliferation of mesothelial cells, which may enhance fibrinolytic activity to suppress postoperative adhesions. This study investigated whether the combined administration of KGF and a sodium hyaluronate (HA gel can prevent intra-abdominal adhesions by improving the orderly repair of the peritoneal mesothelial cells. The possible prevention mechanism was also explored. The cecum wall and its opposite parietal peritoneum were abraded after laparotomy to induce intra-abdominal adhesion formation. Animals were randomly allocated to receive topical application of HA, KGF, KGF + HA, or normal saline (Control. On postoperative day 7, the adhesion score was assessed with a visual scoring system. Masson’s trichrome staining, picrosirius red staining and hydroxyproline assays were used to assess the magnitude of adhesion and tissue fibrosis. Cytokeratin, a marker of the mesothelial cells, was detected by immunohistochemistry. The levels of tissue plasminogen activator (tPA, interleukin-6 (IL-6, and transforming growth factor β1 (TGF-β1 in the abdominal fluid were determined using enzyme-linked immunosorbent assays (ELISAs. Western blotting was performed to examine the expression of the TGF-β1, fibrinogen and α-smooth muscle actin (α-SMA proteins in the rat peritoneal adhesion tissue. The combined administration of KGF and HA significantly reduced intra-abdominal adhesion formation and fibrin deposition and improved the orderly repair of the peritoneal mesothelial cells in the rat model. Furthermore, the combined administration of KGF and HA significantly increased the tPA levels but reduced the levels of IL-6, tumor necrosis factor α (TNF-α and TGF-β1 in the abdominal fluid. The

  14. Adenoid cystic carcinoma of sublingual glands. Surgery and radiotherapy combination

    International Nuclear Information System (INIS)

    Campagnale, Ramiro; Campagnale, Rodrigo; Varalli, Lucas

    2005-01-01

    The Adenoid Cystic Carcinoma (ACC) or Cilindroma is a strange entity classified by the WHO within the carcinomas of salivary glands. It represents only 1 % of all the wicked tumours of the oral and maxillofacial region although, when making reference to the salivary glands, it constitutes 5% of the parotid, submaxilar and sublingual carcinomas, and about 50% of the smallest ones. The most frequent location is in the palatine glands and its main characteristics are: slow but persistent growth, high rates of local relapse and metastasis at distance originating the death between the first 5 and 10 years in 50-70% of the cases approximately. A case of localization is presented in sublingual gland which was first treated surgically and later with radiotherapy, obtaining good results. (author) [es

  15. Effects of postoperative adjuvant chemotherapy and radiotherapy on ovarian function in women undergoing treatment for soft tissue sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Shamberger, R.C. (National Inst. of Health, Bethesda, MD); Sherins, R.J.; Ziegler, J.L.; Glatstein, E.; Rosenberg, S.A.

    1981-12-01

    Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD) (follicle-stimulating hormone (FSH), 10 +/- 15 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml) and 17 ..beta..-estradiol (E/sub 2/) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developd persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 109 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E/sub 2/ (19 +/- 8 pg/ml). Two additional women (ages 21 and 39 yr) who received radiation (7000 rad) to the pelvis plus chemotherapy developed prompt cessation of menses and became functional castrates (FSH, 77 and 80mlU/ml; LH, 40 and 58 mlU/ml; E/sub 2/, 10 and 19 pg/ml). However, this result would be expected from the radiation dose alone. The data demonstrated that ovarian dysfunction may follow the use of doxorubicin, cyclophosphamide, and high doses of methotrexate and that the injury is age related.

  16. Radiotherapy.

    Science.gov (United States)

    Krause, Sonja; Debus, Jürgen; Neuhof, Dirk

    2011-01-01

    Solitary plasmocytoma occurring in bone (solitary plasmocytoma of the bone, SBP) or in soft tissue (extramedullary plasmocytoma, EP) can be treated effectively and with little toxicity by local radiotherapy. Ten-year local control rates of up to 90% can be achieved. Patients with multiple myeloma often suffer from symptoms such as pain or neurological impairments that are amenable to palliative radiotherapy. In a palliative setting, short treatment schedules and lower radiation doses are used to reduce toxicity and duration of hospitalization. In future, low-dose total body irradiation (TBI) may play a role in a potentially curative regimen with nonmyeloablative conditioning followed by allogenic peripheral blood stem cell transplantation.

  17. Therapeutic effect of angiogenesis inhibitor combined with radiotherapy on liver metastasis model of colon cancer

    International Nuclear Information System (INIS)

    Jin Liugen; Zhou Shifu

    2005-01-01

    Objective: To observe the therapeutic effect of angiogenesis inhibitor combined with radiotherapy on liver metastasis model of colon cancer. Methods: Nude mice liver metastasis model of colon cancer was established with human colon cancer cells line (LS174T) inoculated into mice' spleen and followed by splenectomy. Angiogenesis inhibitor 2-ME and radiotherapy were administered after-wads. The growth inhibition effect on metastases and neovessel was examined. Results: The incidences of liver metastasis were 100% in this intrasplenic injection model. The mean weight and microvessel density 4 weeks after inoculation were 53.6 ± 4.7 mg, 8.4 ± 1.7 in treatment group as compared to 173.9 ± 11.6 mg, 41.2 ± 6.3 in control group respectively. Conclusion: 2-ME combined with radiotherapy has significant inhibition on the growth of liver metastases. Angiogenesis inhibition is one of the mechanisms of its efficiency. (authors)

  18. Pattern of relapse in surgical treated patients with thoracic esophageal squamous cell carcinoma and its possible impact on target delineation for postoperative radiotherapy

    International Nuclear Information System (INIS)

    Cai Wenjie; Xin Peiling

    2010-01-01

    Objective: To provide a reference for determination of the postoperative radiotherapy target volume for thoracic esophageal squamous cell carcinoma. Background data: The irradiation target volume is important for effective postoperative treatment of thoracic esophageal squamous cell carcinoma. Methods: One hundred forty patients with recurrent or metastatic thoracic esophageal squamous cell carcinoma who had been treated with radical surgery but not with postoperative radiotherapy were enrolled in this study. The information of locoregional recurrence and distant metastasis for these patients was analyzed. Results: The median time to progression in the 140 patients with recurrence or metastasis was 18.3 months (range 15.4-21.1 months). Anastomotic recurrence accounted for 13.6% of treatment failures. The supraclavicular and station 1-5 and 7 lymph nodes had high metastasis rates for esophageal squamous cell carcinomas in all locations. The order from highest to lowest metastasis rate for the station 3 and 4 lymph nodes was middle, upper and lower thoracic esophageal regions and the order for upper abdominal lymph nodes was lower, middle, and upper thoracic esophageal regions. Locoregional recurrence was the most common type of recurrence. Conclusions: For upper and middle thoracic esophageal squamous cell carcinomas, the anastomosis, supraclavicular, and station 1-5 and 7 lymph nodes should be delineated as the postoperative prophylactic irradiation target volume with upper abdominal lymph nodes excluded; for lower thoracic esophageal squamous cell carcinomas, anastomosis, supraclavicular, station 1-5 and 7 lymph nodes and upper abdominal lymph nodes should be delineated as the postoperative prophylactic irradiation target volume.

  19. Immunological factors correlated in radiation effect in cancer patients treated by radiotherapy alone or radiotherapy with combined chemotherapy

    International Nuclear Information System (INIS)

    Kimura, Shuji

    1981-01-01

    Local immunological factors are thought to be parenchymal reaction of normal and tumor tissues. Those were studied by morphological changes of angiographic findings and histological methods which included photomicroscopic, electromicroscopic and enzymic-histochemical studies. It was demonstrated that the effect of radiotherapy depended on not only local blood supply but also parenchymal reaction of the host. Especially, the parenchymal reaction at 2000 or 3000 rad irradiation was regarded as nonspecific tissue repair as well as immunological protective reactions brought about by enhancement of the tumor antigenicity. It was proved that T-cell system played a main role in this parenchymal reaction. Changes of systemic immunological factors were studied in 17 laryngeal cancer and 80 lung cancer patients treated by radiotherapy alone or radiotherapy with combined chemotherapy. Due to the fact that damages of the host before treatment were not so serious and integral dose given to the patients was a little in cases of laryngeal cancer immunological parameters such as absolute lymphocyte counts, PHA and PPD skin test activities, lymphocyte blastoid transformation with PHA, PWM and Con A, did not show significant change. However, as for lung cancer treated by large integral dose irradiation combined with chemotherapy, immunological parameters were depressed in inverse proportion to the dose of irradiation and chemotherapeutic agents. Moreover T-cell subsets (early E-rosette forming cells, IgG Fc-receptor positive cells), lymphocyte sub-populations, ADCC activity, serum immunoglobulins, and serum protein were also investigated in cases of lung cancer. We have evaluated the immunological parameters in relation to the therapeutic effect. As a result, it was suggested that several parameters should be needed to forecast the prognosis. (author)

  20. Hypofractionated stereotactic radiotherapy combined with topotecan in recurrent malignant glioma

    International Nuclear Information System (INIS)

    Wurm, Reinhard E.; Kuczer, David A.; Schlenger, Lorenz; Matnjani, Gesa; Scheffler, Dirk; Cosgrove, Vivian P.; Ahlswede, Julia; Woiciechowsky, Christian; Budach, Volker

    2006-01-01

    Purpose: To assess hypofractionated stereotactic radiotherapy (H-SRT) with concurrent topotecan in patients with recurrent malignant glioma. Methods and Materials: Between February 1998 and December 2001, 25 patients with recurrent malignant glioma were treated in a phase I-II study (8 females and 17 males; median age, 45 years; range, 11-66 years; median Karnofsky performance status, 80%, range, 50-100%; median Mini Mental Standard Examination score, 25 points; range, 10-30 points). Of the 25 patients, 20% had World Health Organization Grade III and 80% World Health Organization Grade IV glioma. All patients had been treated previously by external beam radiotherapy with 54.4 Gy in 34 fractions twice daily, at least 6 h apart, within 3.5 weeks or 60 Gy in 30 fractions within 6 weeks. In addition, 84% had already received at least one chemotherapy regimen for recurrence. The median H-SRT dose at the 80% isodose was 25 Gy, and the maximal dose was 30 Gy delivered in five to six fractions on consecutive days. Topotecan (1.1 mg/m 2 /d) was given as a continuous i.v. infusion during H-SRT. Depending on the toxicity and compliance, patients received an additional 48 topotecan courses. Results: For all patients, the actuarial median progression-free survival was 10.5 months (range, 1.4-47.8 months), the median functional survival was 12.6 months (range, 1.6-49.5 months), and the median overall survival was 14.5 months (range, 3-56.4 months). Twelve percent of patients developed presumed adverse radiation effects (Radiation Therapy Oncology Group Grade 2). According to the Common Toxicity Criteria, version 2.0, no topotecan-related Grade 4 toxicity was noted. Grade 3 neutropenia was documented after 14 and Grade 3 thrombopenia after 12 courses. Conclusion: H-SRT with topotecan is feasible and well-tolerated in patients with recurrent high-grade glioma and results in similar survival compared with other repeat treatment modalities

  1. Combined therapy of corpus carcinoma with special regard to radiotherapy

    International Nuclear Information System (INIS)

    Wilhelm, C.

    1980-01-01

    From 496 case reports of patients with a corpus carcinoma collected between 1970 and 1976, the clinical findings, separation into clinical stages and the various therapy forms were compiled and evaluated. As a mean age of 62.3 years, 56.9 per cent of patients reached an average five-year, recidivation-free survival periods. Metastases occurred in 19.1 per cent of all treated women, vaginal recidivations in 1.8 per cent. Particular attention was given to the side effects of radiation therapy and retarded harmful effects. In this connexion an increase in complications following treatment with newly introduced radiation qualities had to be recorded. 21.9 per cent of all radiation-treated patients differed side-effects, and in 11.7 per cent of all radiation-treated women retarded harmful effects were found. Owing to the experience collected meanwhile in radiotherapy with ultra-hard X-rays and to the use of computerized tomography establishing the adequate quantity of radiation, complications following radiation treatment are expected to occur less frequently in future. (orig./MG) [de

  2. Inclusion of molecular biotherapies with radical radiotherapy: modeling of combined modality treatment schedules

    International Nuclear Information System (INIS)

    Jones, Bleddyn; Dale, Roger G.

    1999-01-01

    Purpose: The use of molecular biology based therapies concurrently with radical radiotherapy is likely to offer potential benefits, but there is relatively little use of classical radiobiology in the rationale for such applications. The biological mechanisms that govern the outcomes of radiotherapy need to be completely understood before rational application and optimization of such adjuvant biotherapies with radiotherapy. Methods and Materials: Existing biomathematical models of radiotherapy can be used to explore the possible impact of biotherapies that modify tumor proliferation rates and/or radiosensitivity parameters during radiotherapy. Equations that show how to incorporate biotherapies with the linear-quadratic model of radiation cell kill are presented. Also considered are changes in tumor physiology, such as improved blood flow with enhanced delivery of biotherapy to the tumor cells and accelerated clonogen repopulation during radiotherapy. Monte Carlo random sampling methods are used to simulate these effects in heterogenous tumor populations with variation in radiosensitivities, clonogen numbers, and doubling times, as well as variations in repopulation onset rates and in vascular perfusion rates with time. Results: The time onset and duration of exposure of each type of biotherapy during radical radiotherapy can influence the predicted tumor cure probabilities in subtle ways. In general, the efficacy of biotherapies that radiosensitize will depend upon the number of radiotherapy fractions that are sensitized and the change in blood flow with time during radiotherapy. Biotherapies that control repopulation will depend not only on the duration of exposure but also, where accelerated repopulation occurs, on the time at which biotherapy is initiated during radiotherapy. From the ranges of radiobiological parameters and biotherapy efficacies assumed for exploratory examples, large changes of tumor control probability (TCP) are encountered in individual

  3. Application of hyperglycemia induction in combination with radiotherapy for rectal cancer treatment

    International Nuclear Information System (INIS)

    Krimker, V.M.; Goldobenko, G.V.; Ozhiganov, E.L.; Ajtakova, T.I.; Dyuskaliev, Zh.D.

    1986-01-01

    A treatment modality employing radiotherapy wih subsequent hyperglycemia induction was evolved in experiments on mice and then clinically tested in 32 cases of inoperable locally - extensive primary and recurrent cancer of the rectum. A 50% regression of tumor was registered in 14 (43.0%) out of 32 patients treated with radiotherapy in combination with hyperglycemia. Similar degree of regression was observed only in 6 (15.0%) out of 40 patientswo received who received the same radiation treatment unaccompanied by hyperglycemia. The difference was statistically significant. No untoward side-effects developed. The results are encouraging and seem to open up new vistas of clinical research

  4. Radiotherapy combined with aclarubicin and neocarzinostatin for cancer of the gallbladder

    International Nuclear Information System (INIS)

    Okuyama, Shin-ichi; Mishina, Hitoshi; Funaki, Ken-ichi; Mori, Toshihiko

    1991-01-01

    Cancer of the gallbladder is radioresistant. When it was found inoperable, she was subjected to radiotherapy combined with aclarubicin and neocarzinostatin. Therapeutic effectiveness was confirmed at autopsy as she later succumbed to uterine cervical cancer. Thus, the present radiochemotherapeutic regimen would probably provide a means of overcoming those radioresistant inoperable malignancies. Intravenous administrations of appropriate antibiotics such as azthreonam and reniran may probably be helpful in the prevention and treatment of septic peritonitis possible during the course of reinforced radiotherapy of the abdomen. (author)

  5. Cryotherapy and radiotherapy combination in extensive and recurrent types of head and neck skin cancer treatment

    International Nuclear Information System (INIS)

    Pustynskij, I.N.; Paches, A.I.; Tkachev, S.I.; Tabolinovskaya, T.D.; Alieva, S.B.; Yagubov, A.S.; Slanina, S.V.; Bazhutova, G.A.

    2007-01-01

    The method of infiltrative skin cancer treatment based on different variants of radiotherapy and cryotherapy combination is described. During the period of 1988-2006 the Department of head and neck neoplasms of N. N. Blohin Russian Cancer Research Center provided radiation and cryogenic treatment of 94 patients with locally advanced head and neck epidermoid and basal cell cancer. For this purpose before every radiotherapy session the tumor was exposed to cryo cooling till freezing temperature (-5 degrees C). The total involution of tumors was observed at 91 patients. Residual tumors were removed surgically. The follow-up showed good functional and aesthetic results, retention of local tissues.

  6. Nimotuzumab combined with radiotherapy for esophageal cancer: preliminary study of a Phase II clinical trial

    Directory of Open Access Journals (Sweden)

    Liang J

    2013-11-01

    Full Text Available Jun Liang,1 Mingyan E,2 Gang Wu,3 Lujun Zhao,4 Xia Li,5 Xia Xiu,6 Ning Li,1 Bo Chen,1 Zhouguang Hui,1 Jima Lv,1 Hui Fang,1 Yu Tang,1 Nan Bi,1 Wenqing Wang,1 Yirui Zhai,1 Tao Li,1 Dongfu Chen,1 Shuangmei Zou,7 Ning Lu,7 Rolando Perez-Rodríguez,8 Junqi Zheng,9 Luhua Wang11Department of Radiotherapy, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; 2Department of Radiotherapy, Cancer Hospital of Harbin Medical University, Harbin, People's Republic of China; 3Department of Radiotherapy, Tongji Cancer Center Hospital, Wuhan, People's Republic of China; 4Department of Radiotherapy, Cancer Hospital of Tianjin Medical University, Tianjin, People's Republic of China; 5Department of Radiotherapy, LiaoNing Province Cancer Hospital, Shenyang, People's Republic of China; 6Department of Radiotherapy, Beijing Hospital, Beijing, People's Republic of China; 7Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China; 8Center of Molecular Immunology, Havana, Cuba; 9School of Medicine, Tongji University, Shanghai, People's Republic of ChinaObjective: To determine the safety and therapeutic effects of nimotuzumab (h-R3 combined with radiotherapy in esophageal cancer.Methods: This Phase II clinical trial involved 42 patients with stage II (inoperable or refused surgery to stage IV (supraclavicular lymph node metastasis only esophageal cancers treated between November 2008 and July 2010. All patients had squamous cell carcinomas, and all received three-dimensional conformal radiotherapy and 200 mg nimotuzumab per week during radiotherapy.Results: There were 9, 25, and 8 patients with stage II, III and IV disease, respectively. All except two patients received 50–70 Gy radiation; 37 patients (88.1% received more than five nimotuzumab doses. Grade III toxicities (21.4% of all adverse events included esophagitis and gastrointestinal, dermatological and hematological

  7. Combination chemotherapy and radiotherapy of small cell lung cancer

    International Nuclear Information System (INIS)

    Saito, Yasuo; Chohtoh, Shuichi; Nishijima, Hiroshi; Kobayashi, Akihiko; Hirose, Jin-ichiro; Kamimura, Ryoichi; Takashima, Tsutomu; Konishi, Hideo; Miyata, Samon.

    1986-01-01

    Treatment results of 49 patients (25, limited disease, LD, 24, extensive disease, ED) with small cell lung cancer were retrospectively analyzed. Fifteen patients received chemotherapy with Cyclophosphamide (CPM) and Vincristine (VCR) following thoracic radiotherapy (RT). Twenty-two patients were given induction chemotherapy with CPM, Adriamycin (ADM), and VCR and were followed by thoracic RT. Other chemotherapy consisted of CPM, VCR, Methotrexate, and ADM in 2 patients, 5-FU, CPM, Mitomycin C, and Toyomycin in 1 patient. The remaining 9 patients (2, LD, 7, ED) were treated with RT alone. The response rate was 80 % (64 % CR; 16 % PR) for LD patients and 33 % (4 % CR; 29 % PR) for ED patients (P < 0.001). The three-year survival (Kaplan-Meier's product) of all patients was 14 %, with a median survival time (MST) of 8 months. For patients with LD, the 3-year survival was 27 % (MST 15 months). Survival of patients with ED was 14 % at 1 year, 0 % at 2 year (MST 5.5 months). The difference between these figures was statistically significant (P < 0.0003). The 3-year survival and relapse-free survival for complete responders with LD were 43 % (MST 21 months) and 36 % (median CR duration, 11.5 months) respectively. Six of 16 complete responders with LD are alive and well at over 2 years. Local recurrence rate of the complete responders with LD was 28.8 %. None of the 7 complete responders given more than 48 Gy relapsed within the radiation field. We believe that the addition of thoracic RT to patients with LD is necessary for the control of the primary tumors and for long-term disease-free survival. (author)

  8. Post-operative analgesic effects of paracetamol, NSAIDs, glucocorticoids, gabapentinoids and their combinations

    DEFF Research Database (Denmark)

    Dahl, Jørgen Berg; Nielsen, Rasmus; Wetterslev, Jørn

    2014-01-01

    , and no well-documented 'gold standards' exist. The aim of the present topical, narrative review is to provide an update of the evidence for post-operative analgesic efficacy with the most commonly used, systemic non-opioid drugs, paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs)/COX-2 antagonists......, glucocorticoids, gabapentinoids, and combinations of these. The review is based on data from previous systematic reviews with meta-analyses, investigating effects of non-opioid analgesics on pain, opioid-requirements, and opioid-related adverse effects. Paracetamol, NSAIDs, COX-2 antagonists, and gabapentin....... Trials of pregabalin > 300 mg/day indicated a morphine-sparing effect of 13.4 (4, 22.8) mg morphine/24 h. Notably, though, the available evidence for additive or synergistic effects of most combination regimens was sparse or lacking. Paracetamol, NSAIDs, selective COX-2 antagonists, and gabapentin all...

  9. Intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy. Treatment feasibility and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Rutkowski, Tomasz; Wygoda, Andrzej; Hutnik, Marcin; Skladowski, Krzysztof; Wydmanski, Jerzy; Maciejewski, Boguslaw [Dept. of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer and Inst. of Oncology, Gliwice Branch (Poland); Maciejewski, Adam; Szymczyk, Cezary; Wierzgon, Janusz [Dept. of Surgery, Maria Sklodowska-Curie Memorial Cancer Center and Inst. of Oncology, Gliwice Branch (Poland); Orlef, Andrzej [Dept. of Physics, Maria Sklodowska-Curie Memorial Cancer Center and Inst. of Oncology, Gliwice Branch (Poland)

    2010-09-15

    Purpose: To evaluate the feasibility and preliminary results of intraoperative radiotherapy (IORT) with low-energy photons as a boost in patients with early-stage oral cancer with the indications for postoperative radiotherapy. Patients and Methods: Between 2003 and 2006, 16 patients with early-stage cancer of mobile tongue (n = 10 [63%]) or floor of the mouth (n = 6 [37%]) treated at Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Poland, were evaluated for IORT boost with the INTRABEAM {sup registered} System (Carl Zeiss Surgical GmbH; IORT-PRS) because of the high risk of local recurrence due to positive margins on frozen pathologic section. After tumor resection, the applicator was positioned in the tumor bed. The applicator's diameter (range: 1.5-5 cm) was selected to encompass high-risk area of tumor recurrence. The dose (5 Gy, 7 Gy, or 7.5 Gy) was applied according to tumor volume and bone proximity. External-beam radiotherapy (EBRT) was provided to the tumor bed in all patients (50 Gy) and to the nodal area, when needed. Toxicity and local tumor control were assessed. Results: Median follow-up was 36 months. IORT did not increase acute mucosal reaction. Local tumor control was found in all cases. Early mucosal reaction did not exceed 3 according to the RTOG scale and healed in median time of 35 days after completion of EBRT. No late adverse effects were observed. Conclusion: This preliminary report has demonstrated the feasibility of IORT-PRS for patients with early oral cancer with the indications for postoperative radiotherapy. This method may be considered an alternative boost technique, although additional studies are needed to establish long-term results in a larger group of patients. (orig.)

  10. The combination of radiotherapy and chemotherapy in the treatment of malignant tumours: indications and dangers

    International Nuclear Information System (INIS)

    Bartelink, H.; Somers, R.

    1980-01-01

    The combination of radiotherapy and chemotherapy has improved the results of treatment of certain malignant tumours. However, during both experimental investigations and clinical treatment, a number of severe side effects have been observed, during as well as some time after the administration, especially with use of actinomycin and adriamycin. Also the possibility exists that more secondary tumours are induced as the consequence of combination therapy. (Auth.)

  11. Need for postoperative experience in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Corcione, S; Api, P; Magnoni, G

    1984-01-01

    A clinical evaluation regarding the efficacy of post-operative radiotherapy in 294 patients with breast cancer is presented. In the Author's opinion post-operative radiotherapy is fundamental in the treatment of this tumor. 21 refs.

  12. Radiotherapy combined with hormonal therapy in prostate cancer: the state of the art

    Directory of Open Access Journals (Sweden)

    Piotr Milecki

    2010-10-01

    Full Text Available Piotr Milecki1,2, Piotr Martenka1, Andrzej Antczak3, Zbigniew Kwias31Department of Radiotherapy, Greater Poland Cancer Center, Poznan, Poland; 2Department of Electroradiology, Medical University, Poznan, Poland; 3Chair of Urology, Medical University, Poznan, PolandAbstract: Androgen-deprivation therapy (ADT is used routinely in combination with definitive external beam radiation therapy (EBRT in patients with high-risk clinically localized or locally advanced disease. The combined treatment (ADT–EBRT also seems to play a significant role in improving treatment results in the intermediate-risk group of prostate cancer patients. On the other hand, there is a growing body of evidence that treatment with ADT can be associated with serious and lifelong adverse events including osteoporosis, cardiovascular disease, diabetes, and many others. Almost all ADT adverse events are time dependant and tend to increase in severity with prolongation of hormonal manipulation. Therefore, it is crucial to clearly state the optimal schedule for ADT in combination with EBRT, that maintaining the positive effect on treatment efficacy would keep the adverse events risk at reasonable level. To achieve this goal, treatment schedule may have to be highly individualized on the basis of the patient-specific potential vulnerability to adverse events. In this study, the concise and evidence-based review of current literature concerning the general rationales for combining radiotherapy and hormonal therapy, its mechanism, treatment results, and toxicity profile is presented.Keywords: prostate cancer, radiotherapy, androgen deprivation, combined treatment

  13. Hypofractionated stereotactic radiotherapy in five daily fractions for post-operative surgical cavities in brain metastases patients with and without prior whole brain radiation.

    Science.gov (United States)

    Al-Omair, Ameen; Soliman, Hany; Xu, Wei; Karotki, Aliaksandr; Mainprize, Todd; Phan, Nicolas; Das, Sunit; Keith, Julia; Yeung, Robert; Perry, James; Tsao, May; Sahgal, Arjun

    2013-12-01

    Our purpose was to report efficacy of hypofractionated cavity stereotactic radiotherapy (HCSRT) in patients with and without prior whole brain radiotherapy (WBRT). 32 surgical cavities in 30 patients (20 patients/21 cavities had no prior WBRT and 10 patients/11 cavities had prior WBRT) were treated with image-guided linac stereotactic radiotherapy. 7 of the 10 prior WBRT patients had "resistant" local disease given prior surgery, post-operative WBRT and a re-operation, followed by salvage HCSRT. The clinical target volume was the post-surgical cavity, and a 2-mm margin applied as planning target volume. The median total dose was 30 Gy (range: 25-37.5 Gy) in 5 fractions. In the no prior and prior WBRT cohorts, the median follow-up was 9.7 months (range: 3.0-23.6) and 15.3 months (range: 2.9-39.7), the median survival was 23.6 months and 39.7 months, and the 1-year cavity local recurrence progression- free survival (LRFS) was 79 and 100%, respectively. At 18 months the LRFS dropped to 29% in the prior WBRT cohort. Grade 3 radiation necrosis occurred in 3 prior WBRT patients. We report favorable outcomes with HCSRT, and well selected patients with prior WBRT and "resistant" disease may have an extended survival favoring aggressive salvage HCSRT at a moderate risk of radiation necrosis.

  14. Early postoperative magnet application combined with hydrocolloid dressing for the treatment of earlobe keloids.

    Science.gov (United States)

    Park, Tae Hwan; Chang, Choong Hyun

    2013-04-01

    To prevent the recurrence of earlobe keloids after surgical removal, a reliable and safe postoperative treatment method is critical. To the authors' knowledge, no studies have elucidated the most effective postoperative dressing method for preventing the recurrence of earlobe keloids. This study aimed to compare keloid recurrence rates in patients whose keloids were dressed using conventional methods (plain gauze or a polyvinyl alcohol sponge) with those of a matched cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. This observational case-control study compared a retrospective cohort of patients whose keloids were dressed using conventional methods with a matched prospective cohort of patients whose keloids were dressed using magnets combined with hydrocolloid materials. The study included patients with pathologically confirmed earlobe keloids that were surgically excised with primary closure. Patients 8 years of age or older underwent adjuvant pressure therapy with magnets at the study hospital. Patients were excluded from the study if they were unavailable for follow-up evaluation, if they had received additional adjuvant therapy during treatment, or if histologic confirmation of a keloid was not obtained. Matched-pair analysis was performed using the McNemar test. Treatment outcome was evaluated as recurrence or nonrecurrence. Overall, 9 (11.2%) of the 80 study patients experienced recurrence. The recurrence rate was significantly lower in the matched case group (2 of 40, 5%) than in the matched control group (7 of 40, 17.5%) during the follow-up period of 18 months (p=0.0253). The authors' novel dressing of magnets and hydrocolloid materials appears to be effective in reducing earlobe keloid recurrence. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to

  15. Combined effects of radiotherapy and chemotherapy normal tissue, 1

    International Nuclear Information System (INIS)

    Watanabe, Noriaki

    1983-01-01

    The combined effects of radiation and drugs on the fine vasculature of mouse liver were investigated by microangiography. The fine vasculature of the liver showed dilatations one day after 1000 rad of irradiation to the liver. The fine vasculature of the liver showed marked dilatations and slight extravasations one day after 1000 rad of irradiation to the whole body. The fine vasculature of the liver showed dilatations and partial narrowings after the administration of BLM, 2mg/kg/day ip for 5 days. The combined effects of BLM and radiation was greater than that with radiation alone. The fine vasculature of the liver showed marked dilatations and slight extravasation after the administration of BLM, 2mg/kg/day ip for 5 days and MMC 2mg/kg ip on day 6. This findings is about the same as that after the administration of BLM and 1000 rad of irradiation. The administration of urokinase did not diminish the effects of radiation on the fine vasculature of the liver. The administration of YM-08310 diminished the effects of irradiation on the fine vasculature of the liver. (author)

  16. Radiotherapy combined with Tegafur (FT-207s) for brain tumors

    International Nuclear Information System (INIS)

    Aoki, Yoshiro

    1981-01-01

    5-Fluorouracil (5-FU) has anti-tumor effects as an anti-metabolite, but it cannot pass the Blood-Brain-Barrier (BBB). FT-207 a masked-compound of 5-FU, is easily lipid soluble and is able to pass the BBB. Twenty eight patients of primary brain tumor and 8 patients of metastatic brain tumor were treated with irradiation combined with 750 mg of FT-207 suppository. Twenty four patients of primary brain tumor were treated only with irradiation as control. The mean survival time was 20.4 +- 11.8 months for the combined therapy group and 17.6 +- 8.6 months for the control. The concentration of FT-207 and 5-FU in serum and in cerebrospinal fluid (CSF) was investigated after administration of 750 mg of FT-207 suppository per annum. The maximum concentration of FT-207 and of 5-FU in serum was 20.4 +- 11.8 mcg/ml and 0.06 +- 0.02 mcg/ml, respectively. There were observed several side effects, such as anorexia, nausea, exanthema and etc. These side effects were not so great as to interrupt the therapy at the dose level of 750 mg of FT-207. However, at the dose of 1500 mg, one case showed disturbance of consciousness, to which attention should be called. (author)

  17. Acute toxicity and efficacy of postoperative combined modality therapy for adenocarcinoma of the pancreas

    International Nuclear Information System (INIS)

    Davis, Brian J.; Raben, Adam; Casper, Ephraim; Minsky, Bruce D.

    1996-01-01

    PURPOSE: To examine the acute toxicity and outcome in patients (pts) treated with combined modality therapy following resection of adenocarcinoma of the pancreas. MATERIALS AND METHODS: From 2/88 to 2/96, 34 pts (M:20, F:14) received postoperative combined modality therapy following a pancreatic resection. Tumor location included; head only: 28, head and ampulla: 1, ampulla only: 1, body and tail: 2, and tail only: 2. Postoperative stages included: stage I: 7 (21%) and stage III: 27 (79%). Pts were referred for combined modality therapy based on surgeon preference. In general, pts were treated who had one or more adverse prognostic factors. These included positive local/regional lymph nodes (79%), positive margins (50%) or disease invasive into adjacent structures (85 %). Radiation fields included the original primary tumor bed (based on preoperative CT scans) and peri-pancreatic and para-aortic lymph nodes adjacent to vertebral bodies T10 through L3. No attempt was made to include the entire pancreas in the radiation field. Patients received 5040 cGy at 180 cGy/day using a 3 or 4 field technique and CT-based treatment planning. Concurrent bolus 5-FU (375-500 mg/m 2 ) was delivered on the first three and last three days of radiation. Post-radiation maintenance bolus 5-FU was given to 7 patients for a median of 6 cycles. A toxicity assessment using the NCI toxicity criteria was performed at each weekly visit and 4 weeks following the completion of combined modality therapy. The median follow-up was 13 months (range: 2-36 months). Patterns of failure as a component of failure were assessed by radiographic criteria and, in 2 pts, by intraoperative evaluation for symptomatic progression of disease. Local/regional failure was defined as recurrence within the radiation field. Distant failure included liver, peritoneal seeding, and extra-abdominal sites. Actuarial survival was calculated from the time of surgery using the Kaplan-Meier method. RESULTS: The only grade 3

  18. Androgenic suppression combined with radiotherapy for the treatment of prostate adenocarcinoma: a systematic review

    International Nuclear Information System (INIS)

    Sasse, André D; Sasse, Elisa; Carvalho, Albertina M; Macedo, Ligia T

    2012-01-01

    Locally advanced prostate cancer is often associated with elevated recurrence rates. Despite the modest response observed, external-beam radiotherapy has been the preferred treatment for this condition. More recent evidence from randomised trials has demonstrated clinical benefit with the combined use of androgen suppression in such cases. The aim of this meta-analysis is to compare the combination of distinct hormone therapy modalities versus radiotherapy alone for overall survival, disease-free survival and toxicity. Databases (MEDLINE, EMBASE, LILACS, Cochrane databases and ClinicalTrials.gov) were scanned for randomised clinical trials involving radiotherapy with or without androgen suppression in local prostate cancer. The search strategy included articles published until October 2011. The studies were examined and the data of interest were plotted for meta-analysis. Survival outcomes were reported as a hazard ratio with corresponding 95% confidence intervals. Data from ten trials published from 1988 to 2011 were included, comprising 6555 patients. There was a statistically significant advantage to the use of androgen suppression, in terms of both overall survival and disease free survival, when compared to radiotherapy alone. The use of long-term goserelin (up to three years) was the strategy providing the higher magnitude of clinical benefit. In contrast to goserelin, there were no trials evaluating the use of other luteinizing hormone-releasing hormone (LHRH) analogues as monotherapy. Complete hormonal blockade was not shown to be superior to goserelin monotherapy. Based on the findings of this systematic review, the evidence supports the use of androgen suppression with goserelin monotherapy as the standard treatment for patients with prostate cancer treated with radiotherapy, which are at high risk of recurrence or metastases

  19. Dosimetric planning study for the prevention of anal complications after post-operative whole pelvic radiotherapy in cervical cancer patients with hemorrhoids.

    Science.gov (United States)

    Baek, J G; Kim, E C; Kim, S K; Jang, H

    2015-01-01

    Radiation-induced anal toxicity can be induced by low radiation doses in patients with haemorrhoids. The object of this study was to determine the dosimetric benefits of different whole pelvic radiotherapy (WPRT) techniques in terms of dose delivered to the anal canal in post-operative patients with cervical cancer. The planning CT images of 10 patients with cervical cancer undergoing postoperative radiotherapy were used for comparison of three different plans. All patients had been treated using the conventional box technique WPRT (CV-WPRT), and we tried low-margin-modified WPRT (LM-WPRT), three-dimensional conformal techniques WPRT (CF-WPRT) and intensity-modulated WPRT (IM-WPRT) planning for dosimetric comparison of the anal canal, retrospectively. Mean anal canal doses of the IM-WPRT were significantly lower (p 99%, and the proportion that received ≥108% of the prescribed dose for IM-WPRT was <2%. Volumes of bladders and rectums that received ≥30 or ≥40 Gy were significantly lower for IM-WPRT than for three of the four-field WPRT plans (p = 0.000). IM-WPRT can significantly reduce radiation dose delivered to the anal canal and does not compromise PTV coverage. In patients with haemorrhoids, IM-WPRT may be of value for the prevention of anal complications. Although tolerance of the anal canal tends to be ignored in patients undergoing post-operative WPRT, patients with haemorrhoids may suffer complications at low radiation doses. The present study shows IM-WPRT can be meaningful in these patients.

  20. Treatment of lymphatic nodes metastasis in advanced cancer with interventional chemotherapy combined radiotherapy

    International Nuclear Information System (INIS)

    Xia Shian; Guo Weijian; Wu Guohua; Lin Qing; Jiang Mawei; Yao Yuan

    2000-01-01

    Objective: To evaluate the clinical effects of treatment with interventional chemotherapy combined radiotherapy for lymphatic nodes metastasis in advanced cancer. Methods: Treated with interventional chemotherapy for 27 cases of lymphatic rode metastasis once a month with average 2-3 times totally. Simultaneously treated with linear accelerator radiotherapy with average dose of 40-50 Gy/20-25 times/4-5 weeks. Results: To evaluate the clinical effects after finished the whole treatment program two months later. CR + PR reached 77.8% (24/27). All patients showed tolerance to accept the treatment. Conclusion: Treatment for lymphatic node metastasis in advanced cancer with interventional chemotherapy combined radiation therapy seems to be a valuable way

  1. The search for therapeutic gain in the combination of radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Steel, G.G.

    1988-01-01

    The literature on combined treatment with radiation and cytotoxic drugs in experimental tumours and normal tissues of laboratory animals is reviewed in the context of the four previously proposed mechanisms whereby a therapeutic advantage might be gained. There is evidence for strong time-dependent processes occurring in some normal tissues. In tumours, the evidence is much weaker and there is considerable disparity among experimental tumours in optimum timing. This review leads to the conclusion that the clinical use of drug-radiation combinations should not be based on an anticipated beneficial interaction; gain will most probably come from the best radiotherapy and the best chemotherapy given as far as possible independently. Deleterious interactions can be reduced by allowing a gap of some weeks between chemotherapy and radiotherapy and by avoiding drugs that are known to enhance radiation damage to the normal tissues that are irradiated. 131 refs.; 4 figs.; 5 tabs

  2. The effect of endostatin gene in combination with radiotherapy on rats with implanted tumor

    International Nuclear Information System (INIS)

    Li Yong; Jin Ning; Yang Haishan; Piao Chunji; Lv Zhe

    2005-01-01

    Objective: To study the combination therapy effect of the radiotherapy with endostatin gene therapy on the rats with implanted tumor. Methods: Immediate Walker-256 cancerous ascetic injection method was used to make a rat tumor-bearing model, then the tumor was treated with saline, endostatin gene, irradiation or endostatin gene plus irradiation. The tumor growth rate and weight were observed, Western blot and RT-PCR were adopted to check the expressions of endostatin mRNA and protein. Results: The expressions of endostatin mRNA and protein were significant in the gene therapy group and the gene plus radiotherapy group, but there was a significant difference between these two groups. As compared with the control group, the tumor growth rate and weight decreased significantly in all the therapy groups (P 0.05). Conclusion: After the pCMV-Endostatin was induced, the expressions of endostatin mRNA and protein was significant in Walker-256 tumor and the tumor growth was inhibited. However, the effect of the endostatin gene plus radiotherapy was obviously better than that of the endostatin gene therapy group or the radiotherapy group for inhibiting tumor growth. (authors)

  3. Clinical Factors Predicting Late Severe Urinary Toxicity After Postoperative Radiotherapy for Prostate Carcinoma: A Single-Institute Analysis of 742 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cozzarini, Cesare, E-mail: cozzarini.cesare@hsr.it [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Fiorino, Claudio [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Da Pozzo, Luigi Filippo [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Alongi, Filippo; Berardi, Genoveffa; Bolognesi, Angelo [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Briganti, Alberto [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Broggi, Sara [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Deli, Aniko [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Guazzoni, Giorgio [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Perna, Lucia [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Pasetti, Marcella; Salvadori, Giovannella [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Montorsi, Francesco; Rigatti, Patrizio [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Di Muzio, Nadia [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy)

    2012-01-01

    Purpose: To investigate the clinical factors independently predictive of long-term severe urinary sequelae after postprostatectomy radiotherapy. Patients and Methods: Between 1993 and 2005, 742 consecutive patients underwent postoperative radiotherapy with either adjuvant (n = 556; median radiation dose, 70.2 Gy) or salvage (n = 186; median radiation dose, 72 Gy) intent. Results: After a median follow-up of 99 months, the 8-year risk of Grade 2 or greater and Grade 3 late urinary toxicity was almost identical (23.9% vs. 23.7% and 12% vs. 10%) in the adjuvant and salvage cohorts, respectively. On univariate analysis, acute toxicity was significantly predictive of late Grade 2 or greater sequelae in both subgroups (p <.0001 in both cases), and hypertension (p = .02) and whole-pelvis radiotherapy (p = .02) correlated significantly in the adjuvant cohort only. The variables predictive of late Grade 3 sequelae were acute Grade 2 or greater toxicity in both groups and whole-pelvis radiotherapy (8-year risk of Grade 3 events, 21% vs. 11%, p = .007), hypertension (8-year risk, 18% vs. 10%, p = .005), age {<=} 62 years at RT (8-year risk, 16% vs. 11%, p = .04) in the adjuvant subset, and radiation dose >72 Gy (8-year risk, 19% vs. 6%, p = .007) and age >71 years (8-year risk, 16% vs. 6%, p = .006) in the salvage subgroup. Multivariate analysis confirmed the independent predictive role of all the covariates indicated as statistically significant on univariate analysis. Conclusions: The risk of late Grade 2 or greater and Grade 3 urinary toxicity was almost identical, regardless of the RT intent. In the salvage cohort, older age and greater radiation doses resulted in a worse toxicity profile, and younger, hypertensive patients experienced a greater rate of severe late sequelae in the adjuvant setting. The causes of this latter correlation and apparently different etiopathogenesis of chronic damage in the two subgroups were unclear and deserve additional investigation.

  4. Concurrent radiotherapy: fotemustine combination for newly diagnosed malignant glioma patients, a phase II study.

    Science.gov (United States)

    Beauchesne, Patrick D; Taillandier, L; Bernier, V; Carnin, C

    2009-06-01

    Fotemustine is a nitrosourea compound used for the treatment of malignant gliomas, especially in France. Recently, an EORTC-NCIC study has shown that a concomitant combination of radiotherapy plus temozolomide (an oral cytotoxic drug) improved survival in glioblastoma patients. We set out to test a concurrent combination of radiotherapy and fotemustine for newly malignant gliomas. A prospective single-center phase II study opened for accrual in September 2004. Patients over 18 years of age able to give informed consent and with histologically proven, newly diagnosed supratentorial malignant gliomas were eligible. All patients were treated by a standard cranial irradiation (conformal irradiation, tumor bulk plus a margin of 2.5 cm) and concomitant daily administration of 10 mg/m(2) of fotemustine (5 days per week, 6 weeks, 1 h 30 min before radiation therapy). Adjuvant chemotherapy, fotemustine, was administered at tumor progression as standard and classic regimen. Twenty-two patients were enrolled, 16 men and 6 women, median age 56 years (range 32-74), median Karnofsky performance status 70 (range 60-90). Histology included 16 glioblastomas, 3 anaplastic astrocytomas, 2 anaplastic oligodendrogliomas and 1 mixed glioma. Eight patients underwent surgery (three total resections). Fourteen patients had a stereotactic biopsy. The concurrent radiotherapy-fotemustine combination was well tolerated: toxicity was mild and three hematologic toxicities grade 3-4 were observed. Median survival from the initial diagnosis was 9.9 months, two patients are currently alive. Median survival was 11 months for surgery and 9 months for stereotactic biopsy. Concomitant radiotherapy-fotemustine combination is safe and well tolerated. Overall survival of over 10 months for the whole population compares favorably with other reports.

  5. Incidence of severe capsular contracture following implant-based immediate breast reconstruction with or without postoperative chest wall radiotherapy using 40 Gray in 15 fractions

    International Nuclear Information System (INIS)

    Whitfield, Gillian A.; Horan, Gail; Irwin, Michael S.; Malata, Charles M.; Wishart, Gordon C.; Wilson, Charles B.

    2009-01-01

    Purpose: To determine the incidence of capsular contracture (CC) requiring revisional surgery in patients receiving postoperative radiotherapy (RT) or no RT following mastectomy and immediate breast reconstruction. Material and methods: One hundred and seventy-eight immediate breast reconstructions performed at the Cambridge Breast Unit between 1.1.2001 and 31.12.2005 were identified. RT was delivered using a standard UK scheme of 40 Gray in 15 fractions over 3 weeks. The influence of hormones and chemotherapy as well as postoperative RT on time to development of severe CC after implant-based reconstruction was explored in univariate and multivariate analysis. Results: One hundred and ten patients had implant-based reconstructions with a median follow-up of 51 months. In the RT group (41 patients), there were 8 patients with severe CC requiring revisional surgery, a crude rate of 19.5%, with actuarial rates of 0%, 5%, 5%, 21%, 30% and 30% at 1, 2, 3, 4, 5 and 6 years follow-up. In the unirradiated group, there were no cases of severe CC. This difference is highly significant (p < 0.001). Hormones and chemotherapy were not significantly associated with severe CC. Conclusions: This series showed a significantly higher rate of severe CC with postoperative RT. This finding has important clinical implications, when counselling patients for immediate breast reconstruction

  6. Dosimetric comparison of vaginal vault ovoid brachytherapy versus intensity-modulated radiation therapy plans in postoperative patients of cervical carcinoma following whole pelvic radiotherapy

    Directory of Open Access Journals (Sweden)

    Divya Khosla

    2014-01-01

    Full Text Available Introduction: Dosimetric study to compare high dose rate (HDR vaginal vault ovoid brachytherapy plan versus intensity-modulated radiation therapy (IMRT boost plan for doses delivered to target volume and organs at risk (OAR in postoperative patients of cervical carcinoma following whole pelvic radiotherapy (WPRT. Materials and Methods: Fifteen postoperative patients of cervical carcinoma suitable for vaginal ovoid brachytherapy following WPRT of 46 Gy/23 fractions/4.5 weeks were included. All were treated with brachytherapy (two sessions of 8.5 Gy each. The equivalent dose for IMRT was calculated by computing biologically effective dose of brachytherapy by linear quadratic model. Dose of brachytherapy (two sessions of 8.5 Gy was equivalent to IMRT dose of 26 Gy/13 fractions. Doses to target volume and OAR were compared between HDR and IMRT plans. Results: Target volume was well covered with both HDR and IMRT plans, but dose with brachytherapy was much higher (P < 0.05. Mean doses, doses to 0.1, 1, 2, and 5cc, 1/3 rd , 1/2, and 2/3 rd volume of bladder and rectum were significantly lower with HDR plans. Conclusion: In postoperative patients of cervical carcinoma, HDR brachytherapy following WPRT appears to be better than IMRT for tumor coverage and reducing dose to critical organs.

  7. Postoperative radiotherapy-induced morbidity in rectal cancer Morbilidad de la radioterapia postoperatoria en el cáncer de recto

    Directory of Open Access Journals (Sweden)

    M. Garay Burdeos

    2004-11-01

    Full Text Available Objectives: we analyzed long-term morbidity and bowel function alteration after postoperative radiotherapy for rectal cancer following resection with anastomosis. Patients and methods: thirty-seven patients who underwent surgery with intention to cure and a minimal follow-up period of 3 years were included. These patients were divided into two groups: in the first group, 14 patients received postoperative chemo-radiotherapy, 5-fluorouracil plus folinic acid, and 45 Gy plus 5 Gy boost. In the second group, there were 23 patients regarded as controls. We designed a questionnaire about their bowel function and analyzed the morbidity detected in their follow-up. Results: the group that was treated with postoperative chemo-radiotherapy had more daily bowel movements (p = 0.03 and night-time movements (p = 0.04; incontinence (69.2 versus 17.4% in the control group; p = 0.002, and perianal skin irritation (p = 0.04 versus the control group. Although without meaningful differences, the group under treatment wore a pad more often, had more defecatory urgency, could distinguish worse gas from stool, and needed more frequently antidiarrheal measures. Major complications were present in 28.6% of the under-treatment group: three intestinal resections were performed due to actinic stenosis; one patient had a residual stercoral fistula; another had several occlusive crises solved with medical treatment. Conclusions: postoperative chemo-radiotherapy had a high morbidity rate, which determined a significant alteration in quality of life. Accuracy in indication is therefore necessary, as well as a consideration of other alternatives for treatment, such as preoperative chemo-radiotherapy and total mesorectal excision.Objetivos: analizar la morbilidad y alteración del funcionalismo rectal a largo plazo de la radioterapia postoperatoria tras resección con anastomosis en el cáncer de recto. Material y métodos: se incluyen 37 pacientes intervenidos con intenci

  8. Radiotherapy of medulloblastoma combined with OK-432 (Picibanil)

    International Nuclear Information System (INIS)

    Aoki, Yoshiro

    1986-01-01

    The OK-432 group consists of 8 Medulloblastoma patients, 5 Pinealoma patients and 1 Pons glioma patient, while the historical control group consists of 12 Medulloblastoma patients who have been treated only with radiation at NIRS. The frequency of the week when the value of white blood cell counts decreased below 2,500 was 13 weeks per 98 weeks of total observation period (13.3 %) in the OK-432 group. However, it was 37 weeks per 103 weeks (35.9 %) in the control group. The frequency of the week when the value of the platelet counts decreased below 10 x 10 4 was 5 weeks per 98 weeks (5.1 %) in the OK-432 group, while it was 21 weeks per 103 weeks (20.4 %) in the control group. The OK-432 group received 54.4 ± 3.3 Gy/ 34 ± 2 fractions/ 51 ± 4 days to the cerebellar tumor, except a one-year-old girl who received only a half of the radiation dose as the other patients who were older than 5 years, while the control group received 47.2 ± 7.3 Gy/ 34 ± 7 fractions/ 49 ± 10 days. In terms of TDF, the OK-432 group received 83.5 ± 8.7 and the control group received 63.5 ± 10.2, whereby the difference between the OK-432 group and the control group is statistically significant at 2 % level. To the spinal cord, the OK-432 group received 27.1 ± 3.1 Gy/ 27 ± 5 fractions/ 41 ± 9 days, while the control group received 25.4 ± 7.5 Gy/ 27 ± 13 fractions/ 43 ± 25 days. The survival rate of 8 Medulloblastoma patients treated with radiation combined with OK-432 is as follows : the relative survival rate is 75.1 % in one year, 62.5 % in 3 years and 62.5 % in 5 years, in contrast to the rate of 73.3 % in one year, 20.0 % in 3 years and 20.0 % in 5 years in the control group. (J.P.N.)

  9. Experimental study of chemical embolus therapy combined with radiotherapy for VX2 bone tumors

    International Nuclear Information System (INIS)

    Yamaguchi, Hiroshi; Mochizuki, Kazuo; Ishii, Yoshiaki

    2000-01-01

    We conducted an experimental study, using a combination of coarse crystal cisplatin and radiotherapy for bone tumors, to evaluate the possibility of the clinical application of chemical embolus therapy in the field of orthopedic surgery. Experimental femoral bone tumors were produced, in rabbits, using VX2 carcinoma. The rabbits were allocated to five groups: untreated control, embolus, chemical embolus, irradiation alone, and chemical embolus and irradiation combination. These therapies were evaluated comparatively, in terms of local antitumor effects (including body weight, X-ray findings, angiography, and histopathology) and in terms of inhibition of pulmonary metastasis. Local antitumor effects, as evaluated by all parameters, except for body weight, were significantly greater for the chemical and irradiation combination group than for the chemical embolus, irradiation alone, untreated control, and embolus groups. There was no significant difference in the inhibition of pulmonary metastasis among the chemical embolus and irradiation combination, chemical embolus, and irradiation alone groups. These findings demonstrated the synergistic effect of the combination of chemical embolus therapy and radiotherapy. In this study, however, no significant difference was found between the chemical embolus therapy alone and the combination therapy groups in the inhibitory effect on pulmonary tumor metastasis, suggesting the need to conduct combination therapy repeatedly in the clinical setting. (author)

  10. Postoperative radiotherapy in squamous cell carcinoma of the oral cavity: the importance of the overall treatment time

    NARCIS (Netherlands)

    Langendijk, J. A.; de Jong, M. A.; Leemans, C. R.; de Bree, R.; Smeele, L. E.; Doornaert, P.; Slotman, B. J.

    2003-01-01

    To test the hypothesis that (1) the distinction between intermediate- and high-risk patients by clustering different prognostic factors results in a significant difference in treatment outcome and (2) a shorter interval between surgery and radiotherapy and shorter overall treatment times of

  11. Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy?

    International Nuclear Information System (INIS)

    Rudoltz, Marc S.; Benammar, Alia; Mohiuddin, Mohammed

    1995-01-01

    Purpose: To evaluate the effect of pathologic lymph node status and nodal stage on local control at the primary site in patients with advanced squamous cell carcinomas of the head and neck, treated with radical surgery and postoperative irradiation. Methods and Materials: Fifty-seven patients with advanced squamous cell carcinomas of the oral cavity, oropharynx, hypopharynx, larynx, and supraglottic larynx were analyzed. All patients underwent resection of the primary lesion, neck dissection, and postoperative radiotherapy. Minimum follow-up was 2 years. The median dose to the primary tumor bed was 60.4 Gray (range 39.7-72.0). Besides pathologic nodal status (pN0 vs. pN+) and nodal stage, the following factors were analyzed for their impact on local control: age, gender, T stage, tumor grade, resection margins, interval from surgery to irradiation, dose to the primary site, and overall treatment time. Results: The 3-year actuarial local control rate was 78%. When all patients were analyzed, nodal status (pN0 vs. pN+) did not affect control at the primary site (71% vs. 82%, p = 0.42). Nodal stage (pN0-N2a va. pN2b-N2c) was also not a significant factor for local control (74% vs. 82%, p = 0.57). When only patients with negative margins were analyzed, nodal status again did not impact on local control (79% vs. 90% for pN0 vs. pN+, p = 0.39). On univariate analysis, only tumor grade, margin status, and elapsed days were significant factors for local control. Local control was 85% for patients with negative margins vs. 60% for those with positive margins (p = 0.016). For patients with moderately and poorly differentiated tumors, local control was 86% as compared to 50% for patients with well-differentiated tumors (p = 0.007). When radiotherapy was completed within 50 days, local control was 93% as opposed to 63% for >50 days (p 0.016). On multivariate analysis, only margin status (p = 0.002) and tumor grade (p = 0.007) remained significant. Conclusion: We conclude that

  12. Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy?

    Energy Technology Data Exchange (ETDEWEB)

    Rudoltz, Marc S; Benammar, Alia; Mohiuddin, Mohammed

    1995-02-01

    Purpose: To evaluate the effect of pathologic lymph node status and nodal stage on local control at the primary site in patients with advanced squamous cell carcinomas of the head and neck, treated with radical surgery and postoperative irradiation. Methods and Materials: Fifty-seven patients with advanced squamous cell carcinomas of the oral cavity, oropharynx, hypopharynx, larynx, and supraglottic larynx were analyzed. All patients underwent resection of the primary lesion, neck dissection, and postoperative radiotherapy. Minimum follow-up was 2 years. The median dose to the primary tumor bed was 60.4 Gray (range 39.7-72.0). Besides pathologic nodal status (pN0 vs. pN+) and nodal stage, the following factors were analyzed for their impact on local control: age, gender, T stage, tumor grade, resection margins, interval from surgery to irradiation, dose to the primary site, and overall treatment time. Results: The 3-year actuarial local control rate was 78%. When all patients were analyzed, nodal status (pN0 vs. pN+) did not affect control at the primary site (71% vs. 82%, p = 0.42). Nodal stage (pN0-N2a va. pN2b-N2c) was also not a significant factor for local control (74% vs. 82%, p = 0.57). When only patients with negative margins were analyzed, nodal status again did not impact on local control (79% vs. 90% for pN0 vs. pN+, p = 0.39). On univariate analysis, only tumor grade, margin status, and elapsed days were significant factors for local control. Local control was 85% for patients with negative margins vs. 60% for those with positive margins (p = 0.016). For patients with moderately and poorly differentiated tumors, local control was 86% as compared to 50% for patients with well-differentiated tumors (p = 0.007). When radiotherapy was completed within 50 days, local control was 93% as opposed to 63% for >50 days (p 0.016). On multivariate analysis, only margin status (p = 0.002) and tumor grade (p = 0.007) remained significant. Conclusion: We conclude that

  13. The study on the immunological effect of Sizofilan combined with radiotherapy in patients with uterine cervical cancer

    International Nuclear Information System (INIS)

    Sekiguchi, Isao; Suzuki, Mitsuaki; Izumi, Akio; Aida, Ichiro; Tamada, Taro

    1990-01-01

    To investigate the immunological effect of Sizofilan (SPG) combined with radiotherapy, we evaluated the immunological parameters in 22 patients with uterine cervical cancer. Twelve patients were treated with SPG combined with radiotherapy (SPG group), and the other ten patients with radiotherapy only (control group). During radiotherapy, the numbers of lymphocyte and CD2 positive cell decreased in the SPG and control groups. After radiotherapy, however, its numbers in the SPG group became significantly higher than in the control group (p<0.05). The number of CD3 positive cell also presented a tendency to increase after radiotherapy in the SPG group. As for CD20 positive cell, its numbers were kept unchanged after radiotherapy in both groups, and no significant difference was observed between them. NK cell activity decreased during radiotherapy in both groups. After radiotherapy, its activity in the SPG group recovered to its pre-value and became significantly higher than that in the control group (p<0.05). SPG did not have any prominent effect on CD4/CD8 ratio. The adverse effect of SPG to liver or kidney function was not observed in our patients. The SCC level in the SPG group decreased rapidly by radiotherapy as well as that in the control group, and no significant difference was observed in SCC levels between them. So it was suggested that SPG did not suppress the cytocidal effect of radiation to cancer cells. Based on these findings, it was concluded that SPG prompted the recovery of not only lymphocyte, especially T cell, but also NK cell activity. These immunological findings presented a usefulness of clinical application of SPG to radiotherapy in patients with uterine cervical cancer. (author)

  14. Long-term results of preoperative intra-arterial doxorubicin combined with neoadjuvant radiotherapy, followed by extensive surgical resection for locally advanced soft tissue sarcomas of the extremities

    International Nuclear Information System (INIS)

    Nijhuis, P.H.A.; Pras, E.; Sleijfer, D.T.; Molenaar, W.M.; Schraffordt Koops, H.; Hoekstra, H.J.

    1999-01-01

    Background and purpose: In the 1980s a combined modality therapy of intraarterial doxorubicin, neoadjuvant radiotherapy and surgery was initiated at the Groningen University Hospital as a limb-saving treatment for locally advanced, primarily irresectable high-grade soft tissue sarcomas (STS) of the extremities. This study presents the short- and long-term results.Patients and methods: Between 1983 and 1987, 11 patients were treated with intraarterial doxorubicin, preoperative radiotherapy (10x3.5 Gy) and surgical resection. Non-radical resections received additional postoperative radiotherapy of 20-30 Gy.Results: The limb-salvage rate was 91%, without local recurrences during a median hollow-up of 84 months. Six patients died (55%); five from metastatic disease (45%). There were five long-term survivors with a median follow-up of 10 years. Three patients (60%) suffered serious late complications, resulting in disabilitating limb function. Conclusion: Although this approach is feasible as a limb-saving treatment for these unfavorable STS, long-term morbidity is high. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  15. [Efficacy of MVP chemotherapy combined with concurrent radiotherapy for advanced non-small cell lung cancer].

    Science.gov (United States)

    Qiao, Tiankui; Zhou, Daoan; Chen, Wei; Wang, Xianglian

    2004-12-20

    To observe the effects of MVP chemotherapy combined with concurrent radiotherapy for stage IIIB-IV non-small cell lung cancer. Sixty-two patients with stage IIIB-IV non-small cell lung cancer were randomized into two groups, concurrent radiochemotherapy group and MVP che-motherapy group. All patients in two groups were treated with MVP regimen (mitomycin C 6 mg/m² on day 1, vindesine 2 mg/m² on days 1, 8, and cisplatin 80-100 mg/m²). Patients in concurrent radiochemotherapy group received concurrent radiotherapy (46-56 Gy in 5-6 weeks). All patients received 2-4 cycles of MVP chemotherapy. The response rate was 48.4% and 19.4% in concurrent radiochemotherapy group and MVP group respectively (P MVP group.. The results show that efficacy of MVP chemotherapy combined with concurrent radiotherapy is significantly higher than that of MVP chemotherapy alone for advanced non-small cell lung cancer.

  16. Outcomes of Preoperative Chemoradiotherapy and Combined Chemotherapy with Radiotherapy Without Surgery for Locally Advanced Rectal Cancer.

    Science.gov (United States)

    Supaadirek, Chunsri; Pesee, Montien; Thamronganantasakul, Komsan; Thalangsri, Pimsiree; Krusun, Srichai; Supakalin, Narudom

    2016-01-01

    To evaluate the treatment outcomes of patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT) or combined chemotherapy together with radiotherapy (CMTRT) without surgery. A total of 84 patients with locally advanced rectal adenocarcinoma (stage II or III) between January 1st, 2003 and December 31st, 2013 were enrolled, 48 treated with preoperative CCRT (Gr.I) and 36 with combined chemotherapy and radiotherapy (CMTRT) without surgery (Gr.II). The chemotherapeutic agents used concurrent with radiotherapy were either 5fluorouracil short infusion plus leucovorin and/or capecitabine or 5fluorouracil infusion alone. All patients received pelvic irradiation. There were 5 patients (10.4%) with a complete pathological response. The 3 yearoverall survival rates were 83.2% in Gr.I and 24.8 % in Gr.II (prectal cancer demonstrated that in preoperative CCRT a sphincter sparing procedure can be performed. The results of treatment with preoperative CCRT for locally advanced rectal cancer showed comparable rates of overall survival and sphincter sparing procedures as compared to previous studies.

  17. Pilot studies of superfractionated radiotherapy and combination chemotherapy in limited oat cell carcinoma of the bronchus

    International Nuclear Information System (INIS)

    Hodson, D.I.; Malaker, K.; Meikle, A.L.; Levitt, M.

    1984-01-01

    There are sound radiobiologic and suggestive clinical rationale for superfractionating the radiotherapeutic regimens employed for the therapy of rapidly growing malignancies. Oat cell carcinoma of the bronchus is such a tumor. The authors report their experience combining aggressive systemic combination chemotherapy with supperfractionated radiotherapy for the treatment of limited oat cell carcinoma of the bronchus. Overall, patient tolerance was satisfactory and a complete remission rate of 74% was achieved. It remains to be proven, in a prospective randomized fashion, whether this approach is superior to current conventional management

  18. Low dose combined chemotherapy/radiotherapy in the management of locally advanced urethral squamous cell carcinoma

    International Nuclear Information System (INIS)

    Johnson, D.W.; Kessler, J.F.; Ferrigni, R.G.; Anderson, J.D.

    1989-01-01

    The successful treatment of a patient with bulky squamous cell carcinoma of the urethra using low dose preoperative radiation therapy and concurrent chemotherapy is described. Dramatic rapid tumor response facilitated surgical resection of the remaining microscopic disease. This clinical behavior is remarkably similar to that seen with squamous cell carcinoma of the anal canal and esophagus when a similar regimen is used. At the latter tumor sites the successful use of combination radiotherapy and chemotherapy has reduced the morbidity of subsequent surgery, and in selected cases has obviated the need for a radical operation. Further investigation of such combination treatment is warranted for urethral carcinoma

  19. Postoperative treatment of malignant tumors of the parotid gland: radiotherapy, concomitant chemotherapy and radiation therapy; Tumeurs malignes de la parotide: prise en charge multidisciplinaire, role de la radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Bouyon, A.; Durdux, C.; Housset, M. [Hopital Europeen Georges-Pompidou, Service d' Oncoradiotherapie, 75 - Paris (France); Hans, S. [Hopital Europeen Georges-Pompidou, Service d' ORL et de Chirurgie de la Face et du Cou, 75 - Paris (France)

    2007-12-15

    The low incidence, the wide histological spectrum and the natural, sometimes slow, evolution of malignant parotid gland tumours do not allow to easily establish the impact of their treatments. At present, clinical data come from retrospective cohort analysis, whereas randomized phase II-III trials are confidential. Moreover conclusions from these studies are controversial. We present here the therapeutic highlights of parotid cancers: surgery, with the particular concern of facial nerve preservation; and adjuvant treatment essentially based on radiotherapy. This review focused on adjuvant care explores the indications and the technical aspects of radiation, as well as the role of concurrent chemotherapy. (authors)

  20. State of motor function of stomach in patients with cervix uteri carcinoma in combined radiotherapy

    International Nuclear Information System (INIS)

    Zhidovtseva, M.I.; Shutilova, A.A.; Dynnik, M.S.; Lugovskaya, K.A.; Duma, V.A.

    1978-01-01

    Data on studying stomach motor function in patients with carvix uteri carcinoma of 2 and 3 stages in combined radiotherapy are given. The patients were examined before radiotherapy and directly after it as well as in 1-2 years using the X-ray method for 50 patients and electrogastrography for 68 patients. Revealed changes in stomach motor function, being considered as a response to irradiation, were manifested more often in decreasing motility, evacuatory function and bioelectric stomach activity. These functional changes result in disturbance of general state of patients, appearance of symptomatology of stomach dysfunction and serve as indications for the prescription of correcting therapy, which includes diet and preparations strengthening stomach motor activity

  1. Localized field conformation radiotherapy combined with endocrine therapy for the treatment of prostate cancer

    International Nuclear Information System (INIS)

    Karasawa, Katsuyuki; Kaizu, Toshihide; Kurosaki, Hiromasa; Tanaka, Yoshiaki

    1999-01-01

    To improve the quality of life (QOL) of the patients with prostate cancer, we limit the radiotherapy target volume to the prostate and seminal vesicles while using endocrine therapy towards the disease outside the target volume. Radiotherapy technique was rotation conformation technique with computer-controlled multileaf collimators to the total doses of up to 66-70 Gy. Among 145 evaluable cases with the median age of 74, overall and cause-specific 5-year survival rates were 59.3% and 84.1%, respectively, and the relative survival rate of the Stage A-C cases was 100%. The two thirds (33/50) of the deaths were not of prostate cancer. The rate of severe complication was 1.4%. As for QOL, the rate of impotence was 90%, however, the patients' overall satisfaction towards the treatment was 90%. From this analysis, this combined treatment seems beneficial in the treatment of prostate cancer. (author)

  2. BRAF inhibitors and radiotherapy for melanoma brain metastases: potential advantages and disadvantages of combination therapy

    Directory of Open Access Journals (Sweden)

    Chowdhary M

    2016-12-01

    Full Text Available Mudit Chowdhary,1,2 Kirtesh R Patel,1 Hasan H Danish,1 David H Lawson,3 Mohammad K Khan1 1Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, 2Department of Radiation Oncology, Rush University Medical Center, Chicago, IL, 3Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA Abstract: Melanoma is an aggressive malignancy that frequently spreads to the brain, resulting in rapid deterioration in both quality and quantity of life. Historically, treatment options for melanoma brain metastases (MBM have predominantly consisted of surgery and radiotherapy. While these options can help provide local control, the majority of patients still develop intracranial progression. Indeed, novel therapeutic options, including molecularly targeted agents and immunotherapy, have improved outcomes and are now changing the role of radiotherapy. Up to 50% of melanomas contain an activating BRAF mutation, resulting in hyperactive cellular proliferation and survival. Drugs that target BRAF have been introduced for the treatment of metastatic melanoma and offer hope in improving disease outcomes; however, many of these trials either excluded or had a limited amount of patients with MBM. Recent studies have revealed that melanoma cell lines become more radiosensitive following BRAF inhibition, thus providing a potential synergistic mechanism when combining BRAF inhibitor (BRAFi and radiotherapy. However, neurotoxicity concerns also exist with this combination. This article reviews the efficacy and limitations of BRAFi therapy for MBM, describes current evidence for combining BRAFis with radiation, discusses the rationale and evidence for combination modalities, and highlights emerging clinical trials specifically investigating this combination in MBM. Keywords: brain metastases, melanoma, radiation, BRAF inhibitors, vemurafenib, dabrafenib

  3. One life saved by four prevented recurrencies? Update of the early breast cancer trialists confirms. Postoperative radiotherapy improves survival after breast conserving surgery

    International Nuclear Information System (INIS)

    Sautter-Bihl, M.L.; Budach, W.

    2012-01-01

    The debate about the impact of local control on survival in early breast cancer patients is still going on, in spite of the continuously growing evidence that avoidance of locoregional disease reduces the risk of tumor-specific death. Recently, B. Fisher, one of the pioneers of breast conserving therapy claimed that during the last two decades, as a result of the use of systemic therapy in conjunction with breast conserving surgery and radiation, the incidence of locoregional recurrence has been reduced to a level where further reduction is likely to have little impact on survival. The penultimate meta-analysis of the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) reported the effect of radiotherapy in early breast cancer on recurrence and survival in 2005 and provided the essential message that four prevented local recurrences at 5 years would avoid one breast cancer death in 15 years. The scientific community has eagerly awaited the quinquennial update of the EBCTCG which has now been published. A total of 17 randomized studies comparing postoperative radiotherapy vs. none were analyzed and comprised 7 new studies in addition to follow-up data of from 9 previously reported trials. A total of 10,801 patients with pT1-2 tumors were included, the majority of whom (n=7,287) were node negative, while 1,050 were node positive (2,464 unknown). In contrast to the previous meta-analysis, all patients received breast conserving surgery, consisting of lumpectomy (n=8,422) or more extensive techniques like quadrantectomy or sectoral resection (n= 2,399). The effect of radiotherapy on 10-year recurrences of any type and their relation to the 15-year breast cancer death rate were studied in correlation to various prognostic parameters and treatment characteristics (e.g., surgery, tamoxifen use). Moreover, a subgroup analysis was performed according to low, intermediate, and high initial risk of recurrence, from which the expected absolute benefit was derived by

  4. Postmastectomy radiotherapy

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    Shikama, Naoto; Koguchi, Masahiko; Sasaki, Shigeru; Kaneko, Tomoki; Shinoda, Atsunori; Nishikawa, Atsushi [Shinshu Univ., Matsumoto, Nagano (Japan). School of Medicine

    2000-10-01

    Since there have been few reports on postmastectomy radiotherapy having a high evidence level in Japan, the significance of postoperative radiotherapy and the irradiation techniques were reviewed based on reports from Western countries. Authors focused on the indications for postoperative irradiation, irradiation methods (irradiation sites, irradiation techniques; prosthetics, methods of irradiating the chest wall and lymph nodes, timing of irradiation), and complications, and discuss them. The factors thought to be adaptable to postmastectomy radiotherapy have been listed. Axillary lymph node metastasis and the size of the primary focus are thought to be important factors in locoregional recurrence. The chest wall and the supraclavicular lymph nodes are the usual sites of irradiation after mastectomy. The irradiation method consists of tangential irradiation of the chest wall and single-field irradiation of the supraclavicular lymph nodes, with 46-50 Gy in fractional doses of 1.8-2 Gy x 5/w is administered for 4.5-5.5 weeks. The timing of irradiation in the West is generally after chemotherapy. Adverse radiation effects include ischemic heart disease, pneumonitis, arm edema, rib fractures, and brachial plexus paralysis. The frequency of these complications is increased by the combined use of chemotherapy or surgery. The breast cancer cure rate in Japan is generally better than in the West. It remains to be determined whether the clinical data from Europe and America are applicable to the treatment of breast cancer in Japan. To address this issue, a clinical investigation should be performed in Japan with close cooperation between surgeons, physicians, pathologists, and radiotherapists. (K.H.)

  5. Tumor cell expression of CD163 is associated to postoperative radiotherapy and poor prognosis in patients with breast cancer treated with breast-conserving surgery.

    Science.gov (United States)

    Garvin, Stina; Oda, Husam; Arnesson, Lars-Gunnar; Lindström, Annelie; Shabo, Ivan

    2018-05-03

    Cancer cell fusion with macrophages results in highly tumorigenic hybrids that acquire genetic and phenotypic characteristics from both maternal cells. Macrophage traits, exemplified by CD163 expression, in tumor cells are associated with advanced stages and poor prognosis in breast cancer (BC). In vitro data suggest that cancer cells expressing CD163 acquire radioresistance. Tissue microarray was constructed from primary BC obtained from 83 patients treated with breast-conserving surgery, 50% having received postoperative radiotherapy (RT) and none of the patients had lymph node or distant metastasis. Immunostaining of CD163 in cancer cells and macrophage infiltration (MI) in tumor stroma were evaluated. Macrophage:MCF-7 hybrids were generated by spontaneous in vitro cell fusion. After irradiation (0, 2.5 and 5 Gy γ-radiation), both hybrids and their maternal MCF-7 cells were examined by clonogenic survival. CD163-expression by cancer cells was significantly associated with MI and clinicopathological data. Patients with CD163-positive tumors had significantly shorter disease-free survival (DFS) after RT. In vitro generated macrophage:MCF-7 hybrids developed radioresistance and exhibited better survival and colony forming ability after radiation compared to maternal MCF-7 cancer cells. Our results suggest that macrophage phenotype in tumor cells results in radioresistance in breast cancer and shorter DFS after radiotherapy.

  6. Efficacy of intensity-modulated radiotherapy combined with chemotherapy or surgery in locally advanced squamous cell carcinoma of the head-and-neck

    Directory of Open Access Journals (Sweden)

    Yang H

    2013-10-01

    Full Text Available Hua Yang,* Li-Qiong Diao,* Mei Shi, Rui Ma, Jian-Hua Wang, Jian-Ping Li, Feng Xiao, Ying Xue, Man Xu, Bin ZhouDepartment of Radiotherapy Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China*These authors contributed equally to this workObjectives: Long-term locoregional control following intensity-modulated radiotherapy (IMRT for locally advanced squamous cell carcinoma of the head-and-neck (SCCHN remains challenging. This study aimed to assess the efficacy and toxicity of IMRT with and without chemotherapy or surgery in locally advanced SCCHN.Materials and methods: Between January 2007 and January 2011, 61 patients with locally advanced SCCHN were treated with curative IMRT in the Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University; 28% underwent definitive IMRT and 72% postoperative IMRT, combined with simultaneous cisplatin-based chemotherapy in 58%. The mean doses of definitive and postoperative IMRT were 70.8 Gy (range, 66–74 Gy. Outcomes were analyzed using Kaplan–Meier curves. Acute and late toxicities were graded according to Radiation Therapy Oncology Group/European Organisation for Research and Treatment of Cancer radiation morbidity scoring criteria.Results: At a median follow-up of 35 months, 3-year local recurrence-free survival (LRFS, regional recurrence-free survival (RRFS, distant metastasis-free survival (DMFS, disease-free survival (DFS, and overall survival (OS were 83.8%, 86.1%, 82.4%, 53.2%, and 62%, respectively. Postoperative IMRT (n = 44, 72% had significantly higher LRFS/OS/DMFS than definitive IMRT (n = 17, 28%; P < 0.05. IMRT combined with chemotherapy (n = 35, 58% had significantly higher LRFS/OS/DMFS than IMRT alone (n = 26, 42%; P < 0.05. One year after radiotherapy, the incidence of xerostomia of grade 1, 2, or 3 was 13.1%, 19.7%, and 1.6%, respectively. No grade 4 acute or late toxicity was observed.Conclusion: IMRT combined with

  7. Adenovirus-mediated IL-12 gene therapy in combination with radiotherapy for murine liver cancer

    International Nuclear Information System (INIS)

    Wei Daoyan; Dai Bingbing; Wang Zhonghe; Chen Shishu

    2001-01-01

    Objective: To investigate the synergistic antitumor effects of adenovirus-mediated IL-12 gene therapy in combination with radiotherapy in mice bearing liver cancer. Methods: Balb/c mice bearing liver cancer received the treatment at day 1 with tumor local irradiation (TLI) of 20 Gy or mask irradiation when tumor size reached 0.6-1.0 cm. Within 1 hour after irradiation, adenovirus containing IL-12 gene or PBS was intra-tumor injected once a week. Forty-eight hours after the second injection, IFN-γ levels in sera and the supernatant of cultured spleen cells were assayed by ELISA, CTL activity of spleen cells was measured by 3 H-TdR release assay, and phenotypes of tumor-infiltrating lymphocytes were analysed by immunohistochemical staining. Results: The growth of tumors in animals treated with a combination of IL-12 gene therapy and TLI was inhibited more significantly than those with either single treatment (P + and CD8 + lymphocyte infiltration and tumor-specific cytolytic activities, and the levels of IFN-γ in sera were higher in IL-12 gene therapy and IL-12 gene therapy combined with TLI groups. Conclusion: These results suggest that IL-12 gene therapy combined with radiotherapy is more effective than both single treatment modalities and can induce specific antitumor immuno-response greatly

  8. Cytotoxic effect of Erythroxylum suberosum combined with radiotherapy in head and neck cancer cell lines

    Energy Technology Data Exchange (ETDEWEB)

    Macedo, Taysa B.C.; Torres, Hianne M.; Yamamoto-Silva, Fernanda Paula; Silva, Maria Alves G. [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Escola de Odontologia; Elias, Silvia T.; Silveira, Damaris; Magalhaes, Perola O.; Lofrano-Porto, Adriana; Guerra, Eliete N.S., E-mail: elieteneves@unb.br [Universidade de Brasilia (UnB), Brasilia, DF (Brazil). Faculdade de Ciencias da Saude

    2016-01-15

    The mouth and oropharynx cancer is the 6{sup th} most common type of cancer in the world. The treatment may involve surgery, chemotherapy and radiotherapy. More than 50% of drugs against cancer were isolated from natural sources, such as Catharanthus roseus and epipodophyllotoxin, isolated from Podophyllum. The biggest challenge is to maximize the control of the disease, while minimizing morbidity and toxicity to the surrounding normal tissues. The Erythroxylum suberosum is a common plant in the Brazilian Cerrado biome and is popularly known as 'cabelo-de-negro'. The objective of this study was to evaluate the cytotoxic activity of Erythroxylum suberosum plant extracts of the Brazilian Cerrado biome associated with radiotherapy in human cell lines of oral and hypopharynx carcinomas. Cells were treated with aqueous, ethanolic and hexanic extracts of Erythroxylum suberosum and irradiated at 4 Gy, 6 Gy and 8 Gy. Cytotoxicity was evaluated by MTT assay and the absorbance was measured at 570 nm in a Beckman Counter reader. Cisplatin, standard chemotherapy, was used as positive control. The use of Erythroxylum suberosum extracts showed a possible radiosensitizing effect in vitro for head and neck cancer. The cytotoxicity effect in the cell lines was not selective and it is very similar to the effect of standard chemotherapy. The aqueous extract of Erythroxylum suberosum, combined with radiotherapy was the most cytotoxic extract to oral and hypopharynx carcinomas. (author)

  9. Cytotoxic effect of Erythroxylum suberosum combined with radiotherapy in head and neck cancer cell lines

    International Nuclear Information System (INIS)

    Macedo, Taysa B.C.; Torres, Hianne M.; Yamamoto-Silva, Fernanda Paula; Silva, Maria Alves G.; Elias, Silvia T.; Silveira, Damaris; Magalhaes, Perola O.; Lofrano-Porto, Adriana; Guerra, Eliete N.S.

    2016-01-01

    The mouth and oropharynx cancer is the 6 th most common type of cancer in the world. The treatment may involve surgery, chemotherapy and radiotherapy. More than 50% of drugs against cancer were isolated from natural sources, such as Catharanthus roseus and epipodophyllotoxin, isolated from Podophyllum. The biggest challenge is to maximize the control of the disease, while minimizing morbidity and toxicity to the surrounding normal tissues. The Erythroxylum suberosum is a common plant in the Brazilian Cerrado biome and is popularly known as 'cabelo-de-negro'. The objective of this study was to evaluate the cytotoxic activity of Erythroxylum suberosum plant extracts of the Brazilian Cerrado biome associated with radiotherapy in human cell lines of oral and hypopharynx carcinomas. Cells were treated with aqueous, ethanolic and hexanic extracts of Erythroxylum suberosum and irradiated at 4 Gy, 6 Gy and 8 Gy. Cytotoxicity was evaluated by MTT assay and the absorbance was measured at 570 nm in a Beckman Counter reader. Cisplatin, standard chemotherapy, was used as positive control. The use of Erythroxylum suberosum extracts showed a possible radiosensitizing effect in vitro for head and neck cancer. The cytotoxicity effect in the cell lines was not selective and it is very similar to the effect of standard chemotherapy. The aqueous extract of Erythroxylum suberosum, combined with radiotherapy was the most cytotoxic extract to oral and hypopharynx carcinomas. (author)

  10. High intratumoral accumulation of stealth liposomal doxorubicin in sarcomas--rationale for combination with radiotherapy

    International Nuclear Information System (INIS)

    Koukourakis, M.I.; Koukouraki, S.; Giatromanolaki, A.; Kakolyris, S.; Georgoulias, V.; Velidaki, A.; Archimandritis, S.; Karkavitsas, N.N.

    2000-01-01

    Sarcomas are radioresistant tumors, the only curative therapy being radical surgical resection. Stealth liposomal doxorubicin (Caelyx) is a novel drug formulation that allows prolonged circulation and high intratumoral concentration. This study investigates the concurrent use of radiotherapy with Caelyx in a cohort of 7 patients with locally advanced or recurrent sarcoma. Radiotherapy was given as a standard fractionation regimen to a total dose of 70 Gy. Caelyx was given as a 30-min infusion at a dose of 25 mg/m 2 every 2 weeks. Scintigraphic imaging with Caelyx- 99m Tc-DTPA showed an increased (2.8 +/- 0.9 times higher) intratumoral drug accumulation compared to the surrounding healthy tissue. The regimen was well tolerated without any severe hematological or systemic toxicity. 'In field' radiation toxicity was not increased. Complete response was observed in 4/7 cases. It is concluded that combined chemo-radiotherapy with stealth liposomal doxorubicin for locally advanced sarcomas is feasible and promising, the benefit expected from the unique ability of the stealth liposomes to accumulate selectively in the tumoral tissue

  11. Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy

    Directory of Open Access Journals (Sweden)

    Hala Saad Abdel-Ghaffar

    2017-01-01

    Conclusion: Wound instillation of bupivacaine/ketamine is a simple, noninvasive, and effective technique that could be a safe alternative to CK for postoperative analgesia in children undergoing inguinal hernia repair.

  12. Laser surgery combined with radiotherapy for T1/T2 hypopharyngeal squamous cell carcinomas

    International Nuclear Information System (INIS)

    Sakamoto, Kikuo; Nakashima, Tadashi

    2006-01-01

    We analyzed the results and clinical features of 41 patients with T1 or T2 squamous cell carcinoma of the hypopharynx who received the treatment of laser surgery combined with radiotherapy at the Kurume University Hospital between 1989 and 2003. The patients consisted of 38 males and 3 females (mean age: 64 years); T classification was 8 T1 cases and 33 T2 cases. N classification of the patients was 20 N0 cases, 9 N1 cases, 10 N2 cases, and 2 N3 cases. Three were stage I, 17 were stage II, 9 were stage III, and 12 were stage IV. Sub-sites of the tumor were 33 of piriform sinus type, 6 of post-cricoid type and 2 of poterior wall type. The primary disease was treated by laser debulking surgery combined with radiotherapy. Local recurrence was recognized in 4 cases and laryngectomy was performed in 3 cases. As a result, 38 (92.6%) cases were treated by preserving the larynx. All patients could eat a meal from the day following the operation. Tracheostomy was performed in six cases, but the tracheal stoma could be closed in five. The disease-specific 5-year survival rate was 87.7%. The 5-year local control rate was 90.2%. The overall 5-year survival rate was 49.2%. Four patients died of the primary disease (lymph node death: 3, distant metastasis death: 1). This retrospective review indicates that laser debulking surgery combined with radiotherapy is a successful treatment for T1/T2 hypopharyngeal carcinoma. (author)

  13. Pharmacokinetics and biodistribution of Erufosine in nude mice - implications for combination with radiotherapy

    International Nuclear Information System (INIS)

    Henke, Guido; Jendrossek, Verena; Lindner, Lars H; Vogeser, Michael; Eibl, Hans-Jörg; Wörner, Jürgen; Müller, Arndt C; Bamberg, Michael; Wachholz, Kirsten; Belka, Claus

    2009-01-01

    Alkylphosphocholines represent promising antineoplastic drugs that induce cell death in tumor cells by primary interaction with the cell membrane. Recently we could show that a combination of radiotherapy with Erufosine, a paradigmatic intravenously applicable alkylphosphocholine, in vitro leads to a clear increase of irradiation-induced cell death. In view of a possible combination of Erufosine and radiotherapy in vivo we determined the pharmacokinetics and bioavailability as well as the tolerability of Erufosine in nude mice. NMRI (nu/nu) nude mice were treated by intraperitoneal or subcutaneous injections of 5 to 40 mg/kg body weight Erufosine every 48 h for one to three weeks. Erufosine-concentrations were measured in brain, lungs, liver, small intestine, colon, spleen, kidney, stomach, adipoid tissue, and muscle by tandem-mass spectroscopy. Weight course, blood cell count and clinical chemistry were analyzed to evaluate general toxicity. Intraperitoneal injections were generally well tolerated in all dose groups but led to a transient loss of the bodyweight (<10%) in a dose dependent manner. Subcutaneous injections of high-dose Erufosine caused local reactions at the injection site. Therefore, this regimen at 40 mg/kg body weight Erufosine was stopped after 14 days. No gross changes were observed in organ weight, clinical chemistry and white blood cell count in treated compared to untreated controls except for a moderate increase in lactate dehydrogenase and aspartate-aminotransferase after intensive treatment. Repeated Erufosine injections resulted in drug-accumulation in different organs with maximum concentrations of about 1000 nmol/g in spleen, kidney and lungs. Erufosine was well tolerated and organ-concentrations surpassed the cytotoxic drug concentrations in vitro. Our investigations establish the basis for a future efficacy testing of Erufosine in xenograft tumor models in nude mice alone and in combination with chemo- or radiotherapy

  14. Results and hazards of postoperative radiotherapy using orthovoltage (300 kV) in carcinomas of the breast

    International Nuclear Information System (INIS)

    Antonopoulos, K.

    1984-01-01

    A total of 338 bearers of mammary carcinomas treated between 1971 and 1980 were included in this study and analysed for survival times, metastisation, local relapses and radiation-related hazards so as to permit the results of radiotherapy using hard X-rays (300 kV) to be evaluated and compared to those achieved with other methods of irradiation. In all, it was concluded that the method under investigation did not significantly alter the survival times given for those patients in the relevant literature. As far as the occurrence of local relpases and radiation hazards is concerned, it appears to be marginally better than other techniques. (orig.) [de

  15. Morphometrical analysis of pathomorphosis of squamous cell lung carcinoma after radiotherapy combined with hyperglycemia

    International Nuclear Information System (INIS)

    Furmanchuk, A.V.; Demidchik, Yu.E.; Khodina, T.V.

    1987-01-01

    Morphological changes are analysed and morphological assessment of the parenchyma, stroma, vessels and necrosis are provided in the squamous cell lung carcinoma tissue of 40 patients without preliminary irradiation, 40 patients after γ-beam therapy and 49 patients after radiotherapy combined with induced hyperglycemia (IH). The total focal dosage was 20 Gy (5 fractions during a week). In 25 patients IH was followed by irradiation and in 24 patients it followed irradiation. Operation was performed on the 7-8th day after therapy was initiated. It was concluded that preoperative γ-beam therapy followed by IH produced the most noticeable damaging effect on squamous cell lung carcinoma

  16. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Motohiko, E-mail: xackey2001@gmail.com [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Ishikawa, Hiroyuki [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Kunii, Ryosuke [Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Hashimoto, Takehisa; Tsuchida, Masanori [Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences (Japan); Aoyama, Hidefumi [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan)

    2015-01-15

    Objectives: To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. Methods: This retrospective study included 250 consecutive patients who underwent complete resection for ≤3-cm pathological stage I (T1–2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Results: Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (P < 0.05). A combination of these three findings had a greater accuracy in predicting 5-year disease-free survival than did %solid alone (AUC = 0.853 versus 0.792; P = 0.023), with a sensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥48% and ≥3.7 ng/mL, respectively. Conclusion: Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

  17. Postoperative radiotherapy in stage III non-small cell lung cancer: Is a reassessment necessary in modern times?

    OpenAIRE

    Billiet, Charlotte

    2017-01-01

    Background: The role of postoperative radiation therapy (PORT) in patients with completely resected non-small cell lung cancer (NSCLC) with pathologically involved mediastinal lymph nodes (N2) remains unclear. Despite a reduction of local recurrence (LR), its effect on overall survival (OS) remains unproven. Therefore we conducted a review of the current literature. Methods: To investigate the benefit and safety of modern PORT, we identified published phase III trials for PORT. We inves...

  18. [Dexmedetomidine combined with ropivacaine for continuous femoral nerve block improved postoperative sleep quality in elderly patients after total knee arthroplasty].

    Science.gov (United States)

    Wang, X L; Wang, J; Mu, D L; Wang, D X

    2018-03-13

    Objective: To investigate the effect of dexmedetomidine adding to ropivacaine for continuous femoral nerve block on the improvement of postoperative sleep quality in elderly patients after total knee arthroplasty. Methods: One hundred and sixty patients aged 60 years or older in Jishuitan Hospital scheduled for single total knee arthroplasty between Nov. 2016 and Jun. 2017 were recruited. All patients received spinal anesthesia and were randomized to receive either combined ropivacaine and dexmedetomidine (0.2% ropivacaine 250 ml and 5 μg/kg dexmedetomidine, at a rate of 5 ml/h or 0.1 μg·kg -1 ·h -1 dexmedetomidine, dexmedetomidine group) or only ropivacaine (0.2% ropivacaine, at a rate of 5 ml/h, controlled group) for continuous femoral nerve block as postoperative analgesia after surgery. The severity of postoperative pain was assessed with numeric rating scale at 4, 24, and 48 hours after surgery both at rest and with movement. Subjective sleep quality and delirium were evaluated daily during the first 3 days postoperatively. Results: The subjective sleep quality scores were 2(1-4), 2(1-4) and 4(2-8), 4(2-7) in dexmedetomidine group and controlled group respectively on the 1st and 2nd days after surgery. The scores of dexmedetomidine group were much better than those of controlled group ( Z =-4.597, -4.183, both P quality, postoperative analgesia, and reduce delirium in the elderly after total knee arthroplasty.

  19. Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

    Directory of Open Access Journals (Sweden)

    Chen Yu-Jen

    2011-01-01

    Full Text Available Abstract Background The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT for postoperative high-risk oral cavity cancer. Methods From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84% or without (16% chemotherapy. Results The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. Conclusions HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings.

  20. Image-guided intensity modulated radiotherapy with helical tomotherapy for postoperative treatment of high-risk oral cavity cancer

    International Nuclear Information System (INIS)

    Hsieh, Chen-Hsi; Hsieh, Yen-Ping; Lin, Shoei Long; Chen, Chun-Yi; Chen, Chien-An; Shueng, Pei-Wei; Kuo, Ying-Shiung; Liao, Li-Jen; Hu, Kawang-Yu; Lin, Shih-Chiang; Wu, Le-Jung; Lin, Yu-Chin; Chen, Yu-Jen; Wang, Li-Ying

    2011-01-01

    The aim of this study was to assess the treatment results and toxicity profiles of helical tomotherapy (HT) for postoperative high-risk oral cavity cancer. From December 6, 2006 through October 9, 2009, 19 postoperative high-risk oral cavity cancer patients were enrolled. All of the patients received HT with (84%) or without (16%) chemotherapy. The median follow-up time was 17 months. The 2-year overall survival, disease-free survival, locoregional control, and distant metastasis-free rates were 94%, 84%, 92%, and 94%, respectively. The package of overall treatment time > 13 wk, the interval between surgery and radiation ≤ 6 wk, and the overall treatment time of radiation ≤ 7 wk was 21%, 84%, and 79%, respectively. The percentage of grade 3 mucositis, dermatitis, and leucopenia was 42%, 5% and 5%, respectively. HT achieved encouraging clinical outcomes for postoperative high-risk oral cavity cancer patients with high compliance. A long-term follow-up study is needed to confirm these preliminary findings

  1. Comparison of different combinations of chemotherapy and radiotherapy in patients with cancer of oral cavity and pharynx

    International Nuclear Information System (INIS)

    Kachmar, T.B.

    1999-01-01

    The study involved 341 cases. The use of simultaneous chemoradiotherapy increases total regression of the malignant process by 10% and prolongs survival by 14% in patients with advanced cancer of the oral cavity and pharynx. Neo adjuvant therapy combined with radiotherapy vs radiotherapy alone increases the frequency of total regression by 9% and prolongs the survival by 15% in the patients with cancer of the oral cavity and throat (IV stage, male patients, the tumor located in the oral cavity and oropharynx)

  2. The combination of chemotherapy and radiotherapy towards more efficient drug delivery.

    Science.gov (United States)

    Cao, Wei; Gu, Yuwei; Meineck, Myriam; Xu, Huaping

    2014-01-01

    Research on anticancer therapies has advanced significantly in recent years. New therapeutic platforms that can further improve the health of patients are still highly demanded. We propose the idea of combining regular chemotherapy with radiation therapy to minimize side effects as well as increase drug-delivery efficiency. In this Focus Review, we seek to provide an overview of recent advances that can combine chemotherapy and radiotherapy. We begin by reviewing the current state of systems that can combine chemotherapy and gamma radiation. Among them, diselenide-containing polymers are highlighted as sensitive drug-delivery vehicles that can disassemble under gamma radiation. Then X-ray responsive materials as promising alternative systems are summarized, including X-ray responsive drug-delivery vehicles, prodrugs that can be activated by X-rays, and radiation-site-targeting systems. Finally, we describe strategies that involve phototherapies. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. The Results of Combined External Radiotherapy and Chemotherapy in the Management of Esophageal Cancer

    International Nuclear Information System (INIS)

    Lee, Hyun Joo; Suh, Hyun Suk; Kim, Jun Hee; Kim, Chul Soo; Kim, Sung Rok; Kim, Re Hwe

    1996-01-01

    Purpose : To evaluate the role of combination therapy of external radiotherapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. Methods and Materials : A retrospective review of evaluable 55 esophageal cancer patients referred to the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul. 1983 and Dec.1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group(ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fifty patients had squamous cell carcinomas. Radiation doses of 2520-6480c Gy were delivered over a period of 4-7 weeks. using 4MV LIVAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1,2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. Results : Median follow up period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months(20 days-73 months) in B group. The 1,2 YSRs were 26.7%, 8.9% in A group. 12.7%, 4.3% in B group (p>0.05), respectively. The 1,2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose(5000c Gy more or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000c Gy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were 43.8%, 25.0%, respectively. Complete response rate of 25.0% in A and 8.3% in B were achieved. The local failure and distant metastasis were 52.4%, 23.8% in A group. 64.3%, 14.3% in B group, respectively. The combination

  4. A comparative dosimetric study of conventional, conformal and intensity-modulated radiotherapy in postoperative pelvic irradiation of cervical cancer

    International Nuclear Information System (INIS)

    Li Bin; An Jusheng; Wu Lingying; Huang Manni; Gao Juzhen; Xu Yingjie; Dai Jianrong

    2008-01-01

    Objective: To evaluate target-volume coverage and organ at risk (OAR) protection achieved with conventional radiotherapy (CRT), three dimensional conformal radiotherapy (3DCRT), and intensity-modulated radiotherapy(IMRT) through dosimetric comparison in patients with cervical cancer after hysterectomy. Methods: The planning CT scans of 10 patients treated with pelvic radiation after hysterectomy for cervical cancer were used to generate CRT, 3DCRT and IMRT plans for this study. Clinical target volume(CTV) was contoured on the individual axial CT slices of every patient. The CTV was then uniformly expanded by 1.0 cm to create the planning target volume (PTV). The small bowel, rectum, bladder, bone marrow, ovaries, and femoral heads were outlined for the organ at risk (OAR) evaluation. The CRT, 3DCRT and IMRT plans were generated using commercial planning software. CRT plan was prescribed to deliver 45 Gy to the reference point, while IMRT and 3DCRT plans were 45 Gy to 95% of the PTV. Isodose line and dose volume histograms(DVH) were used to evaluate the dose distribution in CTV and OAR. Results: For 10 patients, the average volume of CTV receiving the prescribed dose of CRT was significantly lower than 3DCRT(Q=8.27, P<0.01) and IMRT(Q=8.37, P<0.01), respectively. Comparing with the CRT plan, the 3DCRT and IMRT plans notably reduced the volume of bowel at 30 and 45 Gy levels. The IMRT plan significantly spared rectum and bladder at 30 and 45 Gy levels comparing with the CRT (P<0.01) and 3DCRT(P<0.05) plans, while the 3DCRT plan significantly spared rectum and bladder at 45 Gy level comparing with the CRT(P<0.01) plans. For 4 patients with ovarian transposition, the average doses of ovary over 3 Gy were 2 patients with the 3 DCRT and IMRT plans, and 2 with all three plans. Conclusions: IMRT and 3DCRT are superior to CRT in improving dose coverage of target volume and sparing of OAR, while IMRT being the best. The superiority of IMRT and 3DCRT is obvious in sparing

  5. Three dimensional-conformal radiotherapy combined with capecitabine chemotherapy for locally advanced (unresectable) rectal cancer

    International Nuclear Information System (INIS)

    Zhu Yaqun; Tian Ye; Zhang Junning; Wang Bin

    2010-01-01

    Objective: To evaluate the compliance and efficacy of chemoradiotherapy for locally advanced (unresectable) rectal cancer. Methods: Thirty eight patients with locally advanced (T4 or recurred) rectal cancer received three dimensional-conformal radiotherapy (for 46 ∼ 50Gy/5 weeks and was boosted to the tumor 16 ∼ 18Gy/2 weeks, 2Gy/fraction, 5 days/week) in combination with capecitabine 1 650mg · m -2 · d -1 , day 1-14, every 3 weeks. Results: The overall response rate was 57.9%, with CR 5 (13.2%), PR 17(44.7%), SD 10 (26.3%), PD 6 (15.8%), median survival time, the 1-year overall survival rate and the 2-year overall survival rate were 18 months, 64.43%, 18.78%, respectively. The remission rate of pain and improvement rate of performance status were 100% and 52.8%. Treatment-related toxicity mainly showed at diarrhea, neutrocytopenia and hand-foot syndrome, the incidence of grade 3 toxicity were 15.8%, 15.8%, 7.9%, respectively. there were no grade 4 toxicity and treatment-related death. Conclusion: Combination of three dimensional-conformal radiotherapy with capecitabine is active in advanced rectal cancer, It is a well-tolerated regimen. (authors)

  6. Quality of life in locally advanced prostate cancer patients who underwent hormonal treatment combined with radiotherapy

    International Nuclear Information System (INIS)

    Koga, Hirofumi; Naito, Seiji; Fukui, Iwao; Tsukamoto, Taiji; Matsuoka, Naoki; Fujimoto, Hiroyuki

    2004-01-01

    The aim of this study is to estimate the feasibility of quality of life (QOL) research and to evaluate the QOL prospectively in locally advanced prostate cancer patients treated with hormonal treatment combined with radiotherapy. The treatment schedule was that patients with decreasing prostatic specific antigen (PSA) levels below 10 ng/ml after receiving 6 months of neoadjuvant hormonal treatment were randomly divided into two groups; one group was the continuous hormonal treatment group and the other was the intermittent hormonal treatment group. Both groups received a total dose of 72 Gy external beam radiotherapy with concomitant hormonal treatment followed by 6 months of adjuvant hormonal treatment following radiotherapy. At 14 months, patients either underwent continuous or intermittent hormonal treatment according to the random allocation. QOL was assessed at baseline, and at 6, 8, 14, and 20 months after treatment using functional assessment of cancer treatment-general (FACT-G), P with the other 3 items comprising bother of urination, bother of bowel movement, and bother of sexual activity. Between January 2000 and June 2003, a total of 188 patients were enrolled in this study. The rate of collection of baseline QOL sheets was 98.0%. The rate of answer to questions of QOL sheets was 99.0%. At baseline, the average score of FACT-G, P was 120.7 and the maximum score was more than twice the minimum score. Dysfunction of urination and bowel movement was correlated with the bother of urination and bowel movement, respectively. On the other hand, dysfunction of sexual activity was not correlated with the bother of sexual activity. In June 2003, all of the QOL sheets at baseline, and at 6, 8, and 14 months were completely collected from a total of 72 patients. Although QOL at 8 months was significantly affected compared with QOL at baseline and at 6 months, QOL at 14 months was significantly improved compared with that at 8 months and there was no significant

  7. Chemotherapy by superselective intraarterial infusion of nedaplatin combined with radiotherapy for oral cancer

    International Nuclear Information System (INIS)

    Yamashita, Yoshio; Goto, Masaaki; Katsuki, Takeshi

    2002-01-01

    Nedaplatin (CDGP), which is a CDDP derivative, has been reported to be an effective anticancer agent for head and neck cancer. This study was performed to assess the feasibility of chemotherapy by superselective intraarterial infusion of nedaplatin (CDGP) in patients with oral cancers. Ten patients were treated with chemotherapy by superselective intraarterial infusion of CDGP combined with radiotherapy. The complete and partial response rates were 7/10 (70%) and 3/10 (30%), respectively. Nine patients showed grade 1-2 hematological toxicity including leukocytopenia and anemia. Thrombocytopenia of grade 4 was seen in only one patient. However, all the patients were free from renal dysfunction. From these results, it is suggested that this combination therapy might be quite effective and safe. Further study will be needed to determine its efficacy against oral cancer. (author)

  8. Chemotherapy by superselective intraarterial infusion of nedaplatin combined with radiotherapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Yoshio; Goto, Masaaki; Katsuki, Takeshi [Saga Medical School (Japan)

    2002-06-01

    Nedaplatin (CDGP), which is a CDDP derivative, has been reported to be an effective anticancer agent for head and neck cancer. This study was performed to assess the feasibility of chemotherapy by superselective intraarterial infusion of nedaplatin (CDGP) in patients with oral cancers. Ten patients were treated with chemotherapy by superselective intraarterial infusion of CDGP combined with radiotherapy. The complete and partial response rates were 7/10 (70%) and 3/10 (30%), respectively. Nine patients showed grade 1-2 hematological toxicity including leukocytopenia and anemia. Thrombocytopenia of grade 4 was seen in only one patient. However, all the patients were free from renal dysfunction. From these results, it is suggested that this combination therapy might be quite effective and safe. Further study will be needed to determine its efficacy against oral cancer. (author)

  9. Fractionation and delivery schedules in combined radiotherapy-cisplatin for head and neck cancer

    International Nuclear Information System (INIS)

    Marcu, L.; Van Doorn, T.; Royal Adelaide Hospital,; Olver, I.

    2000-01-01

    Full text: Since Rosenberg's initial discovery, cisplatin has become one of the most effective anticancer drugs, with particular significance in head and neck cancer. For advanced disease, where the tumour is unresectable, radiotherapy and chemotherapy, either singularly or combined, remain the possible therapeutic modalities. The majority of the trials using a combination of cisplatin and radiation obtained much better results than the single-agent trials. But the best schedule, dosage and timing between radiation and drug administration are still unknown. Many positive steps were however made to eliminate the cisplatin-produced side effects, as much as possible. The tendency in current trials is to fractionate the drug dose by daily administration and also to hyperfractionate the radiation. In this way the long-term benefits are improved and the toxicity is better tolerated

  10. Results of radiotherapy and a combined radio- and chemotherapy for hypopharyngeal carcinomas

    International Nuclear Information System (INIS)

    Mariya, Yasushi; Tarusawa, Nobuko; Takekawa, Shoichi; Yodono, Hiraku; Mori, Isao; Shinkawa, Hidekazu; Watanabe, Sadao; Miyano, Kazuo; Kattou, Keiichi.

    1992-01-01

    We analyzed the results of radiotherapy in 36 patients with hypopharyngeal carcinoma. The overall 2-year and 5-year survival rates were 45.3% and 31.1%, respectively. For 23 patients given radical irradiation, the corresponding figures were 37.8% and 28.3%. However, in 16 patients receiving a combined therapy of radical irradiation and chemotherapy, mainly an intraarterial injection of cisplatin, the survivals were better; the 2-year survival rate was 50.0% and four patients have survived for more than three years without recurrence. In managing patients with hypopharyngeal carcinoma, this combined therapy would improve therapeutic outcome and also assist in larynx preservation. (J.P.N.)

  11. Combined radiotherapy and chemotherapy for pediatric medulloblastoma: a clinical study of 33 cases

    Directory of Open Access Journals (Sweden)

    Wei ZHENG

    2011-06-01

    Full Text Available Objective To retrospectively review the clinical characteristics of medulloblastoma,discuss the optimized treatment regimen,and analyze the prognostic influential factors.Methods Thirty-three children with pathologically certified medulloblastoma(aged 3-14 years with average of 6.5 years,admitted from Aug.2004 to Dec.2007,received radiotherapy within 3 weeks post surgery.Ratiotherapy consisted of 28~36Gy whole craniospinal radiation and a supplementary radiation aimed at tumors by three-dimensional conformal radiotherapy(3D-CRT for a total dose of 50~54Gy(conventional fraction dose of 1.8-2.0Gy.A part of patients received hyperfractionation radiotherapy(1.0Gy/f,2f/d for alleviating the tardive adverse events.Meanwhile,a synchronized chemotherapy,consisting of lomustine + vincristine + cisplatin,or isophosphamide + carboplatin + etoposide,was administered after the completion of whole craniospinal radiation,and 3-5 courses of sequential chemotherapy were given after the overall radiotherapy was finished.According to the metastasis,and the residual tumor and its size,the 33 patients were divided into 2 groups as follows: low-risk group(n=24: no metastases,total or sub-total excision of tumors(residual tumors ≤1.5cm3;high-risk group(n=9: either metastases or residual tumor > 1.5cm3.The 3-year survival rates of two groups were then compared.Results The combined radiotherapy and chemotherapy was effective to 10 of the 11 patients(90.9% with residual tumors.Out of the 33 patients,31 obtained complete remission(93.9%,and 2 patients showed partial remission or stable status(3.0%,respectively.The median survival time of 33 patients was 51 months,3-year disease free survival(DFS was 75.8%,and 3-year overall survival(OS was 78.8%,including 33.3% in high-risk group and 95.8% in low-risk group(P < 0.01.The major side effects occurred in haematological system and digestive system,such as an incidence of 21.2%(7/33 with grade Ⅲ-Ⅳ bone marrow suppression

  12. Variations in Target Volume Definition for Postoperative Radiotherapy in Stage III Non-Small-Cell Lung Cancer: Analysis of an International Contouring Study

    International Nuclear Information System (INIS)

    Spoelstra, Femke; Senan, Suresh; Le Pechoux, Cecile; Ishikura, Satoshi; Casas, Francesc; Ball, David; Price, Allan; De Ruysscher, Dirk; Soernsen de Koste, John R. van

    2010-01-01

    Purpose: Postoperative radiotherapy (PORT) in patients with completely resected non-small-cell lung cancer with mediastinal involvement is controversial because of the failure of earlier trials to demonstrate a survival benefit. Improved techniques may reduce toxicity, but the treatment fields used in routine practice have not been well studied. We studied routine target volumes used by international experts and evaluated the impact of a contouring protocol developed for a new prospective study, the Lung Adjuvant Radiotherapy Trial (Lung ART). Methods and Materials: Seventeen thoracic radiation oncologists were invited to contour their routine clinical target volumes (CTV) for 2 representative patients using a validated CD-ROM-based contouring program. Subsequently, the Lung ART study protocol was provided, and both cases were contoured again. Variations in target volumes and their dosimetric impact were analyzed. Results: Routine CTVs were received for each case from 10 clinicians, whereas six provided both routine and protocol CTVs for each case. Routine CTVs varied up to threefold between clinicians, but use of the Lung ART protocol significantly decreased variations. Routine CTVs in a postlobectomy patient resulted in V 20 values ranging from 12.7% to 54.0%, and Lung ART protocol CTVs resulted in values of 20.6% to 29.2%. Similar results were seen for other toxicity parameters and in the postpneumectomy patient. With the exception of upper paratracheal nodes, protocol contouring improved coverage of the required nodal stations. Conclusion: Even among experts, significant interclinician variations are observed in PORT fields. Inasmuch as contouring variations can confound the interpretation of PORT results, mandatory quality assurance procedures have been incorporated into the current Lung ART study.

  13. Postoperative nausea and vomiting prophylaxis: A comparative study of ondansetron, granisetron and granisetron and dexamethasone combination after modified radical mastectomy

    OpenAIRE

    Gupta, Pushplata; Jain, Shilpi

    2014-01-01

    Background: Post-operative nausea and vomiting (PONV) is commonly seen after modified radical mastectomy (MRM). In this randomized double-blind prospective study we compared the efficacy of ondansetron, granisetron and granisetron and dexamethasone combination for prevention of PONV following MRM in female patients. Materials and Methods: A total of 75 patients (20-60 years of age) undergoing elective MRM were randomly allocated to one of the three groups of 25 patients each. Group O received...

  14. Effect of sugammadex versus neostigmine/atropine combination on postoperative cognitive dysfunction after elective surgery.

    Science.gov (United States)

    Batistaki, C; Riga, M; Zafeiropoulou, F; Lyrakos, G; Kostopanagiotou, G; Matsota, P

    2017-09-01

    This study aimed to assess the effects of sugammadex and neostigmine/atropine on postoperative cognitive dysfunction (POCD) in adult patients after elective surgery. A randomised, double-blind controlled trial was carried out on 160 American Society of Anesthesiologists physical status I to III patients who were >40 years. The Mini-Mental State Evaluation, clock-drawing test and the Isaacs Set test were used to assess cognitive function at three timepoints: 1) preoperatively, 2) one hour postoperatively, and 3) at discharge. The anaesthetic protocol was the same for all patients, except for the neuromuscular block reversal, which was administered by random allocation using either sugammadex or neostigmine/atropine after the reappearance of T2 in the train-of-four sequence. POCD was defined as a decline ≥1 standard deviation in ≥2 cognitive tests. The incidence of POCD was similar in both groups at one hour postoperatively and at discharge (28% and 10%, in the neostigmine group, 23% and 5.4% in the sugammadex group, P =0.55 and 0.27 respectively). In relation to individual tests, a significant decline of clock-drawing test in the neostigmine group was observed at one hour postoperatively and at discharge. For the Isaacs Set test, a greater decline was found in the sugammadex group. These findings suggest that there are no clinically important differences in the incidence of POCD after neostigmine or sugammadex administration.

  15. Biomarkers of histone deacetylase inhibitor activity in a phase 1 combined-modality study with radiotherapy.

    Directory of Open Access Journals (Sweden)

    Anne Hansen Ree

    Full Text Available Following the demonstration that histone deacetylase inhibitors enhanced experimental radiation-induced clonogenic suppression, the Pelvic Radiation and Vorinostat (PRAVO phase 1 study, combining fractionated radiotherapy with daily vorinostat for pelvic carcinoma, was designed to evaluate both clinical and novel biomarker endpoints, the latter relating to pharmacodynamic indicators of vorinostat action in clinical radiotherapy.Potential biomarkers of vorinostat radiosensitizing action, not simultaneously manifesting molecular perturbations elicited by the radiation itself, were explored by gene expression array analysis of study patients' peripheral blood mononuclear cells (PBMC, sampled at baseline (T0 and on-treatment two and 24 hours (T2 and T24 after the patients had received vorinostat.This strategy revealed 1,600 array probes that were common for the comparisons T2 versus T0 and T24 versus T2 across all of the patients, and furthermore, that no significantly differential expression was observed between the T0 and T24 groups. Functional annotation analysis of the array data showed that a significant number of identified genes were implicated in gene regulation, the cell cycle, and chromatin biology. Gene expression was validated both in patients' PBMC and in vorinostat-treated human carcinoma xenograft models, and transient repression of MYC was consistently observed.Within the design of the PRAVO study, all of the identified genes showed rapid and transient induction or repression and therefore, in principle, fulfilled the requirement of being pharmacodynamic biomarkers of vorinostat action in fractionated radiotherapy, possibly underscoring the role of MYC in this therapeutic setting.

  16. Adjuvant post-operative radiotherapy vs radiotherapy plus 5-FU and levamisole in patients with TNM stage II-III resectable rectal cancer. A phase III randomized clinical trial

    Energy Technology Data Exchange (ETDEWEB)

    Cafiero, F.; Gipponi, M.; Di Somma, C. [Istituto Nazionale per la Ricerca sul Cancro, Geneo (Italy). Istituto di Oncologia Clinica] [and others

    1995-08-01

    Loco-regional and distant relapses contribute to impair the outcome of rectal cancer patients. As to the former, either pre-or post-operative radiation therapy (RT) significantly reduce loco-regional recurrence; post-operative chemotherapy (CT), alone or in different combinations with RT, is effective in improving both disease-free survival and survival. However, many drawbacks still exist regarding the method of RT delivery as well as the toxicity of combination adjuvant chemotherapy. The aim of this trial is to assess the effectiveness and toxicity of adjuvant post-operative RT vs combined RT and CT (5-FU plus levamisole) in patients with TNM stage II-III resectable rectal cancer (pT3-4, pN0, M0; pT1-4, pN1-3, M0). The primary endpoint is overall survival; secondary endpoints are disease-free survival rate of loco-regional recurrence, and treatment-related toxicity/morbidity. (author).

  17. A phase I study of postoperative concurrent radiotherapy and oral doxifluridine and leucovorin for II/III stage rectal cancer

    International Nuclear Information System (INIS)

    Jin Jing; Li Yexiong; Tang Yuan; Wang Weihu; Wang Shulian; Song Yongwen; Liu Yueping; Yu Zihao; Liu Xinfan

    2008-01-01

    Objective: A phase I study was conducted to determine the maximal tolerated dose (MTD) and the dose-limiting toxicity (DLT) of chemotherapy of oral doxifluridine (5-dFUR) and leucovorin with concurrent standard radiotherapy(RT) as adjuvant treatment in patients with rectal cancer. Methods: Patients aged 18-75 years old, Kamofsky scored ≥70%, stage II/III rectal cancer after curative surgery were eligible. Total RT dose was delivered as DT 50 Gy in the fraction of 2.0 Gy per day for 5 weeks to the pelvic area. 5-dFUR was administered concurrently with radiotherapy in escalating doses, and oral leucovorin was administered in a fixed dose of 30 mg/(m 2 ·d), both 3 times daily, from the 1 st day of RT to the last day. The DLTs included grade 3 or grade 4 hematologic and nonhematologie toxicity. Results: From Aug. 2005 to Mar. 2007, 16 patients were enrolled at the following dose levels: 450 mg/(m 2 ·d) (3 patients), 550 mg/(m 2 ·d) (6 patients) and 650 mg/(m 2 ·d) (7 patients). Diarrhea, neutropenia and nausea/vomit were the most common side effects although all neutropenia was less grade 3. The DLT was observed in 1 patient at 550 mg/(m 2 ·d) (grade 4 diarrhea), but none in the following 3 patients at the same dose level. At 650 mg/(m 2 ·d) level, the first patient quitted the study due to a severe abdominal cramp pain in the 3rd week of RT. In the following 3 enrolled patients, one suffered grade 3 abdominal cramp pain, diarrhea, fatigue, nausea/vomit and grade 2 neutropenia and fever. Grade 3 diarrhea was also observed in all the additional 3 patients at 650 mg/(m 2 ·d) dose level. So the dose escalation was ended up to 650 mg/(m 2 ·d). Four of 16 patients didn't complete the scheduled concurrent chemoradiotherapy due to severe side effects, including 1 at 550 mg/(m 2 ·d) dose level, and 3 at 650 mg/(m 2 ·d). The DLTs were observed as grade 3/4 diarrhea, grade 3 abdominal cramp pain, fatigue and nausea/vomit. Conclusions: Diarrhea is the most common and

  18. Clinicopathological studies on preoperative three combined treatments with hyperthermo-chemo-radiotherapy for rectal cancer

    International Nuclear Information System (INIS)

    Yoshioka, Yuji

    1995-01-01

    To prevent local recurrence of rectal cancer postoperatively, we treated patients using preoperative hyperthermia (5-6 times), irradiation (total 30 Gy) and a 5-Fluorouracil suppository (2000-2500 mg). The subjects were 31 patients given combined preoperative treatments and 28 patients given surgery alone. The results were as follows: Histologically, therapeutic effects were recognized in 80.6% of the combined treatments group. The mean distance from the adventitia to the site of cancer infiltration was 6.44 mm in the combined treatments group and 3.35 mm in the surgery alone group. The difference between the two was significant (p<0.05). The combined treatments produced a reduced tumor infiltration into the anal side, and resulted in making a safe margin for anastomosis. The rate of local recurrence in the combined treatments group was less than that of the surgery alone group. No systematic side effects or severe complications were observed during hospitalization in the combined treatments group. The survival rate of the combined treatments group was higher than that of the surgery alone group. It was considered that combined preoperative treatments for rectal cancer is beneficial to expand indications of super low anterior resection. (author)

  19. Clinicopathological studies on preoperative three combined treatments with hyperthermo-chemo-radiotherapy for rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yuji [Kyoto Prefectural Univ. of Medicine (Japan)

    1995-08-01

    To prevent local recurrence of rectal cancer postoperatively, we treated patients using preoperative hyperthermia (5-6 times), irradiation (total 30 Gy) and a 5-Fluorouracil suppository (2000-2500 mg). The subjects were 31 patients given combined preoperative treatments and 28 patients given surgery alone. The results were as follows: Histologically, therapeutic effects were recognized in 80.6% of the combined treatments group. The mean distance from the adventitia to the site of cancer infiltration was 6.44 mm in the combined treatments group and 3.35 mm in the surgery alone group. The difference between the two was significant (p<0.05). The combined treatments produced a reduced tumor infiltration into the anal side, and resulted in making a safe margin for anastomosis. The rate of local recurrence in the combined treatments group was less than that of the surgery alone group. No systematic side effects or severe complications were observed during hospitalization in the combined treatments group. The survival rate of the combined treatments group was higher than that of the surgery alone group. It was considered that combined preoperative treatments for rectal cancer is beneficial to expand indications of super low anterior resection. (author).

  20. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    International Nuclear Information System (INIS)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan

    2017-01-01

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ≤2 cm) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy

  1. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2017-03-15

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip{sub p}, ≤2 cm) and 3 distal clips (clip{sub d}, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

  2. The importance of immunohistochemical expression of EGFr in squamous cell carcinoma of the oral cavity treated with surgery and postoperative radiotherapy

    International Nuclear Information System (INIS)

    Smid, Ernst J.; Stoter, T. Rianne; Bloemena, Elisabeth; Lafleur, M. Vincent M.; Leemans, C. Rene; Waal, Isaac van der; Slotman, Ben J.; Langendijk, Johannes A.

    2006-01-01

    Purpose: The aim of this study was to investigate the prognostic significance of epidermal growth factor (EGFr) expression in oral cavity squamous cell carcinoma (OCSCC) treated with curative surgery and postoperative radiotherapy. Methods and Materials: This retrospective study included 165 OCSCC patients. The expression of EGFr was assessed on paraffin-embedded tissue of the primary tumor by immunohistochemistry using a monoclonal antibody directed against EGFr. Intensity of the EGFr expression was scored by two authors blinded for the clinical outcome. Results: In the univariate analysis, locoregional control at 3 years (LRC) in the EGFr-negative cases was 69% compared with 77% in the EGFr-positive cases (p 0.22). In the multivariate analysis for local control, a significant interaction was found between EGFr and overall treatment time of radiation (OTT). After stratification for EGFr expression, the OTT was of no importance in the EGFr-negative cases, whereas a significant difference in LRC was found in the EGFr-positive cases, in which the LRC after 3 years was 69% and 94% in case of an OTT of 0-42 days and >42 days, respectively (p = 0.009; hazard ratio = 3.42; 95% confidence interval, 1.28-8.96). No significant association was found between EGFr expression and overall survival. Conclusions: In the present study, no association was found between EGFr expression and outcome regarding locoregional control and overall survival. However, the results of the present study suggest that patients with squamous cell carcinoma of the oral cavity with high EGFr expression benefit more from a reduction of the overall treatment time of postoperative radiation than those with low EGFr expression

  3. Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Wan-Yu [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Kuo, Sung-Hsin [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Chia-Hsien Cheng, Jason [Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan (China); Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan (China); Hong, Ruey-Long [Division of Medical Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan (China); Chen, Ya-Fang [Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan (China); Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping [Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan (China); Chong, Fok-Ching [Graduate Institute of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China); Wang, Chun-Wei, E-mail: cwwang@ntuh.gov.tw [Graduate Institute of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China)

    2012-03-15

    Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6-33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.

  4. Postoperative Intensity-Modulated Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: Treatment Outcomes, Marginal Misses, and Perspective on Target Delineation

    International Nuclear Information System (INIS)

    Chen, Wan-Yu; Kuo, Sung-Hsin; Chen, Yu-Hsuan; Lu, Szu-Huai; Tsai, Chiao-Ling; Chia-Hsien Cheng, Jason; Hong, Ruey-Long; Chen, Ya-Fang; Hsu, Chuan-Jen; Lin, Kai-Nan; Ko, Jenq-Yuh; Lou, Pei-Jen; Wang, Cheng-Ping; Chong, Fok-Ching; Wang, Chun-Wei

    2012-01-01

    Purpose: To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials: A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6–33 months). Results: Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions: Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity.

  5. Adding concurrent chemotherapy to postoperative radiotherapy improves locoregional control but Not overall survival in patients with salivary gland adenoid cystic carcinoma—a propensity score matched study

    International Nuclear Information System (INIS)

    Hsieh, Cheng-En; Lin, Chien-Yu; Lee, Li-Yu; Yang, Lan-Yan; Wang, Chun-Chieh; Wang, Hung-Ming; Chang, Joseph Tung-Chieh; Fan, Kang-Hsing; Liao, Chun-Ta; Yen, Tzu-Chen; Fang, Ku-Hao; Tsang, Yan-Ming

    2016-01-01

    To compare the long-term outcomes in patients with salivary gland adenoid cystic carcinoma (SGACC) treated with post-operative chemoradiotherapy (POCRT) versus post-operative radiotherapy (PORT). We retrospectively reviewed the records of 91 SGACC patients treated with surgery followed by PORT (n = 58) or POCRT (n = 33) between 2000 and 2013. Treatment outcomes between groups were compared using propensity score matching (1:1 nearest neighbor). The median radiation dose was 66 Gy, and patients were followed up for a median of 71 months. Cisplatin-based concurrent regimens were the most commonly used chemotherapy schedules. In the entire study cohort, patients undergoing POCRT showed a trend toward higher locoregional control (LRC) rates than those treated with PORT alone at both 5 and 8 years (97 and 97 % versus 84 and 79 %, respectively; P = .066). Distant metastases were the most common form of treatment failure and occurred in 31 (34 %) patients (PORT, n = 17; POCRT, n = 14). After propensity score matching (33 pairs), patients receiving POCRT had 5- and 8 year LRC rates of 97 and 97 %, respectively, compared with 79 and 67 % for patients treated with PORT alone (P = .017). The two groups did not differ significantly in terms of distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS). However, a significantly better opioid-requiring pain-free survival (ORPFS) was achieved in POCRT group (P = .038). Subgroup analyses revealed that patients with stage III − IV disease (P = .040 and .017), positive surgical margins (P = .011 and .050), or perineural invasion (P = .013 and .035) had significantly higher 5- and 8 year LRC and ORPFS when treated with POCRT, respectively. In SGACC patients, adding concurrent chemotherapy to PORT may increase LRC and ORPFS rates, particularly in presence of stage III − IV disease, positive surgical margins, or perineural invasion. However, no significant differences in DMFS, DFS, and OS were

  6. Neuropsychological evaluation of patients with inoperable non-small cell lung cancer treated with combination chemotherapy or radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kaasa, S; Olsnes, B T; Mastekaasa, A

    1988-01-01

    Neuropsychological tests were used to evaluate possible central nervous system dysfunction in patients treated with chemotherapy. Ninety-five patients with non-small cell lung cancer limited disease were randomized to either radiotherapy (2.8 Gyx15) or combination chemotherapy with cisplatin and etoposide. In order to evaluate cognitive functions three neuropsychological tests were applied: Trail Making, Benton Visual Retention Test and Verbal Learning. Changes in the patients' test scores before and after treatment were compared. The chemotherapy patients showed reduced performance on some of the neuropsychological tests compared to the radiotherapy group. This indicates a treatment related effect on the central nervous system, possibly caused by the combination chemotherapy.

  7. Neuropsychological evaluation of patients with inoperable non-small cell lung cancer treated with combination chemotherapy or radiotherapy

    International Nuclear Information System (INIS)

    Kaasa, S.; Olsnes, B.T.; Mastekaasa, A.

    1988-01-01

    Neuropsychological tests were used to evaluate possible central nervous system dysfunction in patients treated with chemotherapy. Ninety-five patients with non-small cell lung cancer limited disease were randomized to either radiotherapy (2.8 Gyx15) or combination chemotherapy with cisplatin and etoposide. In order to evaluate cognitive functions three neuropsychological tests were applied: Trail Making, Benton Visual Retention Test and Verbal Learning. Changes in the patients' test scores before and after treatment were compared. The chemotherapy patients showed reduced performance on some of the neuropsychological tests compared to the radiotherapy group. This indicates a treatment related effect on the central nervous system, possibly caused by the combination chemotherapy. (orig.)

  8. Post-operative treatment of endometrial carcinoma. Chapter 20

    International Nuclear Information System (INIS)

    Kuipers, Tj.; Star, W.M.

    1980-01-01

    The alternative forms of post-operative radiotherapy given in Rotterdam for endometrial carcinoma are described. Patients with infiltration involving less than half the thickness of the myometrium are treated with low dose-rate 137 Cs afterloading techniques. However, in patients with deep infiltration, a combination of high dose-rate Cathetron treatment and external irradiation is used. (U.K.)

  9. Risk Factors Associated with Disease Recurrence in Patients with Stage III/IV Squamous Cell Carcinoma of the Oral Cavity Treated with Surgery and Postoperative Radiotherapy.

    Science.gov (United States)

    Noble, Anisha R; Greskovich, John F; Han, Jaehong; Reddy, Chandana A; Nwizu, Tobenna I; Khan, Mumtaz F; Scharpf, Joseph; Adelstein, David J; Burkey, Brian B; Koyfman, Shlomo A

    2016-02-01

    The purpose of the present study was to identify variables associated with high risk of failure in patients with locally advanced squamous cell carcinoma of the oral cavity (SCC-OC). This retrospective study included 191 patients with stage III-IVb SCC-OC treated with post-operative radiotherapy (RT) or chemoradiotherapy (CRT) between 1995 and 2013. Disease-free (DFS) and overall survival (OS) were analyzed; variables associated with inferior DFS were identified. Seventy-five patients (39%) recurred. DFS and five-year OS were 52% and 54%, respectively. Poorly differentiated tumors (p=0.03), recurrent tumors (p=0.02) and high nodal ratio (p=0.02) were associated with an increased risk of recurrence. CRT was associated with improved DFS in patients with positive margins and/or extracapsular extension (p=0.021). Tumors that are recurrent, high grade, or have high nodal ratio are at risk of recurrence. Presence of these disease features should be taken into consideration for better risk stratification. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  10. Defining the target volume for post-operative radiotherapy after D2 dissection in gastric cancer by CT-based vessel-guided delineation

    International Nuclear Information System (INIS)

    Yoon, Hong In; Chang, Jee Suk; Lim, Joon Seok; Noh, Sung Hoon; Hyung, Woo Jin; An, Ji Yeong; Lee, Yong Chan; Rha, Sun Young; Kim, Kyung Hwan; Koom, Woong Sub

    2013-01-01

    Purpose: To determine the recurrent nodal gross tumor volume (rnGTV) based on CT-guided vascular structure to refine the clinical target volume (CTV) delineation in postoperative radiotherapy for advanced gastric cancer following radical gastrectomy with D2 dissection. Materials and methods: We retrospectively reviewed follow-up images from 91 patients with their first regional recurrence after D2 dissection in stage III gastric cancer with N3 disease. We defined rnGTV as recurrent nodes shown in follow-up CT images, in which one diagnostic radiologist with specialty of gastrointestinal tract investigated. We drew rnGTVs at the equivalent location based on the same vessels of reference comparing CT images to recurrence CT images. Results: We propose vessel-based locations of rnGTVs on CT images with axial and coronal views. We show different patterns of regional recurrence according to the location of primary gastric cancer using CT and digitally reconstructed radiograph (DRR) images. Frequently recurred sites, overlapped by more than five rnGTVs, are depicted in a DRR image. Conclusions: This study suggests vessel-based delineations of rnGTVs on CT images depending on nodal recurrence sites from follow-up images after D2 lymphadenectomy. Our results could help reduce the inter-observer variation of CTV delineation after D2 dissection in gastric cancer

  11. Carbon-ion radiotherapy for locally advanced primary or postoperative recurrent epithelial carcinoma of the lacrimal gland

    International Nuclear Information System (INIS)

    Mizoguchi, Nobutaka; Tsuji, Hiroshi; Toyama, Shingo; Kamada, Tadashi; Tsujii, Hirohiko; Nakayama, Yuko; Mizota, Atsushi; Ohnishi, Yoshitaka

    2015-01-01

    Purpose: To evaluate the applicability of carbon ion beams for the treatment of carcinoma of the lacrimal gland with regard to normal tissue morbidity and local tumor control. Methods and materials: Between April 2002 and January 2011, 21 patients with locally advanced primary epithelial carcinoma of the lacrimal gland were enrolled in a Phase I/II clinical trial of carbon-ion radiotherapy (CIRT) at the National Institute of Radiological Sciences. Acute radiation toxicity was the primary endpoint of this dose-escalation study and the late toxicity, local control, and overall survival were additionally evaluated as secondary endpoints. Of the 21 subjects enrolled, all patients were followed for more than 6 months and analyzed. Results: The radiation dose was increased from the initial dose of 48.0 Gy equivalents (GyE)/12 fractions at 10% increments up to 52.8 GyE. Of the 21 patients, five received a total dose of 48.0 GyE, and 16 received a total dose of 52.8 GyE. No patient developed grade 3 or higher skin toxicity. As late ocular/visual toxicity, three patients had grade 3 retinopathy and seven patients lost their vision. Among the 10 patients treated until May 2005, five patients had local recurrence, three of whom had marginal recurrence. Therefore, the margin for the CTV (clinical target volume) was set to a range according to the orbital exenteration since June 2005. After the application of the extended margin, no local recurrence has been observed. The three-year overall survival and local control rates were 82.2% and 79.0%, respectively. Conclusion: CIRT can be applied for primary epithelial carcinoma of the lacrimal gland, with a borderline acceptable morbidity and sufficient antitumor effect when an extended margin is adopted

  12. Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial

    DEFF Research Database (Denmark)

    Rasmussen, M L; Dierking, G; Lech, K

    2008-01-01

    BACKGROUND: Multimodal analgesia may be important for optimal postoperative pain treatment and facilitation of early mobilization and recovery. We investigated the analgesic effect of pregabalin and dexamethasone in combination with paracetamol after abdominal hysterectomy. METHODS: One hundred...... and sixteen patients were randomly assigned to either group A (paracetamol+placebo x 2), group B (paracetamol+pregabalin+placebo) or group C (paracetamol+pregabalin+dexamethasone). According to randomization and preoperatively, patients received paracetamol 1000 mg, pregabalin 300 mg, dexamethasone 8 mg...... or placebo. General anaesthesia was performed. Postoperative pain treatment was paracetamol 1000 mg x 4 and patient-controlled intravenous morphine, 2.5 mg bolus. Nausea was treated with ondansetron. Morphine consumption, pain score (visual analogue scale) at rest and during mobilization, nausea, sedation...

  13. Feasibility of dose planning using CBCT images combined with MSCT images for adaptive radiotherapy

    International Nuclear Information System (INIS)

    Usui, Keisuke; Kunieda, Etsuo; Ogawa, Koichi

    2013-01-01

    If a kilo-voltage cone-beam computed tomography (CBCT) system mounted on a linear accelerator becomes available for dose calculation, we can confirm the dose distribution of treatment in each day by referring it to the initially planned dose distribution. In this paper, we verified the validity of the calculation method using CBCT images combined with multi-slice CT images. To evaluate the accuracy of calculated dose distribution, γ analysis, distance-to-agreement analysis and dose-volume-histogram analysis were used as the conventional dose calculation methods using CBCT images. The results showed that the dose distribution calculated by our proposed method agreed with the initial treatment plan better compared with the other methods. In addition, our method was so stable that the calculated dose distribution was insensitive to variations in clinical conditions. We demonstrated the feasibility of our proposed method for adaptive radiotherapy. (author)

  14. Combined intra-arterial infusion and radiotherapy for the head and neck tumors, 1

    International Nuclear Information System (INIS)

    Hattori, Takao

    1989-01-01

    A superselective insertion of a long-term retaining infusion catheter via superficial temporal artery was attempted in 77 patients with head and neck cancer treated between February 1984 and April 1988. It was successfully accomplished in 73 patients (95%). In 67 patients receiving the combination of radiotherapy, average durations of the catheter inserted into the maxillary, lingual, and facial arteries were 27, 31, and 29 days, respectively. Continuous arterial infusion chemotherapy was attained through the catheter. Possible complications of catheter insertion were as follows: local infection (5), blood clots inside the catheter (4), change in the tip of the catheter (3), spontaneous removal of the catheter (3), catheter injury (2), bleeding in the inserted area (one), and intimal injury (one). No other severe complications were observed. The superselective insertion of the catheter seemed to be superior to conventional method in view of its safety and accuracy. (Namekawa, K)

  15. The effect of postoperative radiotherapy on the feasibility of optimal dose adjuvant CMF chemotheraphy in stage II breast carcinoma

    International Nuclear Information System (INIS)

    Sulkes, A.; Brufman, G.; Rizel, S.; Weshler, Z.; Biran, S.; Fuks, Z.

    1983-01-01

    The impact of a number of variables upon the effectiveness of adjuvant chemotherapy given to 87 patients with Stage II breast carcinoma was retrospectively analyzed. Adjuvant chemotherapy consisted of cyclophosphamide, methotrexate and 5-fluorouracil (CMF). Drugs were given in optimal doses (85% or more of the planned dose) to 17% of the patients; in intermediate doses (66 to 84% of the planned dose) to 50% of the patients; and in low doses (65% or less of the planned dose) to 33% of the patients. Myelosuppression was the main reason for giving intermediate or low doses. At a median follow-up of three years, 84% of all patients remain alive. Radiation therapy preceding chemotherapy was given to 70% of the patients, concomitant irradation and chemotherapy to 15%, and 13 patients (15%) received chemotheapy only. Of the 14 patients who received optimal doses of CMF, 12 (86%) also received radiation therapy. Disease-free survival at three years is similar for irradiated and nonirradiated patients, but the latter have a higher incidence of local recurrence (5% vs. 15%), although the difference is not statistically significant. Delay in the intiation of chemotherapy, mostly because of the administration of postoperative irradiation, adversely affected the probability and duration of disease-free survival, particulararly in premenopausal women in whom chemotherapy was started within more than 90 days of mastectomy. The administration of optimal doses of adjuvant chemotherapy should follow the primary treatment to the breast tumor as closely as possible. If radiation therapy is indicated as well, it should be delivered concomitantly with chemotherapy, given the feasibility of administering both modalities simultaneously, as demonstrated in this study

  16. Estimating the Magnitude and Field-Size Dependence of Radiotherapy-Induced Mortality and Tumor Control After Postoperative Radiotherapy For Non-Small-Cell Lung Cancer: Calculations From Clinical Trials

    International Nuclear Information System (INIS)

    Miles, Edward F.; Kelsey, Chris R.; Kirkpatrick, John P.; Marks, Lawrence B.

    2007-01-01

    Purpose: To create, on the basis of available data, a mathematical model to describe the tumor stage- and field size-dependent risks/benefits of postoperative radiotherapy (PORT) for non-small-cell lung cancer (NSCLC), and to assess whether this simple model can accurately describe the reported changes in overall survival. Methods and Materials: The increase in overall survival afforded by PORT is assumed equal to the increase in cancer-specific survival minus the rate of RT-induced mortality. The increase in cancer-specific survival is the product of the probabilities of (residual local disease) x (sterilization of residual disease with PORT) x (absence of metastatic disease). Data were extracted from the literature to estimate these probabilities. Different models were considered to relate the RT-induced mortality to field size. Results: The rate of RT-induced mortality seems to be proportional to the cube of the field size. When these mortality rates are included in the model, the predicted changes in overall survival approximate the literature values. Conclusion: Clinical data can be explained by a simple model that suggests that RT-induced mortality is strongly dependent on field size and at least partly offsets the benefit afforded by PORT. Smaller RT fields, tailored to treat the areas most at risk for recurrence, provide the highest therapeutic ratio. The data used do not reflect the impact of chemotherapy, which will reduce the rate of distant metastases and enhance the efficacy of RT

  17. Effect of combined radiotherapy, hyperthermia, radioprotective agent and hypoxic cell sensitizer on mice testes

    Energy Technology Data Exchange (ETDEWEB)

    Nakano, Yasuhiko

    1985-08-01

    Application of hyperthermia was executed by immersing pelvis, testes and legs of mice in a thermostatically controlled water bath. Irradiation was carried out using Toshiba KXC-18 type X-ray therapy machine. Mice were killed 30 days after treatment. The testis weights obtained after hypertheramia alone were compared with that of the control and the relative testis weight ratios were calculated. The testis weights of mice treated for 5, 10, 20 and 40 min. in 40 deg C water and for 5 and 10 min. in 43 deg C water were not significantly different from the control. Their weights were reduced when treated for 20 min. in 43 deg C water and for 5 min. in 46 deg C water and their testis weight ratios were 0.81 and 0.46, respectively. The testis weights of irradiated mice decreased to about 45 % of the control at 250 rad. Beyond this dose, reduction of their weights was slowed down and testis weight at 1,000 rad was 28 %. There was not significantly difference between the relative testis weight ratios of the irradiation alone and that of the radiotherapy combined with YM-08310 (S-2-)3-aminopropylamino) ethyl phosphorothioic acid monohydrate). But when hyperthermia was added to their treatment, the effectiveness of the YM-08310 was slightly increased. The relative testis weight ratio on 400 rad X-ray combined with YM-08310 was 0.32 of the control, while its ratio on the radiotherapy and YM-08310 combined with the hyperthermia (43 deg C, 10 min.) was 0.43. (p < 0.01). The misonidazole treatments at 50, 100 and 200 rads were found to be effectuve. Radiation alone gave the relative testis weight ratios of 0.78, 0.71 and 0.49, respectively. In contrast, its ratios on the irradiation combined with the misonidazole were 0.57 (p < 0.01), 0.46 (p < 0.01) and 0.41 (p < 0.001). But, the additional hyperthermia combined with their treatment was found to be ineffective. (J.P.N.).

  18. The results of ab interno laser thermal sclerostomy combined with cataract surgery versus trabeculectomy combined with cataract surgery 6 to 12 months postoperatively.

    Science.gov (United States)

    Kendrick, R; Kollarits, C R; Khan, N

    1996-07-01

    When cataract surgery and glaucoma surgery are combined, the theoretical advantages of pressure control, removal of the visual impairment, and protection against an increase in intraocular pressure (IOP) in the immediate postoperative period are gained. The authors' objective was to determine whether ab interno laser thermal sclerostomy (LTS) combined with cataract surgery would be as effective as trabeculectomy combined with cataract surgery. Ab interno LTS was compared with trabeculectomy, retrospectively, for patients who had undergone combined cataract and glaucoma surgery. There was no significant difference in the numbers of patients using no medications or fewer medications at 6 and 12 months. There was a greater reduction in IOP in the LTS group. LTS may be better than trabeculectomy in combined cataract and glaucoma surgery because it reduces the IOP more. Compared with trabeculectomy, LTS is simpler to perform and adds less operating time to cataract surgery. Continued follow-up is recommended.

  19. Two cases of fatal necrosis of the lesser pelvis in patients treated with combined radiotherapy and hyperthermia for cervical carcinoma

    NARCIS (Netherlands)

    Wiggenraad, R.; Koning, C.; Westermann, C.; Jansen, C.; van der Zee, J.

    2005-01-01

    This study reports two cases of fatal necrosis of the lesser pelvis in patients with advanced cervical carcinoma, who had received combined radiotherapy and hyperthermia. The necrosis reached far from the high dose area, in one of the cases even outside the radiation portals. Both patients initially

  20. Combined-modality treatment of solid tumors using radiotherapy and molecular targeted agents.

    Science.gov (United States)

    Ma, Brigette B Y; Bristow, Robert G; Kim, John; Siu, Lillian L

    2003-07-15

    Molecular targeted agents have been combined with radiotherapy (RT) in recent clinical trials in an effort to optimize the therapeutic index of RT. The appeal of this strategy lies in their potential target specificity and clinically acceptable toxicity. This article integrates the salient, published research findings into the underlying molecular mechanisms, preclinical efficacy, and clinical applicability of combining RT with molecular targeted agents. These agents include inhibitors of intracellular signal transduction molecules, modulators of apoptosis, inhibitors of cell cycle checkpoints control, antiangiogenic agents, and cyclo-oxygenase-2 inhibitors. Molecular targeted agents can have direct effects on the cytoprotective and cytotoxic pathways implicated in the cellular response to ionizing radiation (IR). These pathways involve cellular proliferation, DNA repair, cell cycle progression, nuclear transcription, tumor angiogenesis, and prostanoid-associated inflammation. These pathways can also converge to alter RT-induced apoptosis, terminal growth arrest, and reproductive cell death. Pharmacologic modulation of these pathways may potentially enhance tumor response to RT though inhibition of tumor repopulation, improvement of tumor oxygenation, redistribution during the cell cycle, and alteration of intrinsic tumor radiosensitivity. Combining RT and molecular targeted agents is a rational approach in the treatment of solid tumors. Translation of this approach from promising preclinical data to clinical trials is actively underway.

  1. Combined treatment of radiotherapy and local hyperthermia using 8 MHz RF-wave for advanced carcinoma of the breast

    Energy Technology Data Exchange (ETDEWEB)

    Fuwa, Nobukazu

    1988-01-01

    During the period from January 1983 through September 1986, 13 patients with carcinoma of the breast were treated with local hyperthermia combined with radiotherapy. Six patients were inoperable advanced cases and the other 7 were recurrent cases. Local heat was applied with an 8-MHz RF-capacitive heating equipment, once or twice a week after radiotherapy, for 40 approx. 60 minutes per session. Of the 6 cases with inoperable advanced lesions, 4 achieved CR and the other 2 achieved PRa (80 approx. 100 % regression), and of the 7 cases with local recurrent tumors, 3 achieved CR and the other 4 achieved PRa. As complications of the thermoradiotherapy, grade I-II skin burns were observed in 9 cases, pain around the ribs in 8 cases, mild lassitude in 2 cases, persistent tachycardia in 1 case and acute erosive gastritis in 1 case. It is worth noting that CR was achieved in these huge tumors, which can not be controlled by radiotherapy alone.

  2. Combined laparoscopic cholecystectomy with ileostomy reversal: A method of delayed definitive management of postoperative gallstone pancreatitis

    Directory of Open Access Journals (Sweden)

    Gaurav V Kulkarni

    2014-01-01

    Full Text Available Traditional management of gallstone pancreatitis (GP has been to perform cholecystectomy during the same hospital admission after resolution. However, when GP develops in the immediate postoperative period from a major colorectal operation, cholecystectomy may be fraught with difficulty due to the inflammatory response that occurs. Thus, delaying cholecystectomy until the inflammatory response subsides may be worthwhile, and it maximizes the chances of completing the cholecystectomy laparoscopically. We have described our management of 2 patients with GP occurring after colorectal operations, which required proximal diverting ileostomy. In both cases, we deferred management of GP with either endoscopic retrograde cholangiopancreatography (ERCP or medical conservative measures during the acute attack and performed laparoscopic cholecystectomy during ostomy reversal surgery utilizing the existing ostomy takedown site for port placement. Both patients tolerated this management well.

  3. Variations in CT determination of target volume with active breath co-ordinate in radiotherapy for post-operative gastric cancer.

    Science.gov (United States)

    Li, Gui-Chao; Zhang, Zhen; Ma, Xue-Jun; Yu, Xiao-Li; Hu, Wei-Gang; Wang, Jia-Zhou; Li, Qi-Wen; Liang, Li-Ping; Shen, Li-Jun; Zhang, Hui; Fan, Ming

    2016-01-01

    To investigate interobserver and inter-CT variations in using the active breath co-ordinate technique in the determination of clinical tumour volume (CTV) and normal organs in post-operative gastric cancer radiotherapy. Ten gastric cancer patients were enrolled in our study, and four radiation oncologists independently determined the CTVs and organs at risk based on the CT simulation data. To determine interobserver and inter-CT variation, we evaluated the maximum dimensions, derived volume and distance between the centres of mass (CMs) of the CTVs. We assessed the reliability in CTV determination among the observers by conformity index (CI). The average volumes ± standard deviation (cm(3)) of the CTV, liver, left kidney and right kidney were 674 ± 138 (range, 332-969), 1000 ± 138 (range, 714-1320), 149 ± 13 (range, 104-183) and 141 ± 21 (range, 110-186) cm(3), respectively. The average inter-CT distances between the CMs of the CTV, liver, left kidney and right kidney were 0.40, 0.56, 0.65 and 0.6 cm, respectively; the interobserver values were 0.98, 0.53, 0.16 and 0.15 cm, respectively. In the volume size of CTV for post-operative gastric cancer, there were significant variations among multiple observers, whereas there was no variation between different CTs. The slices in which variations more likely occur were the slices of the lower verge of the hilum of the spleen and porta hepatis, then the paraoesophageal lymph nodes region and abdominal aorta, and the inferior vena cava, and the variation in the craniocaudal orientation from the interobserver was more predominant than that from inter-CT. First, this is the first study to evaluate the interobserver and inter-CT variations in the determination of the CTV and normal organs in gastric cancer with the use of the active breath co-ordinate technique. Second, we analysed the region where variations most likely occur. Third, we investigated the influence of interobserver variation on

  4. Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Seon; Park, Sung Kwang; Cho, Heung Lae; Ahn, Ki Jung [Dept. of Radiation Oncology, (Korea, Republic of); Lee, Yun Han [Dept. of Molecular Medicine, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2–3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ≥25 kg/m{sup 2}) in local control was evaluated. The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of 25.6 kg/m{sup 2} as a cutoff value. Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted.

  5. Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

    International Nuclear Information System (INIS)

    Choi, Yun Seon; Park, Sung Kwang; Cho, Heung Lae; Ahn, Ki Jung; Lee, Yun Han

    2016-01-01

    The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2–3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ≥25 kg/m 2 ) in local control was evaluated. The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of 25.6 kg/m 2 as a cutoff value. Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted

  6. Combined radiotherapy and surgery : Local control and complications in early carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Gerbaulet, A.L.; Haie, C.; Michel, G.; Prade, M.; Lhomme, C.; Masselot, M.; Albano, M.; Dutreix, A.; Chassagne, D.; Kunkler, I.H.; Kerr, G.R.

    1992-01-01

    From January 1975 to December 1984, 41 patients were treated by combined radiotherapy and surgery at Institut Gustave Roussy for Stage IB (288) and II (proximal) (103) carcinoma of uterine cervix. Standard treatment consisted of pre-operative utero-vaginal brachytherapy (60 Gy) using a mould technique followed by colpho-hysterectomy and external iliac lymphadenectomy. Overall 5 year actuarial survival for whole population was 87% and disease-free survival 85%. Locoregional relapse occurred in 23 patients (5%). Of these, 12 where central pelvic failures, 8 regional failures and 3 combined central and regional failures. Of 36 systemic relapses (8%), 12 relapsed concurrently in pelvis. Five year actuarial pelvic disease-free, disease-free and overall survival was 87, 85 and 87%, resp., for the whole population. 340 patients developed one or more complications [Grade 1: 198/441 (44%), Grade 2: 121/441 (27%) and Grade 3 or 4: 21/441 (4.7%)]. Five year actuarial survival for the whole population was poorer for histologically node positive than for node negative (89 vs. 55%, p<0.0001). Pre-operative brachytherapy by surgery can provide good local control with acceptable morbidity in early cervical cancer. (author). 39 refs.; 4 figs.; 4 tabs

  7. Three-dimensional conformal radiotherapy with concurrent chemotherapy for postoperative recurrence of esophageal squamous cell carcinoma: clinical efficacy and failure pattern

    International Nuclear Information System (INIS)

    Bao, Yong; Rong, TieHua; Li, Qun; Liu, Hui; Liu, ShiLiang; Zhou, QiChao; Cai, PeiQiang; Anfossi, Simone; Li, QiaoQiao; Hu, YongHong; Liu, MengZhong; Fu, JianHua

    2013-01-01

    To assess the therapeutic outcome and failure pattern of three-dimensional conformal radiotherapy (3D-CRT)-based concurrent chemoradiotherapy (CCRT) for recurrence of esophageal squamous cell carcinoma (SCC) after radical surgery. Treatment outcome and failure pattern were retrospectively evaluated in 83 patients with localized cervical and thoracic recurrences after radical surgery for thoracic esophageal SCC. All patients were treated with 3DCRT-based CCRT (median radiation dose 60 Gy), in which 39 received concurrent cisplatin plus 5-fluorouracil (PF), and 44 received concurrent docetaxel plus cisplatin (TP). Treatment response was evaluated at 1–3 months after CCRT. With a median follow-up of 34 months (range, 2–116 months), the 3-year overall survival (OS) of all the patients was 51.8% and the median OS time was 43.0 months. The overall tumor response rate was 75.9% (63/83), with a complete remission (CR) rate of 44.6% (37/83). In univariate analysis, tumor response after CCRT (p = 0.000), recurrence site (p = 0.028) and concurrent chemotherapy (p = 0.090) showed a trend favoring better OS. Multivariate analysis revealed that tumor response after CCRT (p = 0.000) and concurrent chemotherapy (p = 0.010) were independent predictors of OS. Forty-seven patients had progressive diseases after CCRT, 27 had local failure (27/47, 57.4%), 18 had distant metastasis (18/47, 38.3%) and 2 had both local and distant failures (2/47, 4.3%). 3DCRT-based CCRT is effective in postoperatively recurrent esophageal SCC. Patients that obtained complete remission after CCRT appeared to achieve long-term OS and might benefit from concurrent TP regimen. Local and distant failures remained high and prospective studies are needed to validate these factors

  8. SU-E-T-235: Monte Carlo Analysis of the Dose Enhancement in the Scalp of Patients Due to Titanium Plate Backscatter During Post-Operative Radiotherapy

    International Nuclear Information System (INIS)

    Hardin, M; Elson, H; Lamba, M; Wolf, E; Warnick, R

    2014-01-01

    Purpose: To quantify the clinically observed dose enhancement adjacent to cranial titanium fixation plates during post-operative radiotherapy. Methods: Irradiation of a titanium burr hole cover was simulated using Monte Carlo code MCNPX for a 6 MV photon spectrum to investigate backscatter dose enhancement due to increased production of secondary electrons within the titanium plate. The simulated plate was placed 3 mm deep in a water phantom, and dose deposition was tallied for 0.2 mm thick cells adjacent to the entrance and exit sides of the plate. These results were compared to a simulation excluding the presence of the titanium to calculate relative dose enhancement on the entrance and exit sides of the plate. To verify simulated results, two titanium burr hole covers (Synthes, Inc. and Biomet, Inc.) were irradiated with 6 MV photons in a solid water phantom containing GafChromic MD-55 film. The phantom was irradiated on a Varian 21EX linear accelerator at multiple gantry angles (0–180 degrees) to analyze the angular dependence of the backscattered radiation. Relative dose enhancement was quantified using computer software. Results: Monte Carlo simulations indicate a relative difference of 26.4% and 7.1% on the entrance and exit sides of the plate respectively. Film dosimetry results using a similar geometry indicate a relative difference of 13% and -10% on the entrance and exit sides of the plate respectively. Relative dose enhancement on the entrance side of the plate decreased with increasing gantry angle from 0 to 180 degrees. Conclusion: Film and simulation results demonstrate an increase in dose to structures immediately adjacent to cranial titanium fixation plates. Increased beam obliquity has shown to alleviate dose enhancement to some extent. These results are consistent with clinically observed effects

  9. Postoperative Radiotherapy for Pathologic N2 Non–Small-Cell Lung Cancer Treated With Adjuvant Chemotherapy: A Review of the National Cancer Data Base

    Science.gov (United States)

    Robinson, Cliff G.; Patel, Aalok P.; Bradley, Jeffrey D.; DeWees, Todd; Waqar, Saiama N.; Morgensztern, Daniel; Baggstrom, Maria Q.; Govindan, Ramaswamy; Bell, Jennifer M.; Guthrie, Tracey J.; Colditz, Graham A.; Crabtree, Traves D.; Kreisel, Daniel; Krupnick, Alexander S.; Patterson, G. Alexander; Meyers, Bryan F.; Puri, Varun

    2015-01-01

    Purpose To investigate the impact of modern postoperative radiotherapy (PORT) on overall survival (OS) for patients with N2 non–small-cell lung cancer (NSCLC) treated nationally with surgery and adjuvant chemotherapy. Patients and Methods Patients with pathologic N2 NSCLC who underwent complete resection and adjuvant chemotherapy from 2006 to 2010 were identified from the National Cancer Data Base and stratified by use of PORT (≥ 45 Gy). A total of 4,483 patients were identified (PORT, n = 1,850; no PORT, n = 2,633). The impact of patient and treatment variables on OS was explored using Cox regression. Results Median follow-up time was 22 months. On univariable analysis, improved OS correlated with younger age, treatment at an academic facility, female sex, urban population, higher income, lower Charlson comorbidity score, smaller tumor size, multiagent chemotherapy, resection with at least a lobectomy, and PORT. On multivariable analysis, improved OS remained independently predicted by younger age, female sex, urban population, lower Charlson score, smaller tumor size, multiagent chemotherapy, resection with at least a lobectomy, and PORT (hazard ratio, 0.886; 95% CI, 0.798 to 0.988). Use of PORT was associated with an increase in median and 5-year OS compared with no PORT (median OS, 45.2 v 40.7 months, respectively; 5-year OS, 39.3% [95% CI, 35.4% to 43.5%] v 34.8% [95% CI, 31.6% to 38.3%], respectively; P = .014). Conclusion For patients with N2 NSCLC after complete resection and adjuvant chemotherapy, modern PORT seems to confer an additional OS advantage beyond that achieved with adjuvant chemotherapy alone. PMID:25667283

  10. Treatment Results of Postoperative Radiotherapy on Squamous Cell Carcinoma of the Oral Cavity: Coexistence of Multiple Minor Risk Factors Results in Higher Recurrence Rates

    International Nuclear Information System (INIS)

    Fan, Kang-Hsing; Wang, Hung-Ming; Kang, Chung-Jan

    2010-01-01

    Purpose: The aim of this study was to investigate the treatment results of postoperative radiotherapy (PORT) on squamous cell carcinoma of the oral cavity (OSCC). Materials and Methods: This study included 302 OSCC patients who were treated by radical surgery and PORT. Indications for PORT include Stage III or IV OSCC according to the 2002 criteria of the American Joint Committee on Cancer, the presence of perineural invasion or lymphatic invasion, the depth of tumor invasion, or a close surgical margin. Patients with major risk factors, such as multiple nodal metastases, a positive surgical margin, or extracapsular spreading, were excluded. The prescribed dose of PORT ranged from 59.4 to 66.6Gy (median, 63Gy). Results: The 3-year overall and recurrence-free survival rates were 73% and 70%, respectively. Univariate analysis revealed that differentiation, perineural invasion, lymphatic invasion, bone invasion, location (hard palate and retromolar trigone), invasion depths ≥10mm, and margin distances ≤4mm were significant prognostic factors. The presence of multiple significant factors of univariate analysis correlated with disease recurrence. The 3-year recurrence-free survival rates were 82%, 76%, and 45% for patients with no risk factors, one or two risk factors, and three or more risk factors, respectively. After multivariate analysis, the number of risk factors and lymphatic invasion were significant prognostic factors. Conclusion: PORT may be an adequate adjuvant therapy for OSCC patients with one or two risk factors of recurrence. The presence of multiple risk factors and lymphatic invasion correlated with poor prognosis, and more aggressive treatment may need to be considered.

  11. Combination of Vandetanib, Radiotherapy, and Irinotecan in the LoVo Human Colorectal Cancer Xenograft Model

    International Nuclear Information System (INIS)

    Wachsberger, Phyllis; Burd, Randy; Ryan, Anderson; Daskalakis, Constantine; Dicker, Adam P.

    2009-01-01

    Purpose: The tumor growth kinetics of the human LoVo colorectal xenograft model was assessed in response to vandetanib, an orally available receptor tyrosine kinase inhibitor, radiotherapy (RT), or irinotecan (CPT-11), as single therapies and in combination. Methods and Materials: LoVo cells were injected subcutaneously into the right hind limb (5x10 6 cells in 100μL phosphate-buffered saline) of athymic NCR NUM mice and tumors were grown to a volume of 200-300 mm 3 before treatment. Vandetanib was administered at 50 mg/kg daily orally for 14 days starting on Day 1. RT was given as three fractions (3x3 Gy) on Days 1, 2, and 3. CPT-11 was given at 15 mg/kg intraperitoneally on Days 1 and 3. Tumor volumes were measured on a daily basis and calculated by measuring tumor diameters with digital calipers in two orthogonal dimensions. Results: All three single treatments (vandetanib, CPT-11, and radiation) significantly slowed LoVo colorectal tumor growth. Vandetanib significantly increased the antitumor effects of CPT-11 and radiation when given in combination with either of these treatments. These treatment combinations resulted in a slow tumor growth rate during the 2 weeks of vandetanib administration. The triple combination of vandetanib, CPT-11, and radiation produced the most marked improvement in response as observed by measurable shrinkage of tumors during the first week of treatment. Conclusions: The tumor growth delay kinetics observed in this study of the LoVo colorectal model suggest concurrent and sustained post-sequencing of vandetanib with cytotoxic therapy may be beneficial in tumors of this type.

  12. Study on combined chemotherapy and radiotherapy of the microcellular bronchial carcinoma (CCR study): chemo-/radiotherapy opposed to radio-/chemotherapy

    International Nuclear Information System (INIS)

    Heilmann, H.P.; Buenemann, H.; Arnal, M.L.; Calavrezos, A.; Engel, J.; Hain, E.; Koschel, G.; Seysen, U.; Allgemeines Krankenhaus Harburg, Hamburg; Franke, H.D.; Juengst, G.; Kohl, F.V.; Wichert, P. v.

    1983-01-01

    The authors studied the effect of a chemo-/radiotherapy or radio-/chemotherapy on 52 cases of microcellular bronchial carcinoma, classification ''limited disease''. The survival curves were slightly better for the patients submitted to primary chemotherapy, but the difference was not statistically significant, and the curves coincided again after 18 months. 60 to 80% of the patients had no complaints or only unimportant complaints during more than half of their survival time. In 23 patients with ''extensive disease'' who received only a symptomatic therapy or a combined palliative chemotherapy, chemotherapy had a slightly better effect, but this was not statistically significant. (orig.) [de

  13. The impact of respiratory motion and active breathing control on the displacement of target area in patients with gastric cancer treated with post-operative radiotherapy

    International Nuclear Information System (INIS)

    Yu Xiaoli; Zhang Zhen; Gu Weilie; Hu Weigang; Zhu Ji; Cai Gang; Li Guichao; He Shaoqin

    2010-01-01

    Objective: To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods: From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T 3 / N +, staging II - IV. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results: The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4

  14. Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries

    Directory of Open Access Journals (Sweden)

    Jimmy Thomas

    2014-01-01

    Full Text Available This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasing number of laparoscopic and robotic procedures. Brachial plexus injury needs to be recognised as a potential complication of prolonged combined plastic surgery. Preventive measures are discussed.

  15. High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

    Directory of Open Access Journals (Sweden)

    Keisei Okamoto

    2017-02-01

    Full Text Available Purpose : To evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR brachytherapy in combination with external beam radiotherapy (EBRT and short-term androgen deprivation therapy (ADT. Material and methods : From 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT. The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%, 61 patients with 2 high-risk factors (43%, and 22 patients with 3 high-risk factors (15% including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition. Results : Six patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS rate of 97.2%, and an overall survival (OS rate of 95.5%. Conclusions : High-dose (BED ≥ 220 Gy radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further.

  16. Breast-conserving radiation therapy using combined electron and intensity-modulated radiotherapy technique

    International Nuclear Information System (INIS)

    Li, J.G.; Williams, S.S.; Goffinet, D.R.; Boer, A.L.; Xing, L.

    2000-01-01

    An electron beam with appropriate energy was combined with four intensity modulated photon beams. The direction of the electron beam was chosen to be tilted 10-20 laterally from the anteroposterior direction. Two of the intensity-modulated photon beams had the same gantry angles as the conventional tangential fields, whereas the other two beams were rotated 15-25' toward the anteroposterior directions from the first two photon beams. An iterative algorithm was developed which optimizes the weight of the electron beam as well as the fluence profiles of the photon beams for a given patient. Two breast cancer patients with early-stage breast tumors were planned with the new technique and the results were compared with those from 3D planning using tangential fields as well as 9-field intensity-modulated radiotherapy (IMRT) techniques. The combined electron and IMRT plans showed better dose conformity to the target with significantly reduced dose to the ipsilateral lung and, in the case of the left-breast patient, reduced dose to the heart, than the tangential field plans. In both the right-sided and left-sided breast plans, the dose to other normal structures was similar to that from conventional plans and was much smaller than that from the 9-field IMRT plans. The optimized electron beam provided between 70 to 80% of the prescribed dose at the depth of maximum dose of the electron beam. The combined electron and IMRT technique showed improvement over the conventional treatment technique using tangential fields with reduced dose to the ipsilateral lung and the heart. The customized beam directions of the four IMRT fields also kept the dose to other critical structures to a minimum. (author)

  17. Acute and long-term adverse effects of postoperative irradiation on limb function of combined modality limb sparing therapy for extermity of soft tissue sarcoma

    International Nuclear Information System (INIS)

    Glinski, B.; Dymek, P.; Walasek, T.; Pecak, M.; Rogowska, M.

    2008-01-01

    The aim of this study is to focus on the aspect of functional outcome for early and late normal tissues damage for patients undergoing postoperative radiotherapy after limb preservation surgery for extremity soft tissues sarcoma (ESTS). The review of the literature suggests that approximately 50% of patients with ESTS have significant impairments, but synthesis of the results is difficult because of the heterogeneity of outcomes used to evaluate function. Future studies require the use of standardized definitions, and reliable and functional outcome measures. (author)

  18. Effect of bleomycin-radiotherapy combination in management of head and neck squamous cell carcinoma

    International Nuclear Information System (INIS)

    Shah, P.M.; Shukla, S.N.; Patel, K.M.; Patel, N.L.; Baboo, H.A.; Patel, D.D.

    1981-01-01

    Twenty-five patients with head and neck squamous cell carcinoma were treated with bleomycin-radiotherapy protocol, 15 mg bleomycin I.V. on alternate days followed by radiation within half an hour. The average total dose of bleomycin was 150 mg. Radiotherapy was given daily. Two patients were lost to follow-up very early in the course of the treatment and were removed from the study for statistical purposes. Thirty-six patients with head and neck squamous cell carcinoma who were treated with radiotherapy alone during the same period were used as controls. The patients were followed for two years. The incidence of response rate did not differ significantly between regimens; however, the incidence of side effects with bleomycin-radiotherapy, 82.61%, is significantly more than that of radiotherapy alone (52.78%). Median survial time (MST) of those responding to bleomycin-radiotherapy protocol was seven months and 12 days and for radiotherapy responders was six months. Neither the response rate nor the MST improve significantly after pretreatment with bleomycin. On the contrary, the incidence of side effects increased significantly

  19. Hypofractionated Proton Boost Combined with External Beam Radiotherapy for Treatment of Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Silvia Johansson

    2012-01-01

    Full Text Available Proton boost of 20 Gy in daily 5 Gy fractions followed by external beam radiotherapy (EBRT of 50 Gy in daily 2 Gy fractions were given to 278 patients with prostate cancer with T1b to T4N0M0 disease. Fifty-three percent of the patients received neoadjuvant androgen deprivation therapy (N-ADT. The medium followup was 57 months. The 5-year PSA progression-free survival was 100%, 95%, and 74% for low-, intermediate-, and high-risk patients, respectively. The toxicity evaluation was supported by a patient-reported questionnaire before every consultant visit. Cumulative probability and actuarial prevalence of genitourinary (GU and gastrointestinal (GI toxicities are presented according to the RTOG classification. N-ADT did not influence curability. Mild pretreatment GU-symptoms were found to be a strong predictive factor for GU-toxicity attributable to treatment. The actuarial prevalence declined over 3 to 5 years for both GU and GI toxicities, indicating slow resolution of epithelial damage to the genitourinary and gastrointestinal tract. Bladder toxicities rather than gastrointestinal toxicities seem to be dose limiting. More than 5-year followup is necessary to reveal any sign of true progressive late side effects of the given treatment. Hypofractionated proton-boost combined with EBRT is associated with excellent curability of localized PC and acceptable frequencies of treatment toxicity.

  20. Hypofractionated Proton Boost Combined with External Beam Radiotherapy for Treatment of Localized Prostate Cancer

    Science.gov (United States)

    Johansson, Silvia; Åström, Lennart; Sandin, Fredrik; Isacsson, Ulf; Montelius, Anders; Turesson, Ingela

    2012-01-01

    Proton boost of 20 Gy in daily 5 Gy fractions followed by external beam radiotherapy (EBRT) of 50 Gy in daily 2 Gy fractions were given to 278 patients with prostate cancer with T1b to T4N0M0 disease. Fifty-three percent of the patients received neoadjuvant androgen deprivation therapy (N-ADT). The medium followup was 57 months. The 5-year PSA progression-free survival was 100%, 95%, and 74% for low-, intermediate-, and high-risk patients, respectively. The toxicity evaluation was supported by a patient-reported questionnaire before every consultant visit. Cumulative probability and actuarial prevalence of genitourinary (GU) and gastrointestinal (GI) toxicities are presented according to the RTOG classification. N-ADT did not influence curability. Mild pretreatment GU-symptoms were found to be a strong predictive factor for GU-toxicity attributable to treatment. The actuarial prevalence declined over 3 to 5 years for both GU and GI toxicities, indicating slow resolution of epithelial damage to the genitourinary and gastrointestinal tract. Bladder toxicities rather than gastrointestinal toxicities seem to be dose limiting. More than 5-year followup is necessary to reveal any sign of true progressive late side effects of the given treatment. Hypofractionated proton-boost combined with EBRT is associated with excellent curability of localized PC and acceptable frequencies of treatment toxicity. PMID:22848840

  1. Prophylaxis against radiation injury. The use of elemental diet prior to and during radiotherapy for invasive bladder cancer and in early postoperative feeding following radical cystectomy and ileal conduit

    International Nuclear Information System (INIS)

    McArdle, A.H.; Reid, E.C.; Laplante, M.P.; Freeman, C.R.

    1986-01-01

    Previous studies done in animals have shown that significant prophylaxis against radiation injury could be afforded by feeding an elemental diet (ED) for three days before and during radiation. In the present study 20 patients were fed an ED for three days before and for the four days during radiotherapy (five fractions of 400 rad [4 Gy] each) prior to radical cystectomy and ileal conduit for invasive bladder cancer; ED feeding was recommenced 24 hours postoperatively via a feeding jejunostomy. The ED-fed patients exhibited positive nitrogen balance preoperatively and had an early return to positive nitrogen balance postoperatively (3.60 +/- 0.32 days). There was also prompt return of bowel sounds (3.00 +/- 0.32 days). Histologically and ultrastructurally, biopsy specimens of the ileal mucosa showed normal morphologic findings, with maintenance of normal levels of enzyme activity in the brush border. Severe or bloody diarrhea was absent in these patients. These data suggest that ED feeding provides prophylaxis against the acute phase of radiation injury in patients undergoing high-dose, short-course radiotherapy for invasive bladder cancer and that it is a safe and feasible means of postoperative nutritional support, even in the presence of a fresh bowel anastomosis

  2. Dependence of the risk of encephalopathy on the radiotherapy volume after combined surgery and radiotherapy of invasive pituitary tumors

    International Nuclear Information System (INIS)

    Rauhut, F.; Stolke, D.; Stuschke, M.; Sack, H.

    2002-01-01

    The effectiveness of radiotherapy in reducing tumor recurrence of pituitary adenomas is well documented. On the other hand, the risk of side effects to the surrounding central nervous system normal tissue should not be underestimated. This retrospective study includes 58 patients with subtotally resected pituitary tumors. Photon from a 5,7 MV linear accelerator of a 60 cobalt unit with a source-isocenter distance of 80 cm were used throughout for treatment. The doses per fraction ranged from 45 Gy to 60 Gy. For a direct comparison of the different fractionation schedules, the biological effective total dose with 2 Gy per fraction was calculated for all the different application schemes with doses per fraction longer or smaller than 2 Gy. To do this, a fractionation sensitivity of the normal cerebral tissue by an □/□ value of 2 Gy was assumed. Encephalopathy developed in 17 cases (28 percentage) after follow-up times of more than 5 years. Pathological CT- or MRI-findings were seen in 13 cases. Two factors were important for the genesis of radiogenic encephalopathy: 1. Multivariate analysis revealed that the risk of encephalopathy was associated with the radiation volume. 2. The location of the upper field border line was the strongest prognostic factor associated with the risk of encephalopathy (p < 0.05). (author)

  3. The application of early post-operative combination therapy with interstitial hyperthermia in the treatment of malignant gliomas

    International Nuclear Information System (INIS)

    Stahl, H.; Wust, P.; Maier-Hauff, K.; Seebass, M.; Mischel, M.; Grammler, M.; Golde, G.; Loeffel, J.; Felix, R.

    1995-01-01

    A pilot study was performed to examine practicality, tolerability, effectiveness and scope for improvement in early postoperative hyperthermia treatment following catheter implantation as part of (partial) tumor resection. Each CT data set was transferred into a VAX 3100 workstation for retrospective analysis of the hyperthermia treatment. The implanted catheters were segmented and the distributions of power density and temperature were simulated. We sought to achieve the best possible temperature distributions by optimising the catheter arrangement in the planning calculations. The corresponding Ir-192-source brachytherapy treatments were simulated in a similar way using the implanted, as well as optimised catheter arrays. Intraoperative catheter implantation in 4 patients was problem-free. Postoperative complications were not observed, neither were infections. Interstitial microwave hyperthermia in combination with percutaneous irradiation or chemotherapy a few days after the operation was also tolerated well by all patients. Effective temperatures (of at least 42 C) were regularly achieved at measurement points, but the temperature distributions were unsatisfactory, with T 90 values (the temperature reached in at least 90% of the target volume) of under 38 C. Measured temperature/position curves showed qualitative correlation with the simulated calculations. The catheter positions determined by optimisation varied significantly from the positions clinically used. (orig./MG) [de

  4. Integrated cancer therapy combined radiotherapy and immunotherapy. The challenge of using Gc protein-derived macrophage activating factor (GcMAF) as a key molecule

    International Nuclear Information System (INIS)

    Uto, Yoshihiro; Hori, Hitoshi

    2013-01-01

    Radiation oncologists know the conflict between radiotherapy and immunotherapy, but now challenged trails of the integrative cancer therapies combined radiation therapy and various immunoreaction/immune therapies begin. We therefore review the recent results of basic research and clinical trial of the integrated cancer therapies which combined radiotherapy and various immune therapies/immunoreaction, and the challenged studies of combined use of radiotherapy and our developed cancer immunotherapy using serum GcMAF which is human serum containing Gc protein-derived macrophage activating factor (GcMAF). (author)

  5. Intraoperative radiotherapy combined with resection for pancreatic cancer. Analysis of survival rates and prognostic factors

    International Nuclear Information System (INIS)

    Kuga, Hirotaka; Nishihara, Kazuyoshi; Matsunaga, Hiroaki; Suehara, Nobuhiro; Abe, Yuji; Ihara, Takaaki; Iwashita, Toshimitsu; Mitsuyama, Shoshu

    2006-01-01

    The purpose of this study was to evaluate the efficiency of intraoperative radiotherapy (IORT) combined with surgical resection. Subjects were consecutive 69 patients with pancreatic cancer treated with surgery alone (n=31) or surgical resection combined with IORT (n=38) in a 13 year period between 1991 and 2003. We evaluated the effects of IORT against local recurrence of cancer and patients' survival, retrospectively. Furthermore, clinicopathological factors affecting the 5-year survival rate in the two groups were comparatively investigated. The IORT group showed a significantly lower local recurrence rate of cancer than that in the surgery alone group (7.8% and 22.6%, respectively; p<0.05). The 5-year survival probability in the IORT group was significantly higher than that in the surgery alone group (29.9% and 3.4%, respectively; p<0.05). According to the Japanese classification of pancreatic cancer, cancers located in the pancreas body or tail, no local residual cancer post operative procedure (R0), low grade local cancer progression (t1, 2), and low grade intrapancreatic neural invasion (ne0, 1) were significantly better prognostic factors in the IORT group than those in the surgery alone group. There were no significant differences between the both groups in the 5-year survival rate in terms of the sex of the patients, cancer of the pancreas head, histological type, more than R1, the presence of lymph node involvement, ne2-3, and clinical stages. IORT is a useful intraoperative adjuvant therapy for pancreatic cancer, when the curative resection is achieved. Our data have suggested that IORT suppresses the local recurrence of cancer and provides the significant survival benefit for those patients. (author)

  6. [Mechanism and Prospect of Radiotherapy Combined with Apotatinib
in the Treatment of Non-small Cell Lung Cancer].

    Science.gov (United States)

    Liu, Guohui; Wang, Chunbo; E, Mingyan

    2017-12-20

    Non-small cell lung cancer is one of the most commom malignant tumor being harmful to people's life and health. Most of the patients have developed to the last stage which not suitable for surgical indications, so radiation and chemotherapy is the main treatment strategy. In recent years, with the theory of anti-angiogenesis therapy for malignant tumors, apatinib as a promising novel medicine to treat malignant tumors, represents synergistic antitumor effects in combination with radiotherapy. The underlying mechanisms may include make blood vessel normalization, alleviating inner hypoxia, and angiogenic factors regulation. Apatinib in combination with radiotherapy may become a new and effective treatment strategy of non-small cell lung cancer.

  7. Colonic resection with early discharge after combined subarachnoid-epidural analgesia, preoperative glucocorticoids, and early postoperative mobilization and feeding in a pulmonary high-risk patient

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Rosenberg, J

    1994-01-01

    BACKGROUND AND OBJECTIVES. A pulmonary high-risk patient undergoing right hemicolectomy for cancer was treated with a combination of intense afferent neural block with subarachnoid-epidural local anesthetics followed by continuous epidural analgesia, preoperative high-dose glucocorticoids......) with unchanged pulmonary function. Nocturnal episodic oxygen desaturation, hyperthermia, and postoperative fatigue were prevented. Defecation occurred on the first postoperative day and oral caloric intake was normal after 24 hours with no postoperative weight loss. Self care was normalized on the third...... postoperative day and the patient discharged from the hospital 80 hours after surgery. CONCLUSIONS. The technique of combined neural and humoral mediator block should be evaluated in other high-risk patients undergoing major surgical procedures, where minimal invasive techniques are not possible....

  8. A randomized trial of combined multidrug chemotherapy and radiotherapy in advanced squamous cell carcinoma of the head and neck

    International Nuclear Information System (INIS)

    1986-01-01

    This report concerns the design and results of a randomized prospective trial (SECOG I) in the treatment of advanced Stage III and IV head and neck cancer with radical radiotherapy combined with polychemotherapy. Synchronous administration of chemotherapy and radiotherapy was compared with sequential chemotherapy and radiotherapy and VBM (vincristine, bleomycin and methotrexate) compared with VBM plus 5-fluorouracil in a 2 x 2 standard factorial design. Two-hundred-and-seventy patients were entered and 267 were included in the analysis. Treatment did not present serious problems of toxicity. The addition of 5-fluorouracil to VBM produced a significant improvement in disease-free survival (P=0.04) though not in overall survival. Synchronous chemotherapy was similarly better than sequential chemotherapy, though not significantly so (P=0.1). A new study (SECOG II), based on this was started in February 1984, and one-third of the patients are now being allocated to treatment by radiotherapy as the sole method of treatment. (author)

  9. Intensity-Modulated Radiotherapy Causes Fewer Side Effects than Three-Dimensional Conformal Radiotherapy When Used in Combination With Brachytherapy for the Treatment of Prostate Cancer

    International Nuclear Information System (INIS)

    Forsythe, Kevin; Blacksburg, Seth; Stone, Nelson; Stock, Richard G.

    2012-01-01

    Purpose: To measure the benefits of intensity-modulated radiotherapy (IMRT) compared with three-dimensional conformal radiotherapy (3D-CRT) when used in combination with brachytherapy for the treatment of prostate cancer. Methods and Materials: We conducted a retrospective review of all patients with localized prostate cancer who received external-beam radiotherapy (EBRT) in combination with brachytherapy with at least 1 year follow-up (n = 812). Combination therapy consisted of 103 Pd or 125 I implant, followed by a course of EBRT. From 1993 to March 2003 521 patients were treated with 3D-CRT, and from April 2003 to March 2009 291 patients were treated with IMRT. Urinary symptoms were prospectively measured with the International Prostate Symptom Score questionnaire with a single quality of life (QOL) question; rectal bleeding was assessed per the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Late Radiation Morbidity Scoring Schema. The Pearson χ 2 test was used to compare toxicities experienced by patients who were treated with either IMRT or 3D-CRT. Logistic regression analyses were also performed to rule out possible confounding factors. Results: Within the first 3 months after treatment, patients treated with 3D-CRT scored their urinary symptoms as follows: 19% mild, 44% moderate, and 37% severe; patients treated with IMRT scored their urinary symptoms as follows: 36% mild, 47% moderate, and 17% severe (p < 0.001). The 3D-CRT patients rated their QOL as follows: 35% positive, 20% neutral, and 45% negative; IMRT patients rated their QOL as follows: 51% positive, 18% neutral, and 31% negative (p < 0.001). After 1 year of follow-up there was no longer any difference in urinary morbidity between the two groups. Logistic regression confirmed the differences in International Prostate Symptom Score and QOL in the acute setting (p < 0.001 for both). Grade ≥2 rectal bleeding was reported by 11% of 3D-CRT patients and 7

  10. Patterns of failure after postoperative radiotherapy for incompletely resected (R1) non-small cell lung cancer: implications for radiation target volume design.

    Science.gov (United States)

    Olszyna-Serementa, Marta; Socha, Joanna; Wierzchowski, Marek; Kępka, Lucyna

    2013-05-01

    Overall survival (OS) and pattern of failure in R1-resected non-small cell lung cancer (NSCLC) patients treated with 3D-planned postoperative radiotherapy (PORT) was retrospectively evaluated. The outcomes and patterns of failure in patients with (+) and without (-) extracapsular nodal extension (ECE) were compared and analyzed with respect to the radiation target volume design. Eighty R1-resected (37 ECE+ and 43 ECE-) patients received PORT (60Gy, 2Gy daily) between 2002 and 2011. Patients with N2 disease received limited elective nodal irradiation (ENI); for pN0-1 disease the use of ENI was optional. Among ECE- (extranodal-R1) patients there were 35 pN0-1 and eight pN2 cases; in pN0-1 patients, patterns of failure and outcomes were analyzed with respect to the use of ENI. Loco-regional failure (LRF) was defined as in-field relapse; isolated nodal failure (INF) was defined as out-of-field regional nodal recurrence occurring without LRF, irrespective of distant metastases. The actuarial 3-year OS rate was 36.3% (median: 30 months). Three-year OS rates in the ECE- and ECE+ group were 40.4% and 31.4%, with median OS of 31 and 24 months, respectively (p=0.43). In multivariate analysis, the presence of ECE was correlated with OS (HR=3.02; 95% CI: 1.00-9.16; p=0.05). Three-year cumulative incidence of LRF (CILRF) was 14.5% and 15.5% in the ECE- and ECE+ groups, respectively (p=0.98). Three-year cumulative incidence of INF (CIINF) was 14.1% in the ECE- group and 11.1% in the ECE+ group (p=0.76). For pN0-1 patients treated with and without ENI (13 and 22 patients) 3-year CILRF rates were 7.7% and 20.8%, respectively (p=0.20); 3-year CIINF rates were 9.1% and 16.3%, respectively (p=0.65). PORT resulted in a relatively good survival of R1-resected NSCLC patients. Relatively high incidence of INF was found in both ECE+ and ECE- patients. For ECE+ patients, treated with limited ENI, distant failure remains a major concern, so the design of ENI fields seems of lesser

  11. External beam radiotherapy for rectal adenocarcinoma

    International Nuclear Information System (INIS)

    Taylor, R.E.; Kerr, G.R.; Arnott, S.J.

    1987-01-01

    A series of 243 patients with adenocarcinoma of the rectum treated with radiotherapy is presented. Radiotherapy was combined with 5-fluorouracil, or given alone. Seventy-four patients were treated with radical external beam radiotherapy for recurrent or inoperable rectal adenocarcinoma. One hundred and forty-five patients with advanced pelvic tumours or metastases were treated with palliative pelvic radiotherapy. Twenty-four patients with small-volume residual pelvic tumour or who were felt to be at high risk of pelvic recurrence following radical resection received postoperative radiotherapy. Complete tumour regression was seen in 38% of radically treated patients, and 24% of palliatively treated patients. Partial regression was observed in 56% of radically treated patients, and 58% of palliatively treated patients. Long-term local tumour control was more commonly observed for small tumours (< 5 cm diameter). Fifty-eight % of patients treated with postoperative radiotherapy remained free of local recurrence. Survival was significantly better with small tumours. The addition of 5FU did not appear to improve survival or tumour control. (author)

  12. Effect of Hyperthermic Intraperitoneal Perfusion Chemotherapy in Combination with Intravenous Chemotherapy as Postoperative Adjuvant Therapy for Advanced Gastric Cancer.

    Science.gov (United States)

    Wu, Zhibing; Ma, Shenglin; Jing, Saisai; Deng, Qinghua; Zheng, Zhishuang; Wu, Kan; Li, Juan; Chen, Sumei; Tang, Rongjun; Li, Xiadong

    2014-06-01

    The aim is to evaluate the preliminary efficacy and side effects of paclitaxel, 5-fluorouracil, and leucovorin intravenous chemotherapy in combination with cisplatin hyperthermic intraperitoneal perfusion chemotherapy (HIPEC) as postoperative adjuvant therapy for patients of locally advanced gastric cancer (GC) at high risk for recurrence after curative resection. Four GC patients who underwent radical gastrectomy with D2 lymphadenectomy were enrolled. All patients received paclitaxel 135 mg/m2 on day 1, 5-FU 500 mg/m2 on days 1-5, LV 200 mg/m2 on days 1-5 intravenous chemotherapy, cisplatin 75 mg/m2 on day 5, and HIPEC one month after surgery. It was repeated at 3 weeks intervals and at least two cycles administered. A total of 181 cycles of chemotherapy were administered (median, 4 cycles). The median disease free survival time of patients was 40.8 months. The median overall survival time was 48.0 months. The one-, two-, and three-year recurrence rates were 14.6%, 26.8%, and 46.3%, respectively. The main relapse patterns were remnant GC and metastases of retroperitoneal lymph nodes. The morbidity of grade 3 and 4 toxicities of myelosuppression, nausea/ vomiting were less than 10%. The side effects of grade 1 and 2 of hematologic toxicity, nausea and vomiting, abnormal function of liver, kidney or cardiac, fatigue and neurotoxicity were well tolerated. Cisplatin HIPEC combined with paclitaxel, 5-fluorouracil, and leucovorin intravenous chemotherapy regimen could improve the survival rate and decrease the postoperative recurrence of locally advanced GC.

  13. Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC·3): a multicentre, randomised, controlled, phase 3 trial.

    Science.gov (United States)

    Brown, Paul D; Ballman, Karla V; Cerhan, Jane H; Anderson, S Keith; Carrero, Xiomara W; Whitton, Anthony C; Greenspoon, Jeffrey; Parney, Ian F; Laack, Nadia N I; Ashman, Jonathan B; Bahary, Jean-Paul; Hadjipanayis, Costas G; Urbanic, James J; Barker, Fred G; Farace, Elana; Khuntia, Deepak; Giannini, Caterina; Buckner, Jan C; Galanis, Evanthia; Roberge, David

    2017-08-01

    Whole brain radiotherapy (WBRT) is the standard of care to improve intracranial control following resection of brain metastasis. However, stereotactic radiosurgery (SRS) to the surgical cavity is widely used in an attempt to reduce cognitive toxicity, despite the absence of high-level comparative data substantiating efficacy in the postoperative setting. We aimed to establish the effect of SRS on survival and cognitive outcomes compared with WBRT in patients with resected brain metastasis. In this randomised, controlled, phase 3 trial, adult patients (aged 18 years or older) from 48 institutions in the USA and Canada with one resected brain metastasis and a resection cavity less than 5·0 cm in maximal extent were randomly assigned (1:1) to either postoperative SRS (12-20 Gy single fraction with dose determined by surgical cavity volume) or WBRT (30 Gy in ten daily fractions or 37·5 Gy in 15 daily fractions of 2·5 Gy; fractionation schedule predetermined for all patients at treating centre). We randomised patients using a dynamic allocation strategy with stratification factors of age, duration of extracranial disease control, number of brain metastases, histology, maximal resection cavity diameter, and treatment centre. Patients and investigators were not masked to treatment allocation. The co-primary endpoints were cognitive-deterioration-free survival and overall survival, and analyses were done by intention to treat. We report the final analysis. This trial is registered with ClinicalTrials.gov, number NCT01372774. Between Nov 10, 2011, and Nov 16, 2015, 194 patients were enrolled and randomly assigned to SRS (98 patients) or WBRT (96 patients). Median follow-up was 11·1 months (IQR 5·1-18·0). Cognitive-deterioration-free survival was longer in patients assigned to SRS (median 3·7 months [95% CI 3·45-5·06], 93 events) than in patients assigned to WBRT (median 3·0 months [2·86-3·25], 93 events; hazard ratio [HR] 0·47 [95% CI 0·35-0·63]; p<0·0001

  14. Comparison of Effect of Intrathecal Sufentanil-Bupivacaine and Fentanyl-Bupivacaine Combination on Postoperative Analgesia

    Directory of Open Access Journals (Sweden)

    Ishwar Singh

    2008-01-01

    Full Text Available Fifty ASA grade I/II patients scheduled for elective lower abdominal, lower limb and urological procedures were divided into two groups of 25 each .The first group (Group S received 2.5 ml of heavy bupivacaine with 0.2. ml sufentanil made up to 3 ml with saline. The second group (Group F received 2.5 ml of heavy bupivacaine with 0.5 ml of fentanyl. From our study it can be concluded that bupivacaine sufentanil combination although had shorter onset of action, but had more side effects especially nausea, vomiting and headache. The time for rescue analgesia in both groups was however similar.

  15. Postoperative Chemotherapy for Medulloblastoma

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    J Gordon Millichap

    2005-03-01

    Full Text Available The survival rate and cognitive function of 43 children, age <3 years, with medulloblastoma treated with intensive postoperative chemotherapy alone, without radiotherapy, were determined at the University of Wurzburg and other centers in Germany Chemotherapy consisted of three two-month cycles of cyclophosphamide, methotrexate, vincristine, carboplatin, and etoposide.

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

    International Nuclear Information System (INIS)

    Fujita, Masahiro; Murayama, Shigeyuki; Matayoshi, Yoshinobu; Ikeda, Hiroshi; Shimizutani, Kimishige; Inoue, Toshihiko; Kozuka, Takahiro; Masaki, Norie.

    1990-01-01

    Serum concentrations of cisplatin (CDDP) and acute complications were studied in patients treated for head and neck cancer by radiotherapy combined with daily administration of low doses of CDDP (5 mg/m 2 or 6 mg/body) at Osaka University Hospital between March 1988 and December 1989. Serum concentrations of total-CDDP (6 patients) and free-CDDP (2 patients) were studied in cases injected intravenously with 5 mg/m 2 daily. Total-CDDP determined just before daily administration of CDDP was increased gradually (0.35 to 0.64 μg/ml by the 7th day, 0.42 to 0.91 μg/ml by the 14th day and 0.60 to 0.82 μg/ml by the 20th or 21st day) and still observed in the serum for more than two weeks after cessation of the chemotherapy. Serum concentrations of free-CDDP were about 0.35 μg/ml at 5 minutes and 0.15 μg/ml at 30 minutes after the intravenous injection of CDDP. Incidence of the acute complications more severe than grade 2 were nausea and vomiting: 4/52 (8%), leukopenia: 11/52 (21%) and thrombocytopenia: 4/52 (8%). Incidence of myelosuppression (leukopenia and/or thrombocytopenia) was 11/26(42%) when the total dose of CDDP exceeded 120 mg, and 3/26 (12%) when it was less than 120 mg. Transient renal dysfunction (increase of serum creatinine) of grade 1 was seen in only 3 patients. (author)

  17. Results of postoperative radiation therapy in medullary carcinoma of the thyroid; A retrospective study by the French Federation of Cancer Institutes-The Radiotherapy Cooperative Group

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, T.D.; Panis, X. (Institut Jean-Godinot, Reims (France)); Chassard, J.L. (Centre de Lutte Contre le Cancer Leon-Berard, 69 - Lyon (France)); Lagarde, P. (Fondation Bergonie, 33 - Bordeaux (France)); Cutuli, B. (Centre Paul-Strauss, 67 - Strasbourg (France)); Fur, R. le (Centre de Lutte Contre le Cancer Henri-Becquerel, 76 - Rouen (France)); Reme-Saumon, M. (Centre Paul-Lamarque, Montpellier (France)); Prevost, B. (Centre de Lutte Contre le Cancer Oscar-Lambret, 59 - Lille (France)); Verrelle, P. (Centre Jean-Perrin, Clermont (France)); Chaplain, G. (Centre de Lutte Contre le Cancer Georges-Francois-Leclerc, 21 - Dijon (France))

    1992-01-01

    Between 1971-1989, 59 patients received external radiation therapy with a curative intent. There were 25 females and 34 males, ranging in age from 19 to 87. No patient had distant metastases at the onset of treatment. The majority had a total thyroidectomy (55/59), generally combined with neck dissection. Residual tumor was left in 11 cases, and 44 had positive cervical nodes. Using megavoltage radiotherapy, the whole neck and upper mediastinum area were most often irradiated through a large anterior Y-shaped field without laryngeal shielding. The mean dose to the tumoral bed was 54 Gy. Dysphagia was observed in 32 patients (11, 17 and 5 scores were grade 1, 2 and 3 respectively). Dyspnea occurred in 5 cases and in 2 of these, it was considered to be severe. Local recurrences were noted in 19 (30%) patients, most of them occurring within the fields of irradiation. Parameters such as age, sex, total dose, irradiated volumes or cervical node enlargement did not modify local control rate. Same conclusions can be drawn for distant failures. Thirty-five patients are still alive and among them, 24 have no evidence of disease. Average length of survival is 70.5 months and is shortened by the occurrence of distant failures except in patients with bone metastases. (author). 13 refs.; 1 fig.; 6 tabs.

  18. Optic neuropathy following combined proton and photon radiotherapy for base of skull tumors

    International Nuclear Information System (INIS)

    Kim, June; Munzenrider, John; Maas, Alicea; Finkelstein, Dianne; Liebsch, Norbert; Hug, Eugen; Suit, Herman; Smith, Al; Goitein, Michael

    1997-01-01

    Purpose/Objective: To evaluate the risk of radiation injury to the optic pathway following high dose radiation therapy (RT) for base of skull tumors with regard to the following variables: diabetes, hypertension, number of surgical procedures, use of patch, patch distance, radiation dose, and volume of optic structures receiving 50, 55, or 60 Cobalt Gray Equivalent (CGE). Materials and Methods: A total of 359 patients with base of skull chordoma or low grade chondrosarcoma received high dose radiation therapy. Patients were treated with external beam radiotherapy utilizing protons alone or combined protons and photons. Protons of 160 MeV were delivered at the Harvard Cyclotron Laboratory using a modulated Bragg peak. The tumor dose ranged from 61 to 76 CGE. CGE was used because modulated protons have an RBE of 1.1 compared to 60 Co. Among 359 patients, 85 patients were excluded from evaluation based on age, tumor location, and pre-RT treatment criteria. All 274 evaluable patients had a minimum follow up of 12 months. Medical records were reviewed to determine the actual cause of vision changes. A total of 12 patients with grade II, III, and IV radiation-induced optic neuropathy were identified. Twenty-four patients without complications who closely matched the aforementioned 12 cases with optic neuropathy were selected from the 274 patients as a control group. Dose volume histograms of 12 cases and 24 controls were reviewed to determine minimum, median, and maximum dose to the optic apparatus as well as dose volume at 50, 55, and 60 CGE. Other information regarding remaining potential risk factors, such as diabetes, hypertension, number of surgical procedures, use of patch, and patch distance, was also obtained. Results: A total of 12 patients (4.4%) developed radiation-induced optic neuropathy: 1 grade II, 9 grade III, and 2 grade IV. Specific sites of involvement were left optic nerve in 9, right optic nerve in 5, and chiasm in 4 cases. The duration to the onset

  19. Efficacy of the SENSIMED Triggerfish® in the postoperative follow-up of PHACO-ExPRESS combined surgery.

    Science.gov (United States)

    Osorio-Alayo, V; Pérez-Torregrosa, V T; Clemente-Tomás, R; Olate-Pérez, Á; Cerdà-Ibáñez, M; Gargallo-Benedicto, A; Barreiro-Rego, A; Duch-Samper, A

    2017-08-01

    To determine the usefulness of the SENSIMED Triggerfish ® system in the postoperative control of combined phacoemulsification and ExPRESS implant (PHACO-ExPRESS) surgery in patients with cataract and chronic open angle glaucoma (COAG) during a 2 months follow-up. A prospective study conducted on 15 eyes that were subjected to PHACO-ExPRESS combined surgery. Using the SENSIMED Triggerfish ® system, two records of the circadian patterns of intraocular pressure (IOP) were performed, one before and one after surgery. A record was made of the best corrected visual acuity (BCVA), comorbidities, previous IOP, and 7-30-60 days after surgery, as well as any hypotensive drugs and complications. The final sample was 12 eyes. The mean pre-operative BCVA (log MAR chart) before surgery was 0.5±0.2, and after surgery 0.14±0.1 (P=.02). The previous IOP was 18.7±3.8mmHg with 2.9±0.7 drugs. The mean IOP at 7, 30, and 60 days after surgery decreased to 13±4.1mmHg (P=.002), 13.5±2mmHg (P=.001), and 13.9±2.5mmHg (P=.001), respectively. The amplitudes of the circadian curves changed significantly after surgery (P=.007). The mean values between daytime and night-time periods decreased significantly from 146.8±80.9 mVeq and 61.2±92.mVeq before surgery to 36.4±36 mVeq (P=.000), and -23,2±47.6mVeq (P=.014) after surgery, respectively. There were complications in one patient. The SENSIMED Triggerfish ® monitoring system showed changes in the curves of the circadian patterns, as well as decreased mean amplitudes after the combined PHACO-ExPRESS technique, suggesting that it may become a useful tool for postoperative follow-up of COAG. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Immediate hematopoietic toxicity of combined chemotherapy-radiotherapy in Hodgkin's disease

    International Nuclear Information System (INIS)

    Peiffert, D.; Bey, P.; Conroy, T.; Lederlin, P.; Witz, F.

    1989-01-01

    The hematologic immediate toxicity during radiotherapy for Hodgkin's disease was studied from a series of 72 patients who received 3 courses or more of chemotherapy before radiotherapy. The toxicity in the group of 36 of them who received total nodal irradiation (TNI) was the most important. Sixteen of the 28 TNI had irradiation interrupted, 12 of them began with inverted Y type. The blood cells count at the beginning of the treatment was crucial; only 16% of the patients had interruption of irradiation when the blood cells count was normal; on the other side, 63% had interruption when the blood cells count was abnormal (P [fr

  1. Low doses of haloperidol combined with ondansetron are not effective for prophylaxis of postoperative nausea and vomiting in susceptible patients.

    Science.gov (United States)

    Veiga-Gil, Leonor; López-Olaondo, Luis; Pueyo, Javier; Callejas, Raquel; Duque, Paula; Carrascosa, Francisco

    2015-02-01

    In this observational study we reviewed the efficacy and side effects of different antiemetic combinations used in our hospital for postoperative nausea and vomiting (PONV) prophylaxis in high-risk women undergoing highly emetogenic surgery. After reviewing retrospectively the medical records of patients undergoing highly emetogenic elective surgeries under general anaesthesia, we selected 368 women whose Apfel risk score was ≥ 3 and receiving a combination of 2 antiemetics for PONV prophylaxis. We analysed the incidence of PONV at 2, 6, 12 and 24h after surgery, antiemetic rescue requirements, pattern of occurrence of PONV, side effects and level of sedation were also assessed. The main goal was complete response defined as no PONV within 24h after surgery. Ondansetron 4mg i.v. plus dexamethasone 8mg i.v. (O&Dex), haloperidol 1mg i.v. (O&Hal1), haloperidol 2mg i.v. (O&Hal2) or droperidol 1.25mg i.v. (O&Dro) were the combinations most frequently used. The complete response was better in groups O&Dex: 68.5% (CI: 58-78), O&Hal2: 64.1% (CI: 53-74) and O&Dro 63% (CI: 52-73) than in group O&Hal1: 41.3% (CI: 31-52) (p<0,01). Peak incidence of PONV occurred within the 2-6h period. The incidence of side effects was higher in group O&Hal2. In high risk patients for PONV who underwent highly emetogenic surgeries, the efficacy of low-dose haloperidol (1mg) in combination is limited. Higher doses (2mg) are more effective but its use is associated with a high incidence of side effects. Copyright © 2013 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Postoperative nausea and vomiting prophylaxis: A comparative study of ondansetron, granisetron and granisetron and dexamethasone combination after modified radical mastectomy

    Directory of Open Access Journals (Sweden)

    Pushplata Gupta

    2014-01-01

    Full Text Available Background: Post-operative nausea and vomiting (PONV is commonly seen after modified radical mastectomy (MRM. In this randomized double-blind prospective study we compared the efficacy of ondansetron, granisetron and granisetron and dexamethasone combination for prevention of PONV following MRM in female patients. Materials and Methods: A total of 75 patients (20-60 years of age undergoing elective MRM were randomly allocated to one of the three groups of 25 patients each. Group O received ondansetron 4 mg, Group G received granisetron 40 mcg/kg and group granisetron and dexamethasone (G + D received granisetron 40 mcg/kg + dexamethasone 8 mg prior to induction. All episodes of PONV within 24 h after induction of anesthesia were recorded. Statistical Analysis: Statistical analysis was done using Kruskal-Wallis test (nonparametric ANOVA. Results: The incidence of complete response (no PONV, no rescue medication was 96% with G+D, as compared with 86% with granisetron and 4% with ondansetron during 0-3h after surgery which was clinically significant (P < 0.05. Similarly clinically significant response was seen during 3-6, 6-9, 9-12 and 12-24 h of surgery. Conclusion: Granisetron and dexamethasone combination is more effective for prevention of PONV in comparison to individual ondansetron and granisetron in MRM.

  3. A JASTRO study group report. A randomized phase III trial of hyperthermia in combination with radiotherapy for superficial tumors

    International Nuclear Information System (INIS)

    Hiraoka, Masahiro; Nishimura, Yasumasa; Mitsumori, Michihide

    1998-01-01

    Result of study about local effect of hyperthermia in combination with radiotherapy for superficial tumors was reported. The irradiation was more than 90% isodose for lesion, and total dose was 60 Gy in cases with anamnesis and 40-50 Gy and without anamnesis at a rate of five times a week and 2 Gy at one time. Hyperthermia was carried out four times; once a week, at 42.5 degrees on tumor side edge, and for 40 minutes. Total 53 cases (neck lymph node metastasis 30 cases, relapse breast cancer 11, advanced breast cancer 1, other superficial tumor 11) were divided into 2 groups. Radiotherapy without hyperthermia (group R) was 27 cases, radiotherapy with hyperthermia (group H) was 26 cases. CR and CR+PR within 2 months after treatment were as follows: Group R: 50%, 85%, Group H: 64%, 100%. The CR+PR was superior in group H (p=0.0497). The CR at maximum effect after treatment was 65% of group R and 86% of group H (p=0.17). The local control rate after CR was not different in both groups. (K.H.)

  4. Combined treatment of radiotherapy and local hyperthermia using 8 MHz RF-wave for advanced carcinoma of the breast

    International Nuclear Information System (INIS)

    Fuwa, Nobukazu

    1988-01-01

    During the period from January 1983 through September 1986, 13 patients with carcinoma of the breast were treated with local hyperthermia combined with radiotherapy. Six patients were inoperable advanced cases and the other 7 were recurrent cases. Local heat was applied with an 8-MHz RF-capacitive heating equipment, once or twice a week after radiotherapy, for 40 ∼ 60 minutes per session. Of the 6 cases with inoperable advanced lesions, 4 achieved CR and the other 2 achieved PRa (80 ∼ 100 % regression), and of the 7 cases with local recurrent tumors, 3 achieved CR and the other 4 achieved PRa. As complications of the thermoradiotherapy, grade I-II skin burns were observed in 9 cases, pain around the ribs in 8 cases, mild lassitude in 2 cases, persistent tachycardia in 1 case and acute erosive gastritis in 1 case. It is worth noting that CR was achieved in these huge tumors, which can not be controlled by radiotherapy alone. (author)

  5. Three-dimensional treatment planning for postoperative radiotherapy in patients with node-positive cervical cancer. Comparison between a conventional and a conformal technique

    Energy Technology Data Exchange (ETDEWEB)

    Olofsen-van Acht, M.J.J.; Quint, S.; Seven, M.; Berg, H.A. van den; Levendag, P.C. [University Hospital Rotterdam (Netherlands). Dept. of Radiation Oncology; Santvoort, J.P.C. van [University Hospital Rotterdam (Netherlands). Subdivision of Clinical Physics; Logmans, A. [University Hospital Rotterdam (Netherlands). Dept. of Gynecologic Oncology

    1999-09-01

    Purpose: Reduction of irradiated small bowel volume, using a conformal three-dimensional treatment planning technique in postoperative radiotherapy of cervical cancer patients. Patients and Methods: Large gynecological treatment fields including the para-aortic nodes were analyzed in 15 patients. A conventional treatment plan with anterior and posterior (AP-PA) parallel opposed fields and a 3D 4-field conformal radiotherapy plan with a central blocking of small bowel were compared for each patient. Dose-volume histograms and dose parameters were established. Because of the tolerance constraints of the small bowel, the cumulative dose applied to the target was 48.6 Gy. Results: The mean Tumor Control Probability (TCP) values for both the conventional and the conformal technique were 0.60 and 0.61, respectively, with ranges of 0.56 to 0.67 and 0.57 to 0.66, respectively. The mean volume receiving 95% or more of the prescribed dose (V95) of the small bowel was 47.6% (32.5 to 66.3%) in the AP-PA technique and 14.9% (7.0 to 22.5%) in the conformal technique (p<0.001), indicating a significant reduction in irradiated volume of small bowel in the higher dose range. The mean Normal Tissue Complication Probability (NTCP) decreased from 0.11 to 0.03 with the conformal plan. In patients who received a pedicled omentoplasty during surgery, the mean V95 for small bowel could be reduced to 8.5% (7.0 to 9.9%). The mean median dose to the kidneys was only slightly elevated in the conformal treatment. Especially the mean dose to the right kidney in conventional vs conformal treatment was 3.3 vs 7.9 Gy. The mean near-minimum dose (D95) to the rectosigmoid decreased from 48.4 to 30.1 Gy in the conformal plan compared to the conventional plan. Conclusion: The small bowel dose can be significantly reduced with 3D treatment planning, particularly if a predicled omentoplasty is performed. This allows dose escalation to the tumor region without unacceptable toxicity for the small bowel

  6. Tramadol/paracetamol combination tablet for postoperative pain following ambulatory hand surgery: a double-blind, double-dummy, randomized, parallel-group trial

    Science.gov (United States)

    Rawal, Narinder; Macquaire, Valery; Catalá, Elena; Berti, Marco; Costa, Rui; Wietlisbach, Markus

    2011-01-01

    This randomized, double-blind, double-dummy, multicenter trial compared efficacy and safety of tramadol HCL 37.5 mg/paracetamol 325 mg combination tablet with tramadol HCL 50 mg capsule in the treatment of postoperative pain following ambulatory hand surgery with iv regional anesthesia. Patients received trial medication at admission, immediately after surgery, and every 6 hours after discharge until midnight of the first postoperative day. Analgesic efficacy was assessed by patients (n = 128 in each group, full analysis set) and recorded in a diary on the evening of surgery day and of the first postoperative day. They also documented the occurrence of adverse events. By the end of the first postoperative day, the proportion of treatment responders based on treatment satisfaction (primary efficacy variable) was comparable between the groups (78.1% combination, 71.9% tramadol; P = 0.24) and mean pain intensity (rated on a numerical scale from 0 = no pain to 10 = worst imaginable pain) had been reduced to 1.7 ± 2.0 for both groups. Under both treatments, twice as many patients experienced no pain (score = 0) on the first postoperative day compared to the day of surgery (35.9% vs 16.4% for tramadol/paracetamol and 36.7% vs 18% for tramadol treatment). Rescue medication leading to withdrawal (diclofenac 50 mg) was required by 17.2% patients with tramadol/paracetamol and 13.3% with tramadol. Adverse events (mainly nausea, dizziness, somnolence, vomiting, and increased sweating) occurred less frequently in patients under combination treatment (P = 0.004). Tramadol/paracetamol combination tablets provided comparable analgesic efficacy with a better safety profile to tramadol capsules in patients experiencing postoperative pain following ambulatory hand surgery. PMID:21559356

  7. Hyperthermia and radiotherapy

    International Nuclear Information System (INIS)

    Fitspatrick, C.

    1990-01-01

    Hyperthermia and radiotherapy have for long been used to assist in the control of tumours, either as separate entities, or, in a combined treatment scheme. This paper outlines why hyperthermia works, thermal dose and the considerations required in the timing when hyperthermia is combined with radiotherapy. Previously reported results for hyperthermia and radiotherapy used together are also presented. 8 refs., 8 tabs

  8. A meta-analysis of hyperfractionated and accelerated radiotherapy and combined chemotherapy and radiotherapy regimens in unresected locally advanced squamous cell carcinoma of the head and neck

    Directory of Open Access Journals (Sweden)

    Budach V

    2006-01-01

    Full Text Available Abstract Background Former meta-analyses have shown a survival benefit for the addition of chemotherapy (CHX to radiotherapy (RT and to some extent also for the use of hyperfractionated radiation therapy (HFRT and accelerated radiation therapy (AFRT in locally advanced squamous cell carcinoma (SCC of the head and neck. However, the publication of new studies and the fact that many older studies that were included in these former meta-analyses used obsolete radiation doses, CHX schedules or study designs prompted us to carry out a new analysis using strict inclusion criteria. Methods Randomised trials testing curatively intended RT (≥60 Gy in >4 weeks/>50 Gy in Results Thirty-two trials with a total of 10 225 patients were included into the meta-analysis. An overall survival benefit of 12.0 months was observed for the addition of simultaneous CHX to either CFRT or HFRT/AFRT (p Conclusion RT combined with simultaneous 5-FU, cisplatin, carboplatin, and mitomycin C as single drug or combinations of 5-FU with one of the other drugs results in a large survival advantage irrespective the employed radiation schedule. If radiation therapy is used as single modality, hyperfractionation leads to a significant improvement of overall survival. Accelerated radiation therapy alone, especially when given as split course radiation schedule or extremely accelerated treatments with decreased total dose, does not increase overall survival.

  9. Phase II trial of Uracil/Tegafur plus leucovorin and celecoxib combined with radiotherapy in locally advanced pancreatic cancer

    International Nuclear Information System (INIS)

    Morak, Marjolein J.M.; Richel, Dick J.; Eijck, Casper H.J. van; Nuyttens, Joost J.M.E.; Gaast, Ate van der; Vervenne, Walter L.; Padmos, Esther E.; Schaake, Eva E.; Busch, Olivier R.C.; Tienhoven, Geertjan van

    2011-01-01

    Background and purpose: To investigate the efficacy and toxicity of a short intensive Uracil/Tegafur (UFT) based chemoradiotherapy scheme combined with celecoxib in locally advanced pancreatic cancer. Material and methods: The Academic Medical Centre, Amsterdam and the Erasmus Medical Centre, Rotterdam enrolled 83 eligible patients with unresectable pancreatic cancer in a prospective multicentre phase II study. Median age was 62 years, median tumour size 40 mm and the majority of the patients (85%) had pancreatic head cancers. Treatment consisted of 20 x 2.5 Gy radiotherapy combined with UFT 300 mg/m 2 per day, leucovorin (folinic acid) 30 mg and celecoxib 800 mg for 28 days concomitant with radiotherapy. Four patients were lost to follow-up. Results: Full treatment compliance was achieved in 55% of patients, 80% received at least 3 weeks of treatment. No partial or complete response was observed. Median survival was 10.6 months and median time to progression 6.9 months. Toxicity was substantial with 28% grades III and IV gastro-intestinal toxicity and two early toxic deaths. Conclusions: Based on the lack of response, the substantial toxicity of mainly gastro-intestinal origin and the reported mediocre overall and progression free survival, we cannot advise our short intensive chemoradiotherapy schedule combined with celecoxib as the standard treatment.

  10. Chemical modification of conventional cancer radiotherapy. Tumor sensitization combined with normal tissue protection

    International Nuclear Information System (INIS)

    Kagiya, Tsutomu

    2006-01-01

    Nitrotriazole radiosensitizer, Sanazole (AK-2123, N-(2'-methoxyethyl)-2-(3''-nitro-1''-triazolyl) acetamide) developed by Kyoto University group was studied by 18 groups of 7 countries on fundamental aspects and clinical studies by 30 groups of 12 countries, and reported its effects on tumor sensitization of conventional cancer radiotherapy. On the other hand, the glucosides of vitamin C (Ascorbic acid glucoside, (AsAG) and water soluble derivative of vitamin-E (α-tocopherol glucoside, TMG) developed by Kyoto University group were studied fundamentally by 4 groups of 4 countries and clinically by 2 groups of 2 countries, and reported their effects on normal tissue protection in cancer treatments. These two studies of tumor sensitization and normal tissue protection were proposed as an advanced strategy of conventional cancer radiotherapy. (author)

  11. Protocol for the combined immunosuppression & radiotherapy in thyroid eye disease (CIRTED trial: A multi-centre, double-masked, factorial randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Kingston Laura

    2008-01-01

    Full Text Available Abstract Background Medical management of thyroid eye disease remains controversial due to a paucity of high quality evidence on long-term treatment outcomes. Glucocorticoids are known to be effective initially but have significant side-effects with long-term use and recrudescence can occur on cessation. Current evidence is conflicting on the efficacy of radiotherapy and non-steroid systemic immunosuppression, and the majority of previous studies have been retrospective, uncontrolled, small or poorly designed. The Combined Immunosuppression and Radiotherapy in Thyroid Eye Disease (CIRTED trial was designed to investigate the efficacy of radiotherapy and azathioprine in combination with a standard course of oral prednisolone in patients with active thyroid eye disease. Methods/design Patients with active thyroid eye disease will be randomised to receive (i azathioprine or oral placebo and (ii radiotherapy or sham-radiotherapy in this multi-centre, factorial randomised control trial. The primary outcome is improvement in disease severity (assessed using a composite binary measure at 12 months and secondary end-points include quality of life scores and health economic measures. Discussion The CIRTED trial is the first study to evaluate the role of radiotherapy and azathioprine as part of a long-term, combination immunosuppressive treatment regime for Thyroid Eye Disease. It will provide evidence for the role of radiotherapy and prolonged immunosuppression in the management of this condition, as well as pilot data on their use in combination. We have paid particular attention in the trial design to establishing (a robust placebo controls and masking protocols which are effective and safe for both radiotherapy and the systemic administration of an antiproliferative drug; (b constructing effective inclusion and exclusion criteria to select for active disease; and (c selecting pragmatic outcome measures. Trial registration Current controlled trials

  12. Randomized study: small cell anaplastic lung cancer treated by combination chemotherapy and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Fox, R.M.; Woods, R.L.; Brodie, G.N.; Tattersall, M.H.N.

    1980-01-01

    Chemotherapy and primary site radiation therapy were compared to chemotherapy alone in a randomized study of 125 patients with small cell cancer of the lung. The sites of initial relapse, as well as disease free and overall survival were analyzed. Radiotherapy to the primary site reduced the rate of local relapse, but median survival was not prolonged in patients with either limited or extensive disease, when the radiation therapy-chemotherapy group was compared to the group that received chemotherapy alone

  13. Overview of different available chemotherapy regimens combined with radiotherapy for the neoadjuvant and definitive treatment of esophageal cancer.

    Science.gov (United States)

    Tomasello, Gianluca; Ghidini, Michele; Barni, Sandro; Passalacqua, Rodolfo; Petrelli, Fausto

    2017-06-01

    Neoadjuvant chemoradiotherapy (CTRT) is the current standard of care for treatment of locally advanced cancer of the esophagus or gastroesophageal junction. Many efforts have been made over the last years to identify the best chemotherapy and radiotherapy combination regimen, but specific randomized trials addressing this issue are still lacking. Areas covered: A systematic review of the literature was performed searching in PubMed all published studies of combinations CTRT regimens for operable or unresectable esophageal cancer to describe activity and toxicity. Studies considered were prospective series or clinical phase II-III trials including at least 40 patients and published in English language. Expert commentary: Long-term results of CROSS trial have established RT combined with carboplatin plus paclitaxel chemotherapy as the preferred neoadjuvant treatment option for both squamous and adenocarcinoma of the esophagus. More effective multimodal treatment strategies integrating novel biological agents including immunotherapy and based on an extensive molecular tumor characterization are eagerly awaited.

  14. Combined parecoxib and I.V. paracetamol provides additional analgesic effect with better postoperative satisfaction in patients undergoing anterior cruciate ligament reconstruction

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    Zeinab Ahmed Elseify

    2011-01-01

    Full Text Available Background : Adequacy of postoperative analgesia is one of the most important factors that determine early hospital discharge and patients′ ability to resume their normal activities postoperatively. The optimal non-opioid analgesic technique for postoperative pain management would reduce pain and enhance patient satisfaction, and it also facilitates earlier mobilization and rehabilitation by reducing pain-related complications after surgery. The aim of this study was to evaluate the analgesic efficacy of intravenous paracetamol and parecoxib when used alone, or in combination. Methods : Sixty American Society of Anesthesiology (ASA physical status I and II adult patients who were scheduled for anterior cruciate ligament reconstruction were included in this study. Patients were allocated into three groups: group I patients received 1g intravenous paracetamol after induction and another 1 g 4 h later, group II received 40 mg parecoxib after induction, while group III received combination of both drugs (paracetamol 1 g and parecoxib 40 mg. Pain during rest and mobility was assessed in the immediate postoperative period, 2 h and 8 h successively using visual analog scale (VAS. Patient satisfaction was rated according to satisfaction score. Results : Total morphine requirements were lower in group III patients (6.9±2.7 mg in comparison to group I patients (12.6±3.6 mg or group II patients (9.8±2.8 mg. The least VAS scores were recorded during knee movement (3.8±1.1 in group III patients compared to group I (6.0±1.8 and group II patients (4.8±1.9. Eight hours postoperatively, group III patients were more satisfied regarding the postoperative pain management. Conclusion : Combination of intravenous paracetamol and parecoxib provided better analgesia and higher patient satisfaction than each drug when used separately.

  15. A meta-analysis of hyperfractionated and accelerated radiotherapy and combined chemotherapy and radiotherapy regimens in unresected locally advanced squamous cell carcinoma of the head and neck

    International Nuclear Information System (INIS)

    Budach, W; Hehr, T; Budach, V; Belka, C; Dietz, K

    2006-01-01

    Former meta-analyses have shown a survival benefit for the addition of chemotherapy (CHX) to radiotherapy (RT) and to some extent also for the use of hyperfractionated radiation therapy (HFRT) and accelerated radiation therapy (AFRT) in locally advanced squamous cell carcinoma (SCC) of the head and neck. However, the publication of new studies and the fact that many older studies that were included in these former meta-analyses used obsolete radiation doses, CHX schedules or study designs prompted us to carry out a new analysis using strict inclusion criteria. Randomised trials testing curatively intended RT (≥60 Gy in >4 weeks/>50 Gy in <4 weeks) on SCC of the oral cavity, oropharynx, hypopharynx, and larynx published as full paper or in abstract form between 1975 and 2003 were eligible. Trials comparing RT alone with concurrent or alternating chemoradiation (5-fluorouracil (5-FU), cisplatin, carboplatin, mitomycin C) were analyzed according to the employed radiation schedule and the used CHX regimen. Studies comparing conventionally fractionated radiotherapy (CFRT) with either HFRT or AFRT without CHX were separately examined. End point of the meta-analysis was overall survival. Thirty-two trials with a total of 10 225 patients were included into the meta-analysis. An overall survival benefit of 12.0 months was observed for the addition of simultaneous CHX to either CFRT or HFRT/AFRT (p < 0.001). Separate analyses by cytostatic drug indicate a prolongation of survival of 24.0 months, 16.8 months, 6.7 months, and 4.0 months, respectively, for the simultaneous administration of 5-FU, cisplatin-based, carboplatin-based, and mitomycin C-based CHX to RT (each p < 0.01). Whereas no significant gain in overall survival was observed for AFRT in comparison to CFRT, a substantial prolongation of median survival (14.2 months, p < 0.001) was seen for HFRT compared to CFRT (both without CHX). RT combined with simultaneous 5-FU, cisplatin, carboplatin, and mitomycin C as

  16. Clinical trial of neoadjuvant chemotherapy combined with radiotherapy for primary intracranial germinomas

    International Nuclear Information System (INIS)

    Kitamura, Kei; Suzuki, Keishiro; Shirato, Hiroki; Kagei, Kenji; Aoyama, Hidefumi; Sawamura, Yutaka; Ikeda, Jun; Miyasaka, Kazuo

    1997-01-01

    Purpose/Objective: Since 1992, we have been using neoadjuvant chemotherapy to reduce the radiation dose and irradiated volume in the treatment of intracranial germinomas. This study evaluates the initial response and complications of the treatment and also the IQ score and pituitary function of patients before radiotherapy. Materials and methods: Fifteen patients with histologically confirmed intracranial germinomas were treated between 1992 and 1997. Six patients with solitary pure germinoma received 3 to 4 courses of etoposide and cisplatin (EP regimen) followed by localized irradiation of 24Gy (in 12 fractions within 3 weeks). Three patients with germinoma with syncytiotrophoblastic giant cells (STGC) and 4 patients with multifocal pure germinoma received 3 to 5 courses of ifosfamide, cisplatin and etoposide (ICE regimen), followed by localized irradiation of 24 Gy. Two patients with disseminated pure germinoma received 2 to 4 courses of ICE regimen followed by craniospinal irradiation of 24 Gy. In the planning of localized irradiation, the treatment field was determined so as to cover the tumor with a margin of 2cm. The IQ score and pituitary function before radiotherapy were also examined. MRI was performed in all patients one month after the completion of treatment and every 6 months in the follow-up study. The treatment data of our institute before 1991, as historical control, was analyzed and compared to that of the present study. Results: Complete remission (CR) was obtained in all patients after the treatment. One patient with germinoma with STGC experienced recurrence out of the field at 39 months after surgery. He was re-treated with salvage therapy including the ICE regimen and obtained a second complete remission. All patients are alive without disease with a median follow-up period of 29 months. The examination of IQ score and pituitary function before radiotherapy revealed mental retardation in 2 patients (22%) and hypopituitarism in 13 patients (86

  17. Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients

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    Ling Cai

    2013-10-01

    Full Text Available The aim of the present study is to assess the disease profile, outcome and prognostic factors in patients treated with surgery combined with radiotherapy (RT, with or without chemotherapy (CXT, for soft-tissue sarcoma (STS in a multidisciplinary setting. One hundred and sixty-four patients with STS treated between 1980 and 2010 at the Centre Hospitalier Universitaire Vaudois were enrolled in this retrospective study. Seventy-six percent of patients underwent postoperative RT with (24%, or without (52% CXT, 15% preoperative RT with (5%, or without (10% CXT, surgery alone (7%, or RT alone (2% with or without CXT. The median follow-up was 60 months (range 6-292. Local failure was observed in 18%, and distant failure in 21% of the patients. Overall survival (OS, disease-free survival (DFS, local control (LC and distant metastases-free survival (DMFS were 88%, 68%, 83%, and 79% at 5 years, and 80%, 56%, 76%, and 69% at 10 years, respectively. In univariate analyses, favorable prognostic factors for OS, DFS, and DMFS were tumor size 6 cm or less, World Health Organization (WHO/Zubrod score 0, and stage 2 or less. Age and superficial tumors were favorable only for OS and DMFS respectively. STS involving the extremities had a better outcome regarding DFS and LC. Histological grade 2 or less was favorable for DFS, DMFS, and LC. Radical surgery was associated with better LC and DMFS. RT dose more than 60 Gy was favorable for OS, DFS, and LC. In multivariate analyses, independent factors were age for OS; tumor size for OS, DFS and DMFS; WHO/Zubrod score for OS, DFS and LC; hemoglobin level for DFS; site for DFS and LC; tumor depth for DMFS; histological grade for DFS and LC; surgical procedure for LC and DMFS; and RT dose for OS. This study confirms that in a multidisciplinary setting, STS have a fairly good prognosis. A number of prognostic and predictive factors, including the role of surgery combined with RT, were identified. Regarding RT, a dose of

  18. Prognostic Factors in Adult Soft Tissue Sarcoma Treated with Surgery Combined with Radiotherapy: A Retrospective Single-Center Study on 164 Patients

    Science.gov (United States)

    Cai, Ling; Mirimanoff, René-Olivier; Mouhsine, Elyazid; Guillou, Louis; Leyvraz, Pierre-Francois; Leyvraz, Serge; Gay, Beatrice; Matzinger, Oscar; Ozsahin, Mahmut; Zouhair, Abderrahim

    2013-01-01

    The aim of the present study is to assess the disease profile, outcome and prognostic factors in patients treated with surgery combined with radiotherapy (RT), with or without chemotherapy (CXT), for soft-tissue sarcoma (STS) in a multidisciplinary setting. One hundred and sixty-four patients with STS treated between 1980 and 2010 at the Centre Hospitalier Universitaire Vaudois were enrolled in this retrospective study. Seventy-six percent of patients underwent postoperative RT with (24%), or without (52%) CXT, 15% preoperative RT with (5%), or without (10%) CXT, surgery alone (7%), or RT alone (2%) with or without CXT. The median follow-up was 60 months (range 6-292). Local failure was observed in 18%, and distant failure in 21% of the patients. Overall survival (OS), diseasefree survival (DFS), local control (LC) and distant metastases-free survival (DMFS) were 88%, 68%, 83%, and 79% at 5 years, and 80%, 56%, 76%, and 69% at 10 years, respectively. In univariate analyses, favorable prognostic factors for OS, DFS, and DMFS were tumor size 6 cm or less, World Health Organization (WHO)/Zubrod score 0, and stage 2 or less. Age and superficial tumors were favorable only for OS and DMFS respectively. STS involving the extremities had a better outcome regarding DFS and LC. Histological grade 2 or less was favorable for DFS, DMFS, and LC. Radical surgery was associated with better LC and DMFS. RT dose more than 60 Gy was favorable for OS, DFS, and LC. In multivariate analyses, independent factors were age for OS; tumor size for OS, DFS and DMFS; WHO/Zubrod score for OS, DFS and LC; hemoglobin level for DFS; site for DFS and LC; tumor depth for DMFS; histological grade for DFS and LC; surgical procedure for LC and DMFS; and RT dose for OS. This study confirms that in a multidisciplinary setting, STS have a fairly good prognosis. A number of prognostic and predictive factors, including the role of surgery combined with RT, were identified. Regarding RT, a dose of more than

  19. Results of postoperative radiotherapy and radiation of recurrent tumours, observed in adenomas of the pituitary gland operated at a primary stage

    International Nuclear Information System (INIS)

    Oettle, E.

    1987-01-01

    This retrospective study included 134 patients showing adenomas of the pituitary gland. It was found that radiotherapy carried out immediately after surgery was superior to radiation commencing only after tumour recidivation. Treatment was predominantly based an 'ultrahard' X-rays (betatron), to a lesser extent on cobalt-60 gamma rays. (MBC) [de

  20. Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy

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    Versmessen Harijati

    2012-10-01

    Full Text Available Abstract Background Health-related quality of life (HRQOL assessment is a key component of clinical oncology trials. However, few breast cancer trials comparing adjuvant conventional radiotherapy (CR and hypofractionated tomotherapy (TT have investigated HRQOL. We compared HRQOL in stage I-II breast cancer patients who were randomized to receive either CR or TT. Tomotherapy uses an integrated computed tomography scanner to improve treatment accuracy, aiming to reduce the adverse effects of radiotherapy. Methods A total of 121 stage I–II breast cancer patients who had undergone breast conserving surgery (BCS or mastectomy (MA were randomly assigned to receive either CR or TT. CR patients received 25 × 2 Gy over 5 weeks, and BCS patients also received a sequential boost of 8 × 2 Gy over 2 weeks. TT patients received 15 × 2.8 Gy over 3 weeks, and BCS patients also received a simultaneous integrated boost of 15 × 0.6 Gy over 3 weeks. Patients completed the EORTC QLQ-C30 and BR23 questionnaires. The mean score (± standard error was calculated at baseline, the end of radiotherapy, and at 3 months and 1, 2, and 3 years post-radiotherapy. Data were analyzed by the 'intention-to-treat' principle. Results On the last day of radiotherapy, patients in both treatment arms had decreased global health status and functioning scores; increased fatigue (clinically meaningful in both treatment arms, nausea and vomiting, and constipation; decreased arm symptoms; clinically meaningful increased breast symptoms in CR patients and systemic side effects in TT patients; and slightly decreased body image and future perspective. At 3 months post-radiotherapy, TT patients had a clinically significant increase in role- and social-functioning scores and a clinically significant decrease in fatigue. The post-radiotherapy physical-, cognitive- and emotional-functioning scores improved faster in TT patients than CR patients. TT patients also had a better

  1. Health-related quality of life in survivors of stage I-II breast cancer: randomized trial of post-operative conventional radiotherapy and hypofractionated tomotherapy

    International Nuclear Information System (INIS)

    Versmessen, Harijati; Vinh-Hung, Vincent; Van Parijs, Hilde; Miedema, Geertje; Voordeckers, Mia; Adriaenssens, Nele; Storme, Guy; De Ridder, Mark

    2012-01-01

    Health-related quality of life (HRQOL) assessment is a key component of clinical oncology trials. However, few breast cancer trials comparing adjuvant conventional radiotherapy (CR) and hypofractionated tomotherapy (TT) have investigated HRQOL. We compared HRQOL in stage I-II breast cancer patients who were randomized to receive either CR or TT. Tomotherapy uses an integrated computed tomography scanner to improve treatment accuracy, aiming to reduce the adverse effects of radiotherapy. A total of 121 stage I–II breast cancer patients who had undergone breast conserving surgery (BCS) or mastectomy (MA) were randomly assigned to receive either CR or TT. CR patients received 25 × 2 Gy over 5 weeks, and BCS patients also received a sequential boost of 8 × 2 Gy over 2 weeks. TT patients received 15 × 2.8 Gy over 3 weeks, and BCS patients also received a simultaneous integrated boost of 15 × 0.6 Gy over 3 weeks. Patients completed the EORTC QLQ-C30 and BR23 questionnaires. The mean score (± standard error) was calculated at baseline, the end of radiotherapy, and at 3 months and 1, 2, and 3 years post-radiotherapy. Data were analyzed by the 'intention-to-treat' principle. On the last day of radiotherapy, patients in both treatment arms had decreased global health status and functioning scores; increased fatigue (clinically meaningful in both treatment arms), nausea and vomiting, and constipation; decreased arm symptoms; clinically meaningful increased breast symptoms in CR patients and systemic side effects in TT patients; and slightly decreased body image and future perspective. At 3 months post-radiotherapy, TT patients had a clinically significant increase in role- and social-functioning scores and a clinically significant decrease in fatigue. The post-radiotherapy physical-, cognitive- and emotional-functioning scores improved faster in TT patients than CR patients. TT patients also had a better long-term recovery from fatigue than CR patients. ANOVA

  2. An experimental study on cervix cancer with combination of HSV-TK/GCV suicide gene therapy system and 60Co radiotherapy

    International Nuclear Information System (INIS)

    Chen, Daozhen; Tang, Qiusha

    2010-01-01

    To evaluate the killing effect of HSV-TK/GCV suicide gene therapy system combined with 60 Co 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 60 Co 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 60 Co 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

  3. Tramadol/paracetamol combination tablet for postoperative pain following ambulatory hand surgery: a double-blind, double-dummy, randomized, parallel-group trial

    Directory of Open Access Journals (Sweden)

    Rawal N

    2011-04-01

    Full Text Available Narinder Rawal1, Valery Macquaire2, Elena Catalá3, Marco Berti4, Rui Costa5, Markus Wietlisbach61Department of Anesthesiology and Intensive Care, Örebro University Hospital, Örebro, Sweden; 2Clinique du Parc Leopold, Brussels, Belgium; 3Pain Clinic, Department Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; 4Department of Anesthesiology and Reanimation, Parma Hospital, Parma, Italy; 5Garcia de Orta Hospital, Almada, Portugal; 6Department of Anesthesiology, Sursee Hospital, Sursee, SwitzerlandAbstract: This randomized, double-blind, double-dummy, multicenter trial compared efficacy and safety of tramadol HCL 37.5 mg/paracetamol 325 mg combination tablet with tramadol HCL 50 mg capsule in the treatment of postoperative pain following ambulatory hand surgery with iv regional anesthesia. Patients received trial medication at admission, immediately after surgery, and every 6 hours after discharge until midnight of the first postoperative day. Analgesic efficacy was assessed by patients (n = 128 in each group, full analysis set and recorded in a diary on the evening of surgery day and of the first postoperative day. They also documented the occurrence of adverse events. By the end of the first postoperative day, the proportion of treatment responders based on treatment satisfaction (primary efficacy variable was comparable between the groups (78.1% combination, 71.9% tramadol; P = 0.24 and mean pain intensity (rated on a numerical scale from 0 = no pain to 10 = worst imaginable pain had been reduced to 1.7 ± 2.0 for both groups. Under both treatments, twice as many patients experienced no pain (score = 0 on the first postoperative day compared to the day of surgery (35.9% vs 16.4% for tramadol/paracetamol and 36.7% vs 18% for tramadol treatment. Rescue medication leading to withdrawal (diclofenac 50 mg was required by 17.2% patients with tramadol/paracetamol and 13.3% with tramadol. Adverse events (mainly nausea, dizziness

  4. Combining radiotherapy with immunotherapy: the past, the present and the future

    DEFF Research Database (Denmark)

    Van Limbergen, Evert J.; De Ruysscher, Dirk K.; Pimentel, Veronica Olivo

    2017-01-01

    The advent of immunotherapy is currently revolutionizing the field of oncology, where different drugs are used to stimulate different steps in a failing cancer immune response chain. This review gives a basic overview of the immune response against cancer, as well as the historical and current...... evidence on the interaction of radiotherapy with the immune system and the different forms of immunotherapy. Furthermore the review elaborates on the many open questions on how to exploit this interaction to the full extent in clinical practice....

  5. In vivo and in vitro experimental study on cervix cancer with combination of HSV-TK/GCV suicide gene therapy system and 60Co radiotherapy

    International Nuclear Information System (INIS)

    Chen Daozhen; Xue Wenqun; Zhan Huiying; Zhu Yunxia; Yang Youyi; Liu Lu; Tang Qiusha

    2006-01-01

    Objective: To evaluate the killing effect of HSV-TK/GCV suicide gene therapy system combined with 60 Co radiotherapy on human cervical cancer HeLa cell line in vivo and in vitro, and to explore radiosensitization by the HSV-TK/GCV system. Methods: The HSV-TK/GCV suicide gene therapy system and 60 Co radiotherapy were used separately or in combination for human cervical cancer HeLa cell line in vivo and in vitro to compare their effects. Colony formation test and the rate of radiosensitization effect(E/O) were employed to observed the radiosensitization by the HSV-TK/GCV system. Results: The HSV-TK/GCV suicide gene therapy system showed strong therapeutic effects on HeLa cells both in vitro and in vivo (the inhibition rates were 45.8% and 39.5%, respectively). Moreover, the combined application of gene therapy and radiotherapy exhibited stronger therapeutic effects in vitro and in vivo (the inhibition rate was 87.5% in vitro, and was 87.9% in vivo) (P 1.4), indicating the HSV-TK/GCV system could exert a sensitizing effect on 60 Co radiotherapy of the transplanted human cervical cancer cells in nude mice. Conclusion: The HSV-TK/GCV system has radiosensitizationaction. Gene therapy combined with radiotherapy may be a good supplementary method for synthetic treatment of cervical cancer. (authors)

  6. SUPREMO (Selective Use of Postoperative Radiotherapy aftEr MastectOmy) - a phase III randomised trial assessing the role of postmastectomy chest wall irradiation in 'intermediate risk' women with operable breast cancer receiving adjuvant systemic therapy

    International Nuclear Information System (INIS)

    Kunkler, I.H.; Price, A.; Dixon, M.; Canney, P.; Prescott, R.; Sainsbury, R.; Aird, E.

    2003-01-01

    Danish and Canadian randomised trials of postmastectomy radiotherapy (PMRT) have shown the importance of loco-regional control to survival in 'high risk' pre and postmenopausal women receiving adjuvant systemic therapy. The effects of radiotherapy (RT) in terms of improving survival are similar to those of systemic therapy. International consensus now supports the use of postmastectomy chest wall irradiation in women with 4 or more involved axillary nodes or primary tumour size=/> 5cm. The role of PMRT in women at intermediate risk' with 1-3 involved nodes or node negative with other risk factors is controversial. The absolute reduction in risk of loco-regional recurrence varies widely (3-23%) in trials of PMRT in women with 1-3 involved nodes receiving systemic therapy. A UK survey of clinical oncologists (Kunkler et al,The Breast 1999;8:235) showed wide variations in opinion on the use of radiotherapy in these subgroups. It is possible that while RT may confer most benefit in loco-regional control, a greater survival benefit might accrue in patients with smaller tumours and fewer involved nodes. The 2000 Oxford overview of randomised trials of postoperative RT identifies non breast cancer deaths from RT related vascular morbidity as counterbalancing the benefits of RT in reducing breast cancer mortality. With the more extensive use of potentially cardiotoxic anthracycline containing adjuvant systemic therapy there are concerns about greater cardiac morbidity in patients receiving PMRT in addition. A large randomised international trial (SUPREMO) is proposed to recruit 3500 patients with (a) 1-3 involved axillary nodes or (b) node negative with other risk factors (grade 3 or lymphovascular invasion) treated by mastectomy, axillary clearance and appropriate systemic therapy for T0-3,N0-1,MO breast cancer. The primary endpoint is overall survival. Secondary endpoints are disease free survival, quality of life, morbidity (including cardiac), cost per life year saved

  7. Preemptive analgesia by using celecoxib combined with tramadol/APAP alleviates post-operative pain of patients undergoing total knee arthroplasty.

    Science.gov (United States)

    Xu, Zhongwei; Zhang, Hua; Luo, Jiao; Zhou, Aiguo; Zhang, Jian

    2017-09-01

    This study was aimed to evaluate the efficacy of preemptive analgesia (PA) by using celecoxib combined with low-dose tramadol/acetaminophen (tramadol/APAP) in treating post-operative pain of patients undergoing unilateral total knee arthroplasty (TKA). A total of 132 patients scheduled for TKA were included in this study. Three-day pre-operative medication was administrated in PA group with subsequent effective intra- and post-operative multimodal analgesia, while control patients received multimodal analgesia without PA. Visual analog scale (VAS) was utilized to assess the pain intensity at rest and during movement. VAS scores of participants were recorded 3 days before surgery, 1 day, 3 days, 1 week, 3 weeks, 6 weeks, 3 months, 6 months, and 12 months postoperatively. Moreover, the length of hospital stay, expense of hospitalization, C-reactive protein (CRP) values during hospitalization, and complications during medication were also recorded. PA showed superiority over control at 3 weeks (P = 0.013) and 6 weeks (P = 0.046) in resting pain, and 1 week (P = 0.015), 3 weeks (P = 0.003), 6 weeks (P = 0.003) and 3 months (P = 0.012) postoperatively in movement pain. There was no statistically significant difference in the length of hospital stay, total expense, CRP values, as well as complications. Based on satisfactory intra- and post-operative analgesia, PA by 3-day administration of celecoxib and low-dose tramadol/APAP might be an effective and safe therapy regarding patients undergoing TKA in terms of alleviating post-operative pain.

  8. Neoadjuvant intra-arterial chemotherapy with a combination of radiotherapy for the treatment of invasive bladder carcinoma

    International Nuclear Information System (INIS)

    Sumiyoshi, Yoshiteru; Uyama, Takeshi.

    1992-01-01

    Fifty patients with invasive bladder carcinoma were treated with neoadjuvant intra-arterial chemotherapy using doxorubicin or pirarubicin, and this was combined with low dose radiotherapy. All of 50 patients were evaluated for clinical and histological efficacy. Twenty-nine of 50 (58%) patients achieved a clinically complete remission (CR) and 17 of 50 (34%) achieved a clinically partial remission (PR). Twenty-eight of 50 (56%) achieved a histological CR and 13 of 50 (26%) achieved a histological PR. The patients who underwent bladder preservation operations after this treatment and were followed up for longer than 3 years were evaluated for long-term results. The 5-year survival for 35 patients in this group was 74.1%. The 5-year survival for patients with a clinical CR was 93.3%, and for patients with a clinical PR it was 45.3%. The survival for patients with a histological CR was 93.3%, and for patients with a histological PR, it was 85.7%. This study suggests that neoadjuvant intra-arterial chemotherapy plus radiotherapy is a useful regimen that could become the treatment of first choice for patients with invasive bladder carcinoma. Patients who achieved a histological CR or PR with this regimen, might be able to retain the function of their bladders. (author)

  9. Combination of peptide receptor radionuclide therapy with fractionated external beam radiotherapy for treatment of advanced symptomatic meningioma

    International Nuclear Information System (INIS)

    Kreissl, Michael C; Flentje, Michael; Sweeney, Reinhart A; Hänscheid, Heribert; Löhr, Mario; Verburg, Frederik A; Schiller, Markus; Lassmann, Michael; Reiners, Christoph; Samnick, Samuel S; Buck, Andreas K

    2012-01-01

    External beam radiotherapy (EBRT) is the treatment of choice for irresectable meningioma. Due to the strong expression of somatostatin receptors, peptide receptor radionuclide therapy (PRRT) has been used in advanced cases. We assessed the feasibility and tolerability of a combination of both treatment modalities in advanced symptomatic meningioma. 10 patients with irresectable meningioma were treated with PRRT ( 177 Lu-DOTA0,Tyr3 octreotate or - DOTA0,Tyr3 octreotide) followed by external beam radiotherapy (EBRT). EBRT performed after PRRT was continued over 5–6 weeks in IMRT technique (median dose: 53.0 Gy). All patients were assessed morphologically and by positron emission tomography (PET) before therapy and were restaged after 3–6 months. Side effects were evaluated according to CTCAE 4.0. Median tumor dose achieved by PRRT was 7.2 Gy. During PRRT and EBRT, no side effects > CTCAE grade 2 were noted. All patients reported stabilization or improvement of tumor-associated symptoms, no morphologic tumor progression was observed in MR-imaging (median follow-up: 13.4 months). The median pre-therapeutic SUV max in the meningiomas was 14.2 (range: 4.3–68.7). All patients with a second PET after combined PRRT + EBRT showed an increase in SUV max (median: 37%; range: 15%–46%) to a median value of 23.7 (range: 8.0–119.0; 7 patients) while PET-estimated volume generally decreased to 81 ± 21% of the initial volume. The combination of PRRT and EBRT is feasible and well tolerated. This approach represents an attractive strategy for the treatment of recurring or progressive symptomatic meningioma, which should be further evaluated

  10. Breast conserving surgery in combination with intraoperative radiotherapy after previous external beam therapy: an option to avoid mastectomy.

    Science.gov (United States)

    Thangarajah, F; Heilmann, J; Malter, W; Kunze, S; Marnitz, S; Mallmann, P; Wenz, F; Sperk, E

    2018-04-01

    Mastectomy is the standard procedure in patients with in-breast tumor recurrence (IBTR) or breast cancer after irradiation of the chest due to Hodgkin's disease. In certain cases a second breast conserving surgery (BCS) in combination with intraoperative radiotherapy (IORT) is possible. To date, data concerning BCS in combination with IORT in pre-irradiated patients are limited. This is the first pooled analysis of this special indication with a mature follow-up of 5 years. Patients with IBTR after external beam radiotherapy (EBRT; treated in two centers) for breast cancer were included. Patients with previous EBRT including the breast tissue due to other diseases were also included. IORT was performed with the Intrabeam™-device using low kV X-rays. Clinical data including outcome for all patients and toxicity for a representative cohort (LENT-SOMA scales) were obtained. Statistical analyses were done including Kaplan-Meier estimates for local recurrence, distant metastasis and overall survival. A total of 41 patients were identified (39 patients with IBTR, 2 with Hodgkin`s disease in previous medical history). Median follow-up was 58 months (range 4-170). No grade 3/4 acute toxicity occurred within 9 weeks. Local recurrence-free survival rate was 89.9% and overall survival was 82.7% at 5 years. Seven patients developed metastasis within the whole follow-up. BCS in combination with IORT in IBTR in pre-irradiated patients is a feasible method to avoid mastectomy with a low risk of side effects and an excellent local control and good overall survival.

  11. Postoperative radiation therapy for adenoid cystic carcinoma

    International Nuclear Information System (INIS)

    Oguchi, Masahiko; Shikama, Naoto; Gomi, Koutarou; Shinoda, Atsunori; Nishikawa, Atsushi; Arakawa, Kazukiyo; Sasaki, Shigeru; Takei, Kazuyoshi; Sone, Syusuke

    2000-01-01

    The authors retrospectively assessed the usefulness of postoperative radiation therapy after local resection of adenoid cystic carcinoma, with emphasis on organ-conserving treatment and the cosmetic results. Between 1985 and 1995, 32 patients underwent local resection followed by postoperative radiation therapy with curative and organ-conserving intent. None of patients received any form of chemotherapy as part of their initial treatment. Radiation therapy was carried out by techniques that were appropriate for the site and extension of each tumor. The 5-year local control, disease-free, and overall survival rates of all patients were 76%, 68%, and 86%, respectively. The 5-year local control rate and disease-free survival rate of patients with microscopically positive margins were 89% and 75%, respectively, and higher than in patients with macroscopically residual disease, but no significant difference in 5-year overall survival rate was observed. The postoperative cosmetic results in 29 patients with head and neck lesions were evaluated. No difference was documented between the cosmetic results postoperatively setting and after postoperative radiotherapy, and no significant differences in cosmetic results were observed according to radiation dose. The combination of local resection with organ-conserving intent and postoperative radiation therapy provided good cosmetic results in patients with T1 or T2 lesions. Postoperative radiation therapy with smaller fractions is useful, because good local control can be achieved in patients with adenoid cystic carcinoma having microscopically positive margins without inducing any late adverse reactions. However, the number of patients was too small and the follow-up period was too short to draw any definite conclusion in regard to fraction size. A much longer follow-up study with a larger number patients will be required to accurately determine the optimal treatment intensity and duration of treatment. (K.H.)

  12. A combination therapy with preoperative full-dose gemcitabine, concurrent 3-dimensional conformal radiation, surgery and postoperative liver perfusion chemotherapy for pancreatic cancer

    International Nuclear Information System (INIS)

    Ohigashi, Hiroaki; Eguchi, Hidetoshi; Takahashi, Hidenori

    2009-01-01

    Due to the high incidence of local recurrence and liver metastasis, long-term outcomes for patients after resection of pancreatic cancer are extremely poor. For improving the survival of the patients, a combination of preoperative chemoradiation, surgery, and postoperative liver-perfusion chemotherapy (LPC) were performed. Postoperative histopathologic study revealed a marked degenerative change in cancer tissue, showing negative surgical margins (R0) in 98% of patients and negative nodal involvement in 85% of patients. The 5-year survival rate after pancreatectomy was 56%, with low incidences of both local recurrence (11%) and liver metastasis (9%). This combination therapy were able to effectively reduce the incidence of both local and liver recurrence and improved long-term outcomes for patients with T3-4 cancers of the pancreas. (author)

  13. Orbital Radiotherapy Combined With Corticosteroid Treatment for Thyroid Eye Disease-Compressive Optic Neuropathy.

    Science.gov (United States)

    Gold, Katherine G; Scofield, Stacy; Isaacson, Steven R; Stewart, Michael W; Kazim, Michael

    To evaluate the effectiveness of orbital radiotherapy (ORT) in the treatment of thyroid eye disease (TED)-compressive optic neuropathy. A retrospective review of patients with corticosteroid-responsive compressive optic neuropathy due to TED treated with ORT. Study was conducted in compliance with Health Insurance Portability and Accountability Act. One hundred four patients (163 orbits) with a mean age of 61.7 years met inclusion criteria. Seventy-four percent (77/104) were female, and 32.7% (34/104) were current or previous smokers. A total absorbed dose of 2000 cGy fractionated in 10 treatment doses over the course of 2 weeks was administered to the retroocular tissues according to a standard protocol. The primary end point was failure of ORT, defined as persistent optic neuropathy following completion of radiotherapy that mandated urgent orbital decompression surgery. Ninety-eight of 104 (94%) patients or 152 of 163 (93.3%) orbits did not require orbital decompression surgery during the acute phase. Patients who responded successfully to ORT had similar improvements in visual acuity, color vision, Humphrey threshold visual field testing, and afferent pupillary defects compared with patients who failed ORT and underwent urgent decompression surgery. Only 36.7% of successfully treated patients ultimately underwent elective surgery, including orbital decompression, strabismus, or eyelid surgery, during the inactive phase of TED. The data from this study, the largest retrospective review reported to date, supports the use of ORT in eyes with corticosteroid-responsive TED-compressive optic neuropathy. ORT may favorably alter the natural history of active-phase TED by preventing recurrent compressive optic neuropathy after withdrawal of corticosteroids.

  14. The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Alvin Ho Yeung Au

    Full Text Available To run a systematic review and meta-analysis of randomized clinical trials aiming to answer the clinical question "which analgesic combination and dosage is potentially the most effective and safe for acute post-operative pain control after third molar surgery?".A systematic search of computer databases and journals was performed. The search and the evaluations of articles were performed by 2 independent reviewers in 3 rounds. Randomized clinical trials related to analgesic combinations for acute post-operative pain control after lower third molar surgery that matched the selection criteria were evaluated to enter in the final review.Fourteen studies with 3521 subjects, with 10 groups (17 dosages of analgesic combinations were included in the final review. The analgesic efficacy were presented by the objective pain measurements including sum of pain intensity at 6 hours (SPID6 and total pain relief at 6 hours (TOTPAR6. The SPID6 scores and TOTPAR6 scores of the reported analgesic combinations were ranged from 1.46 to 6.44 and 3.24 - 10.3, respectively. Ibuprofen 400mg with oxycodone HCL 5mg had superior efficacy (SPID6: 6.44, TOTPAR6: 9.31. Nausea was the most common adverse effect, with prevalence ranging from 0-55%. Ibuprofen 200mg with caffeine 100mg or 200mg had a reasonable analgesic effect with fewer side effects.This systematic review and meta-analysis may help clinicians in their choices of prescribing an analgesic combination for acute post-operative pain control after lower third molar surgery. It was found in this systematic review Ibuprofen 400mg combined with oxycodone HCL 5mg has superior analgesic efficacy when compared to the other analgesic combinations included in this study.

  15. Combination of high-dose rate brachytherapy and external beam radiotherapy for the treatment of advanced scalp angiosarcoma - case report

    International Nuclear Information System (INIS)

    Gentil, Andre Cavalcanti; Lima Junior, Carlos Genesio Bezerra; Soboll, Danyel Scheidegger; Novaes, Paulo Eduardo R.S.; Pereira, Adelino Jose; Pellizon, Antonio Carlos Assis

    2001-01-01

    The authors report a case of a patient with an extensive angiosarcoma of the scalp that was submitted only to radiotherapy with a combination of orthovoltage roentgentherapy and high-dose rate brachytherapy, using a mould. The clinical and technical features as well as the therapeutic outcome are presented, and the usefulness and peculiarities of high-dose rate brachytherapy for this particular indication is discussed. A comparative analysis of the difficulties and limitations of employing low-dose rate brachytherapy is also presented. The authors concluded that high-dose rate brachytherapy might be an useful, practical and safe option to treat neoplastic lesions of the scalp, and an alternative treatment to electrontherapy. (author)

  16. Cellular and molecular properties of 90Y-labeled cetuximab in combination with radiotherapy on human tumor cells in vitro

    International Nuclear Information System (INIS)

    Saki, M.; Toulany, M.; Rodemann, H.P.; Sihver, W.; Zenker, M.; Heldt, J.M.; Mosch, B.; Pietzsch, H.J.; Steinbach, J.; Baumann, M.

    2012-01-01

    Purpose: Anti-EGFR antibody cetuximab (C225) is used in combination with radiotherapy of head and neck squamous cell carcinoma (HNSCC) patients. We investigated whether conjugation of cetuximab with trans-cyclohexyl-diethylene-triamine-pentaacetic acid (CHX-A''-DTPA) and radiolabeling with 90 Yttrium affect the molecular and cellular function of cetuximab and improve its combined effect with external-beam irradiation (EBI). Methods: The following cell lines were used: HNSCC UT5, SAS, FaDu, as well as A43, Chinese hamster ovary cells (CHO), and human skin fibroblast HSF7. Binding affinity and kinetics, specificity, retention, and the combination of 90 Y-cetuximab with EBI were evaluated. Results: Control cetuximab and CHX-A''-DTPA-cetuximab blocked the proliferation activity of UT5 cells. In combination with EBI, CHX-A''-DTPA-cetuximab increased the radiosensitivity of UT5 to a similar degree as control cetuximab did. In contrast, in SAS and HSF7 cells neither proliferation nor radiosensitivity was affected by either of the antibodies. Binding [ 90 Y]Y-CHX-A''-DTPA-cetuximab ( 90 Y-cetuximab) to EGFR in HNSCC cells occurred time dependently with a maximum binding at 24 h. Retention of 90 Y-cetuximab was similar in both HNSCC cell lines; 24 h after treatment, approximately 90% of bound activity remained in the cell layer. Competition assays, using cell membranes in the absence of an internalized fraction of cetuximab, showed that the cetuximab affinity is not lost as a result of conjugation with CHX-A''-DTPA. Cetuximab and CHX-A''-DTPA-cetuximab blocked EGF-induced Y1068 phosphorylation of EGFR. The lack of an effect of cetuximab on EGF-induced Akt and ERK1/2 phosphorylation and the inhibition of irradiation (IR)-induced Akt and ERK1/2 phosphorylation by cetuximab were not affected by DTPA conjugation. 90 Y-cetuximab in combination with EBI resulted in a pronounced inhibition of colony formation of HNSCC cells. Conclusions: Conjugation of CHX-A''-DTPA to cetuximab

  17. Cytoprotection with amifostine in radiotherapy or combined radio-chemotherapy of head and neck cancer; Zytoprotektion mit Amifostin in der Strahlentherapie bzw. Strahlen-/Chemotherapie von Kopf-Hals-Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Altmann, S.; Hoffmanns, H. [Krankenhaus Maria-Hilf, Moenchengladbach (Germany). Strahlentherapie und Radiologische Onkologie

    1999-11-01

    Background: A considerable amount of experimental and clinical data prove the cytoprotective effect of amifostine on normal tissue exposed to different types of antineoplastic treatments. The present study examines its influence on the short-term toxicity of either radiotherapy alone or combined radio-chemotherapy in patients with advanced head and neck cancer. Patients and methods: Twenty-three patients with advanced head and neck cancer, mainly Stage III and IV, were treated with preoperative radiation (n=1), pre- as well as postoperative radiotherapy (n=5), postoperative radiation (n=9) or combined postoperative radio-chemotherapy (n=6). Before each radiation application a total dose of 500 mg amifostine was administered intravenously over 15 minutes. The documentation of this unselected patient group was compared retrospectively to a historical control group comprising 17 patients. Results: In 15 patients (65%) of the amifostine group, therapy induced side effects such as mucositis and dermatitis of WHO Grade {<=}2 were detected, requiring interruptions of the radiotherapy (mean: 6.5, maximum 17 days). No mucosa or dermatologic toxicity of WHO Grade 3 or 4 was observed in this group. Significantly more acute toxicity was detected in the historical control group. Stomatitis or epitheliolysis of WHO Grade 3 occurred in 7 patients (41%). The side effects induced by the antineoplastic therapy caused an interruption of treatment in 15 patients (88%) (mean: 16, maximum 40 days; p=0.0016). Conclusion: The application of amifostine before each radiation treatment seems to result in a distinct reduction of short-term toxicity of radiotherapy or combined radio-chemotherapy in patients with head and neck cancer, allowing for a better adherence to the planned radiation time schedule. (orig.) [German] Hintergrund: Zahlreiche experimentelle und klinische Daten belegen die zytoprotektive Wirkung von Amifostin auf gesundes Gewebe bei Anwendung verschiedener antineoplastischer

  18. A novel combination treatment of armed oncolytic adenovirus expressing IL-12 and GM-CSF with radiotherapy in murine hepatocarcinoma

    International Nuclear Information System (INIS)

    Kim, Wonwoo; Seong, Jinsil; Oh, Hae-Jin; Koom, Woong-Sub; Choi, Kyung-Joo; Yun, Chae-Ok

    2011-01-01

    In this study, a novel combination treatment of armed oncolytic adenovirus expressing interleukin 12 (IL-12) and granulocyte-macrophage colony-stimulating factor (GM-CSF) with radiation was investigated for antitumor and antimetastatic effect in a murine hepatic cancer (HCa-I) model. Tumor bearing syngeneic mice were treated with radiation, armed oncolytic virus Ad-ΔE1Bmt7 (dB7) expressing both IL-12 and GM-CSF (armed dB7), or a combination of both. The adenovirus was administered by intratumoral injection 1 x 10 8 plaque forming units (PFU) per tumor in 50 μl of phosphate buffered saline (PBS) four times every other day. Tumor response to treatment was determined by a tumor growth delay assay. Metastatic potential was evaluated by a lung metastasis model. To understand the underlying mechanism, the level of apoptosis was examined as well as the change in microvessel density and expression of immunological markers: CD4+, CD8+ and Cd11c. The combination of armed dB7 and radiation resulted in significant growth delay of murine hepatic cancer, HCa-1, with an enhancement factor of 4.3. The combination treatment also resulted in significant suppression of lung metastasis. Increase of apoptosis level as well as decrease of microvessel density was shown in the combination treatment, suggesting an underlying mechanism for the enhancement of antitumor effect. Expression of immunological markers: CD4+, CD8+ and Cd11c also increased in the combination treatment. This study showed that a novel combination treatment of radiotherapy with armed oncolytic adenovirus expressing IL-12 and GM-CSF was effective in suppressing primary tumor growth. (author)

  19. No evidence for generalized increased postoperative responsiveness to pain: a combined behavioral and serial functional magnetic resonance imaging study

    DEFF Research Database (Denmark)

    Kupers, Ron; Schneider, Fabien C G; Christensen, Rune

    2009-01-01

    area and to the lower forearm, a site remote from the surgical area. A group of eight age- and sex-matched control subjects underwent the same two-test procedure except that they were not submitted to an orthopedic surgical intervention. RESULTS: Subjective pain and brain responses to innocuous...... and noxious stimulation were not increased postoperatively. Actually, responses in primary and secondary somatosensory cortex for stimulation of the operated leg were significantly smaller after surgery. Brain responses in the control group did not differ significantly across the two sessions. CONCLUSION......BACKGROUND: Although it is generally accepted that increased pain responsiveness and central sensitization develop after major tissue injury, this claim has not been tested using brain imaging methods in a clinical pain setting. We tested this hypothesis using a postoperative pain model...

  20. Interobserver Delineation variation using CT versus combined CT + MRI in intensity- modulated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Villeirs, G.M.; Verstraete, K.L.; Vaerenbergh, K. van; Vakaet, L.; Bral, S.; Claus, F.; Neve, W.J. de; Meerleer, G.O. de

    2005-01-01

    Purpose: to quantify interobserver variation of prostate and seminal vesicle delineations using CT only versus CT + MRI in consensus reading with a radiologist. Material and methods: the prostate and seminal vesicles of 13 patients treated with intensity-modulated radiotherapy for prostatic adenocarcinoma were retrospectively delineated by three radiation oncologists on CT only and on CT + MRI in consensus reading with a radiologist. The volumes and margin positions were calculated and intermodality and interobserver variations were assessed for the clinical target volume (CTV), seminal vesicles, prostate and three prostatic subdivisions (apical, middle and basal third). Results: using CT + MRI as compared to CT alone, the mean CTV, prostate and seminal vesicle volumes significantly decreased by 6.54%, 5.21% and 10.47%, respectively. More importantly, their standard deviations significantly decreased by 63.06%, 62.65% and 44.83%, respectively. The highest level of variation was found at the prostatic apex, followed by the prostatic base and seminal vesicles. Conclusion: addition of MRI to CT in consensus reading with a radiologist results in a moderate decrease of the CTV, but an important decrease of the interobserver delineation variation, especially at the prostatic apex. (orig.)

  1. The conceptual basis for the combined use of radiotherapy and chemotherapy

    International Nuclear Information System (INIS)

    Steel, G.G.

    1979-01-01

    The interactions between drugs and radiation have been observed. In normal tissues, there is evidence both for sensitization and protection, and clear examples of interactive phenomena in tumors do exist. The term ''interaction'' is defined as the situation in which the treatment with one agent modifies the response of cells (tumor or normal) to the treatment with a second agent. Many interactive mechanisms can be envisaged: for instance, drugs modifying the initial events in radiation absorption; repair inhibition; cell-cycle progression phenomena; radiation modifying drug access and drug-induced reoxygenation. ''Spatial cooperation'' is suggested for the situation in which the chemotherapy and radiotherapy given to the diseases in different anatomical sites lead to the therapeutic result that exceeds the results by the separate treatment. The administration of one cytotoxic agent to an animal or a patient would decrease tolerance to the subsequent treatment with another cytotoxic agent. Cytosine arabinoside (Ara-C) is one of the most effective agents. When it was given to mice in a single well-tolerated dose of 200 mg/kg, the proportion of animals that survived wholebody irradiation of 1000 rad was increased from zero to approximately 90%. The timing was critical, and the optimum interval was 2 - 3 days. Under some circumstances, the positive interaction between the tumor cell-killing effects of drugs and radiation can be achieved. Unfortunately, the dose-effect curves are often not linear. (Yamashita, S.)

  2. Pre- and postoperative irradiation in advanced oral carcinoma

    International Nuclear Information System (INIS)

    Zini, G.; Barbieri, E.; Neri, S.; Silvano, N.; Babini, L.; Campobassi, A.; Dallera, P.; Marchetti, C.; Romagnoli, D.; Emiliani, E.

    1989-01-01

    The combination of radiotherapy and surgery in the treatment of advanced oral carcinoma (T3 and T4 lesions) yields good possibilities of recovery; whether radiotherapy should be given before or after surgery is still debated. Fifty patients with advanced oral carcinomas were analyzed: 24 of them were irradiated before and 26 after surgery; doses ranged from 40 to 56 Gy for the first group of patients, and from 50 to 68 Gy for the second one. The disease-free survival 48 months after the diagnosis was 36% in patients who received preoperative irradiation, and 53.6% in patients who received postoperative radiotherapy. the latter allowed local control of the disease to be significantly improved (χ 2 3.99, 0.01< p<0.05). The quality of survival was worse in the group receiving preoperative irradiation, because of radiation-induced surgical complications, which were especially observed in patients with diffuse disease. The findings suggest that postoperative radiotherapy may be advisable if the tumor is resectable, since tolerance and local control rate were acceptable. On the contrary, nearly inoperable masses and massive neck diseases often require preoperative irradiation

  3. MR-guided pulsed high intensity focused ultrasound enhancement of docetaxel combined with radiotherapy for prostate cancer treatment

    International Nuclear Information System (INIS)

    Mu Zhaomei; Ma, C-M; Chen Xiaoming; Cvetkovic, Dusica; Chen Lili; Pollack, Alan

    2012-01-01

    The purpose of this study is to evaluate the efficacy of the enhancement of docetaxel by pulsed focused ultrasound (pFUS) in combination with radiotherapy (RT) for treatment of prostate cancer in vivo. LNCaP cells were grown in the prostates of male nude mice. When the tumors reached a designated volume by MRI, tumor bearing mice were randomly divided into seven groups (n = 5): (1) pFUS alone; (2) RT alone; (3) docetaxel alone; (4) docetaxel + pFUS; (5) docetaxel + RT; (6) docetaxel + pFUS + RT, and (7) control. MR-guided pFUS treatment was performed using a focused ultrasound treatment system (InSightec ExAblate 2000) with a 1.5T GE MR scanner. Animals were treated once with pFUS, docetaxel, RT or their combinations. Docetaxel was given by i.v. injection at 5 mg kg −1 before pFUS. RT was given 2 Gy after pFUS. Animals were euthanized 4 weeks after treatment. Tumor volumes were measured on MRI at 1 and 4 weeks post-treatment. Results showed that triple combination therapies of docetaxel, pFUS and RT provided the most significant tumor growth inhibition among all groups, which may have potential for the treatment of prostate cancer due to an improved therapeutic ratio. (paper)

  4. MR-guided pulsed high intensity focused ultrasound enhancement of docetaxel combined with radiotherapy for prostate cancer treatment

    Science.gov (United States)

    Mu, Zhaomei; Ma, C.-M.; Chen, Xiaoming; Cvetkovic, Dusica; Pollack, Alan; Chen, Lili

    2012-01-01

    The purpose of this study is to evaluate the efficacy of the enhancement of docetaxel by pulsed focused ultrasound (pFUS) in combination with radiotherapy (RT) for treatment of prostate cancer in vivo. LNCaP cells were grown in the prostates of male nude mice. When the tumors reached a designated volume by MRI, tumor bearing mice were randomly divided into seven groups (n = 5): (1) pFUS alone; (2) RT alone; (3) docetaxel alone; (4) docetaxel + pFUS (5) docetaxel + RT (6) docetaxel + pFUS + RT, and (7) control. MR-guided pFUS treatment was performed using a focused ultrasound treatment system (InSightec ExAblate 2000) with a 1.5T GE MR scanner. Animals were treated once with pFUS, docetaxel, RT or their combinations. Docetaxel was given by i.v. injection at 5 mg kg-1 before pFUS. RT was given 2 Gy after pFUS. Animals were euthanized 4 weeks after treatment. Tumor volumes were measured on MRI at 1 and 4 weeks post-treatment. Results showed that triple combination therapies of docetaxel, pFUS and RT provided the most significant tumor growth inhibition among all groups, which may have potential for the treatment of prostate cancer due to an improved therapeutic ratio.

  5. Treatment of necrotic infection on the anterior chest wall secondary to mastectomy and postoperative radiotherapy by the application of omentum and mesh skin grafting. Report of a case

    International Nuclear Information System (INIS)

    Sato, Masaaki; Tanaka, Fumihiro; Wada, Hiromi

    2002-01-01

    We report herein the case of a patient who initially underwent right radical mastectomy for breast carcinoma in 1988, followed by left breast-conserving surgery in 1997. On both occasions she was given postoperative radiation therapy of 50 Gy. Repeated dressings and the administration of antibiotics failed to heal ulcerative infected lesions that had formed on the anterior chest wall in early 1998. In 1999, the sternum and surrounding tissue were debrided and the anterior chest wall was reconstructed by omentum transposition and mesh skin grafting. The patient is currently well and alive without any evidence of recurrence of either infection or breast cancer. (author)

  6. Radiotherapy, combined with simultaneous chemotherapy with mitomycin C and bleomycin for inoperable head and neck cancer--preliminary report

    International Nuclear Information System (INIS)

    Smid, Lojze; Lesnicar, Hotimir; Zakotnik, Brane; Soba, Erika; Budihna, Marjan; Furlan, Ladica; Zargi, Miha; Rudolf, Zvone

    1995-01-01

    Purpose: Prospectively designed randomized clinical study was undertaken to assess the efficacy of simultaneous application of irradiation, Mitomycin C, and Bleomycin in treatment of patients with inoperable head and neck carcinoma. Methods and Materials: Between March 1991 and October 1993, 49 patients with inoperable head and neck carcinoma were randomly assigned to receive either radiation therapy alone (group A) or radiotherapy combined with simultaneous application of Mitomycin C and Bleomycin (group B). Patients in both groups were irradiated five times weekly with 2 Gy to the total dose of 66-70 Gy. Chemotherapy regimen included intramuscular application of Bleomycin 5 units twice a week, with the planned dose being 70 units and Mitomycin C 15 mg/m 2 applied intravenously after delivery of 9-10 Gy of irradiation. The application of Mitomycin C was planned to be repeated on last day of radiotherapy in the dose of 10 mg/m 2 . In attempt to enhance the effect of chemotherapeutic drugs, patients in group B received also Nicotinamide, Chlorpromazine, and Dicoumarol. Results: The difference in complete response rate between both treatment groups (24% in group A and 63% in group B) was statistically significant (p = 0.015). The difference in response rate was much more pronounced in patients with oropharyngeal carcinoma only (18% in group A compared to 81% in group B; p = 0.0003), while for all other subgroups added together, there was observed no benefit of multidrug therapy. Median follow-up was 18 months. Disease-free survival of patients in group A (9%) was significantly lower then in group B (48%) (p 0.001). The difference between both treatment groups was even greater in patients with oropharyngeal carcinoma only: disease-free survival of these patients in group B was 66%, while in group A, all recurred (p = 0.00001). Conclusion: From results of our prospective randomized study it seems that the group of patients that received multidrug treatment with

  7. Prophylaxis of Postoperative Nausea and Vomiting in Adolescent Patients: A Review with Emphasis on Combination of Fixed-Dose Ondansetron and Transdermal Scopolamine

    Directory of Open Access Journals (Sweden)

    Joseph V. Pergolizzi

    2011-01-01

    Full Text Available Postoperative nausea and vomiting (PONV is a relatively common occurrence (20–30% that delays discharge and, if persistent, can lead to serious complications. The incidence of PONV is a function of patient characteristics, the type and duration of surgery, the type of anesthesia, and the choice of pre-, intra-, and postoperative pharmacotherapy. There are no completely effective antiemetic agents for this condition, but recommendations for treatment strategies are separately available for pediatric and adult patients. Left unclear is whether adolescents should be guided by the pediatric or the adult recommendations. We review the developmental physiology of the relevant physiological factors (absorption, distribution, metabolism, and elimination. We also review the clinical evidence regarding the safety and efficacy of a fixed-dose combination of ondansetron (4 mg, i.v. and transdermal scopolamine (1.5 mg.

  8. Double-blind comparison of granisetron, promethazine, or a combination of both for the prevention of postoperative nausea and vomiting in females undergoing outpatient laparoscopies.

    Science.gov (United States)

    Gan, Tong J; Candiotti, Keith A; Klein, Stephen M; Rodriguez, Yiliam; Nielsen, Karen C; White, William D; Habib, Ashraf S

    2009-11-01

    Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) are common problems after surgery. Prophylactic combination antiemetic therapy is recommended for patients at high risk for developing PONV and PDNV. Granisetron, a serotonin antagonist, is an effective antiemetic that is devoid of sedative side effect. Although promethazine is effective, commonly used doses are associated with sedation. This study investigates the combination of low doses of granisetron and promethazine for the prevention of PONV. Women undergoing ambulatory gynecological laparoscopy were enrolled. A standard general anesthetic regimen was prescribed. Fifteen minutes before the expected end of surgery, the patients were randomly assigned to receive granisetron 0.1 mg iv, promethazine 6.25 mg iv, or a combination of the two drugs. Prophylaxis with oral promethazine 12.5 mg, granisetron 1 mg, or both was started in the respective groups 12 hr after the end of surgery and continued every 12 hr until postoperative day 3 (a total of five oral doses). The following outcomes were recorded: total response rate (defined as no vomiting, no more than mild nausea, and no use of rescue antiemetic); incidence of nausea, vomiting, and use of rescue antiemetics; severity of nausea; patient activity level; and patient satisfaction with PONV management. Patients in the combination group had a higher total response rate at 6, 24, 48, and 72 hr after surgery compared with those who received promethazine alone (at 24 hr, Combination 69.6%, Promethazine 36.2%, Granisetron 53.3%; P = 0.0079). The maximum nausea scores were also lower in the combination group at 6, 24, 48, and 72 hr (Combination 1.7 +/- 2.2, Promethazine 4.0 +/- 3.6, Granisetron 3.1 +/- 3.2 at 24 hr; P granisetron and promethazine combination was more effective in reducing PONV and PDNV than promethazine monotherapy. The combination also reduced the severity of nausea.

  9. Association between the location of transposed ovary and ovarian function in patients with uterine cervical cancer treated with (postoperative or primary) pelvic radiotherapy.

    Science.gov (United States)

    Hwang, Jong Ha; Yoo, Heon Jong; Park, Sae Hyun; Lim, Myong Cheol; Seo, Sang-Soo; Kang, Sokbom; Kim, Joo-Young; Park, Sang-Yoon

    2012-06-01

    To evaluate the effectiveness of ovarian transposition procedures in preserving ovarian function in relation to the location of the transposed ovaries in patients who underwent surgery with or without pelvic radiotherapy. Retrospective. Uterine cancer center. A total of 53 patients with cervical cancer who underwent ovarian transposition between November 2002 and November 2010. Ovarian transposition to the paracolic gutters with or without radical hysterectomy and lymph node dissection. Preservation of ovarian function, which was assessed by patient's symptoms and serum FSH level. Lateral ovarian transposition was performed in 53 patients. Based on receiver operator characteristic curve analysis, optimum cutoff value of location more than 1.5 cm above the iliac crest was significantly associated with preservation of ovarian function after treatment (area under receiver operator characteristic curve: 0.757, 95% confidence interval [CI]: 0.572-0.943). In univariate analysis, higher location of transposed ovary more than 1.5 cm from the iliac crest was the only independent factor for intact ovarian function (odds ratio 9.91, 95% CI: 1.75-56.3). Multivariate analysis confirmed that the location of transposed ovary (odds ratio 11.72, 95% CI 1.64-83.39) was the most important factor for intact ovarian function. Location of transposed ovary higher than 1.5 cm above the iliac crest is recommended to avoid ovarian failure after lateral ovarian transposition after primary or adjuvant pelvic radiotherapy in cervical cancer. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Prospective study on the dose distribution to the acoustic structures during postoperative 3D conformal radiotherapy for parotid tumors. Dosimetric and audiometric aspects

    International Nuclear Information System (INIS)

    Jereczek-Fossa, Barbara A.

    2011-01-01

    To analyze dose distribution in the hearing organ and to evaluate the dose effect on the hearing thresholds in patients treated with post-parotidectomy 3-dimensional conformal radiotherapy (3D-CRT). A total of 17 patients received post-parotidectomy 3D-CRT (median dose: 63 Gy). The audiometric evaluation comprised pure tone audiometry and tympanometry performed before radiotherapy (RT) and 3, 6, and 24 months after RT. The ear structures were delineated on planning computer tomography scans. Mean and maximum doses were calculated and dose-volume histograms were plotted. Before RT, the median baseline audiometric thresholds were normal. At 3 months post-RT, 3 patients were diagnosed as having middle ear underpressure and/or effusion that resolved completely by 6 months. During 2-year follow-up, none of the ears showed perceptive hearing loss at speech frequencies. The mean doses at ipsilateral external auditory canal, mastoids cells, tympanic case, Eustachian tube, semicircular canals, and cochlea were 44.8 Gy, 39.0 Gy, 30.9 Gy, 33.0 Gy, 19.6 Gy, and 19.2 Gy, respectively. The doses to the contralateral ear were negligible, except for the Eustachian tube (up to 28.2 Gy). Post-parotidectomy 3D-CRT is associated with relatively low doses to the ear and the surrounding structures. Post-RT audiometry did not show any permanent (neither conductive nor perceptive) hearing impairment. Only in 3 patients were there signs of transient unilateral dysfunction of the Eustachian tube observed during the first few months after RT. Longer follow-up and larger patient series are warranted to confirm these preliminary findings. (orig.)

  11. Combination of gabapentin and ramosetron for the prevention of postoperative nausea and vomiting after gynecologic laparoscopic surgery: a prospective randomized comparative study.

    Science.gov (United States)

    Kim, Kyung Mi; Huh, Jin; Lee, Soo Kyung; Park, Eun Young; Lee, Jung Min; Kim, Hyo Ju

    2017-05-19

    As a drug originally introduced for its anticonvulsant effects, gabapentin has been recently shown to be effective in the treatment of nausea and vomiting in various clinical settings. This study compared the antiemetic efficacy of oral gabapentin, intravenous ramosetron and gabapentin plus ramosetron in patients receiving fentanyl-based patient-controlled analgesia after laparoscopic gynecologic surgery. One hundred and thirty two patients undergoing laparoscopic gynecologic surgery under general anesthesia were allocated randomly into three groups: group G received 300 mg oral gabapentin 1 h before anesthesia, group R received 0.3 mg intravenous ramosetron at the end of surgery, and group GR received a combination of 300 mg oral gabapentin 1 h before anesthesia and 0.3 mg intravenous ramosetron at the end of surgery. Postoperative nausea, retching, vomiting, rescue antiemetic drug use, pain, rescue analgesic requirements and adverse effects were assessed at 0-2, 2-24 and 24-48 h after surgery. Postoperative nausea and vomiting (PONV) was defined as the presence of nausea, retching or vomiting. The incidence of complete response (no PONV and no rescue antiemetics up to 48 h postoperatively) was significantly higher in group GR (26/40, 65%) than group G (16/40, 40%; P = 0.025) and group R (18/44, 41%; P = 0.027), whereas there was no significant difference between group G and group R (P = 0.932). There were no significant between-group differences in the incidence of emetic episodes, use of rescue antiemetics, severe emesis, use of rescue analgesics or any adverse effects. Postoperative pain scores were also similar among groups. The combination with gabapentin and ramosetron is superior to either drug alone for prevention of PONV after laparoscopic gynecologic surgery. ClinicalTrials.gov NCT02617121 , registered November 25, 2015.

  12. Continuous or split-course combined external and intracavitary radiotherapy of locally advanced carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    Pedersen, D.; Bentzen, S.M.; Overgaard, J.

    1994-01-01

    From 1974 to 1984, 442 consecutive patients with carcinoma of the uterine cervix (FIGO IIB: 139, IIIA: 10, IIIB: 221, IVA: 72) were referred for combined intracavitary (IRT) and external radiotherapy (ERT). To improve local control and reduce late rectosigmoid morbidity the treatment strategy was changed from continuous (CRT) to split-course radiotherapy (SCRT) in 1978. Stage by stage the 5-year actuarial estimates of survival, local control, and late morbidity did not differ in relation to strategy. In the patients with tumours larger than 8 cm, the SCRT involved an increased dose in point B, a reduced dose in point A from the IRT, a lower total dose in point A, and a 34 day's prolongation of the total treatment time (TTT). The resulting 5-year actuarial local control rates were significantly lower compared with those after CRT. No difference of late severe morbidity was found except in IVA patients. In the patients with tumours between 4 and 8 cm, the SCRT involved a reduced dose in point A from the IRT, an increased total dose in point A and B, and a 50 day's prolongation of the TTT. In patients with stage IIB, the 5-year actuarial central local control rate was lower (p=0.06), and the 5-year estimate of late severe morbidity significantly higher after SCRT compared with CRT. It is concluded that the increase of the dose in point B in the SCRT was insufficient to prevent the deleterious effect on local tumour control of either the lower dose from IRT in point A, or the prolonged TTT. The increase of the total dose in the SCRT may explain why the late morbidity was not reduced, and may suggest that the TTT is of no significant importance for the risk of late normal tissue damage. (orig.)

  13. Hodgkin Illness in the childhood. Results with combined treatment of OPPA with radiotherapy

    International Nuclear Information System (INIS)

    Terselich z, Gretti

    1999-01-01

    A retrospective revision was made (not randomized) among the years 1988 and 1997, of patients histories that had entered the INC for treatment for the Hodgkin illness. All the cases, patient smaller than 16 years were studied, that had not been treated in other centers neither it had received another oncospecific treatment. The sheets or the anatomy-pathology study were revised, being remarkable that for but of 10 years the histology study is in charge of oneself pathologists' group. In total 144 patients were recruited; 29 were excluded: 2 for treatments in other centers, 17 to only have received radiotherapy, 9 to receive other outlines of treatment chemo therapeutic and a patient to reject the treatment; finally 115 patients were studied. To all they were made complete analysis of hematology with erythro sedimentation and serology for hepatitis study B and C. Biopsy of bony marrow was not made in the I and II states; echography and thorax X rays, was made to all patients but the TAC it could not be carried out to all for logistical difficulties; in some patients the corporal journey was made with gammagraphy, using gallium. The final results showed a complete answer in 100 patients (87%). There were 7 deaths: 2 for causes different to the illness, one for sepsis for klebsiella, one for cardio toxicity for anthracycline, 2 for abandonment of the treatment and 3 patients got lost. 13 patients were presented with neutropenia, 3 patients with pneumonia, 1 with chicken pox and 2 with sepsis. The global survival is of 90%

  14. Intraoperative Radiotherapy Combined With Adjuvant Chemoradiotherapy for Locally Advanced Gastric Adenocarcinoma

    International Nuclear Information System (INIS)

    Fu Shen; Lu Jiade; Zhang Qing; Yang Zhe; Peng Lihua; Xiong, Fei

    2008-01-01

    Purpose: To evaluate the efficacy of intraoperative radiotherapy (IORT) followed by concurrent chemotherapy and external beam RT (EBRT) in the treatment of locally advanced gastric adenocarcinoma. Methods and Materials: A total of 97 consecutive and nonselected patients with newly diagnosed Stage T3, T4, or N+ adenocarcinoma of the stomach underwent gastrectomy with D2 lymph node dissection between March 2003 and October 2005. Of the 97 patients, 51 received adjuvant concurrent chemotherapy (5-fluorouracil, leucovorin, docetaxel, and cisplatin) and EBRT (EBRT group) and 46 received IORT (dose range, 12-15 Gy) immediately after gastrectomy and lymph node dissection before concurrent chemoradiotherapy (EBRT+IORT group). Results: After a median follow-up of 24 months, the 3-year locoregional control rate was 77% and 63% in the two groups with or without IORT, respectively (p = 0.05). The 3-year overall survival and disease-free survival rate was 47% and 36% in the EBRT group and 56% and 44% in the EBRT+IORT group, respectively (p > 0.05). Multivariate analyses revealed that the use of IORT, presence of residual disease after surgery, and pN category were independent prognostic factors for locoregional control and that IORT, pN, and pT categories were independent prognostic factors for overall survival (p < 0.05). Four patients experienced Grade 3 or 4 late complications, but no significant difference was observed between the two groups. Conclusions: Radical gastrectomy with D2 lymph node dissection and IORT followed by adjuvant chemoradiotherapy appeared to be feasible and well-tolerated in the treatment of locally advanced gastric cancer. The addition of IORT to the trimodality treatment significantly improved the 3-year locoregional control rate

  15. Radiotherapy of bladder cancer

    International Nuclear Information System (INIS)

    Ikeda, Yoshiyuki

    1978-01-01

    Methods of treating bladder cancer include surgery, radiotherapy and chemotherapy, as well as various combinations of these. The author investigated clinically and histopathologically the therapeutic results of preoperative irradiation in cases of bladder cancer. 1. The survival rates (crude survival rates) in forty cases of bladder cancer were 90% after one year, 62.5% after three years and 46% after five years from the treatment. 2. As the result of irradiation, urogram improved in 25%, which was comparatively remarkable in high stage cases. There were no cases of deterioration of urogram findings caused by irradiation. Cystoscopy revealed disappearance or remarkable shrinkage of the tumors in 35% of the total cases and effects of the irradiation was observed not correlated to the stage and grade. 3. With respect to the histopathological changes, the changes became greater as the dosage increased and the higher the stage and grade were the more remarkable tendency was observed. 4. From our clinical observations such as urogram, cystoscopy and histopathologically, we estimated the optimum dosage of preoperative irradiation for bladder cancer is 3000 - 4000 rad. Thus, we concluded that the radiotherapy is effective in reducing both surgical invasion and postoperative recurrence. (author)

  16. Is combination of neutrophil to lymphocyte ratio and platelet lymphocyte ratio a useful predictor of postoperative survival in patients with esophageal squamous cell carcinoma?

    Directory of Open Access Journals (Sweden)

    Tanoglu A

    2014-03-01

    Full Text Available Alpaslan Tanoglu,1 Ergenekon Karagoz,2 Nurettin Yiyit,3 Ufuk Berber4 1Department of Gastroenterology, 2Department of Infectious Diseases and Clinical Microbiology, 3Department of Thoracic Surgery, 4Department of Pathology, GATA Haydarpasa Training Hospital, Uskudar, TurkeyWe read with interest the recent article entitled "Combination of neutrophil to lymphocyte ratio and platelet lymphocyte ratio is a useful predictor of postoperative survival in patients with esophageal squamous cell carcinoma" by Feng et al.1 In their study, authors aimed to investigate the usefulness of a novel inflammation-based prognostic system, using the combination of neutrophil lymphocyte ratio (NLR and platelet lymphocyte ratio (PLR, for predicting survival in patients with esophageal squamous cell carcinoma (ESCC. Finally, they concluded that combination of NLR and PLR is a useful predictor of postoperative survival in patients with ESCC and combination of these parameters is superior to NLR or PLR as a predictive factor in patients with ESCC. We would like to thank the authors for their contribution.View original paper by Feng and colleagues.

  17. Preemptive Epidural Analgesia for Postoperative Pain Relief Revisited: Comparison of Combination of Buprenorphine and Neostigmine with Combination of Buprenorphine and Ketamine in Lower Abdominal Surgeries, A Double-blind Randomized Trial.

    Science.gov (United States)

    Choubey, Sanjay; Singh, Raj Bahadur

    2017-01-01

    Postoperative pain relief provides subjective comfort to patient in addition to blunting of autonomic and somatic reflex responses to pain, subsequently enhancing restoration of function by allowing the patient to breathe, cough, and move easily. The aim is to evaluate and compare the effects of neostigmine + buprenorphine and ketamine + buprenorphine for preemptive epidural analgesia for postoperative pain relief in patients undergoing abdominal surgeries under general anesthesia (GA). A double-blind randomized trial. A total of 60 American Society of Anesthesiologists physical status Classes I and II patients undergoing abdominal surgeries under GA were taken up for the study. They were randomly allocated into two groups, Group A and Group B of thirty patients each. Preemptive epidural analgesia for postoperative pain relief was provided by a combination of neostigmine 1 μg/kg + buprenorphine 2 μg/kg in Group A patients and ketamine 1 mg/kg + buprenorphine 2 μg/kg in Group B patients after induction of GA but before surgical incision. Postoperatively, vital parameters, pain score, requirement of top up doses, and side effects in the two groups were observed and recorded at 2, 4, 6, 10, 18, and 22 h. Mean values within each of the Group A and Group B were compared using one-way analysis of variance (one-way ANOVA). Mean values between Group A and Group B were compared using double analysis of variance (two-way ANOVA). Group A patients had a significant analgesia (visual analog scale [VAS] pain scores reduced significantly from 54.6 ± 6.3 at 2 h to 8.1 ± 8.9 at 22 h postoperatively). Group B patients had significant analgesia too (VAS pain scores reduced significantly from 36 ± 12.5 at 2 h to 5.3 ± 10.9 at 22 h postoperatively). There was however no significant difference between the two groups with respect to the degree of postoperative analgesia on comparison of VAS scores, effect on vital parameters, and incidence of side effects. Either of the two

  18. Effect of high-intensity focused ultrasound (HIFU combined with radiotherapy on tumor malignancy in patients with advanced pancreatic cancer and evaluation of side effects

    Directory of Open Access Journals (Sweden)

    Jing Li

    2017-02-01

    Full Text Available Objective: To study the effect of high-intensity focused ultrasound (HIFU combined with radiotherapy on tumor malignancy in patients with advanced pancreatic cancer and the corresponding side effects. Methods: A total of 84 patients with advanced pancreatic cancer treated in our hospital between May 2013 and March 2016 were selected and randomly divided into HIFU group and IGRT group, HIFU group accepted high-intensity focused ultrasound combined with radiotherapy and IGRT group received radiotherapy alone. 4 weeks after treatment, the levels of tumor markers, liver and kidney function indexes, perineural invasionrelated molecules and cytokines in serum as well as the levels of immune cells in peripheral blood were determined. Results: 4 weeks after treatment, serum CA199, CA242, OPN, NGAL, RBP4, NGF, TrkA, p75, BDNF and TrkB levels of HIFU group were significantly lower than those of IGRT group, serum IL-2, TNF-毩, IFN-γ and IL-13 levels as well as peripheral blood NKT cell and CD4+T cell levels were significantly higher than those of IGRT group, and serum ALT, AST, Cr and BUN levels were not significantly different from those of IGRT group. Conclusion: HIFU combined with radiotherapy treatment of advanced pancreatic cancer can more effectively kill cancer cells, inhibit pancreatic cancer cell invasion to the peripheral nerve and enhance the antitumor immune response mediated by NKT cells and CD4+T cells.

  19. A prospective randomized study of postoperative adjuvant chemo-radiotherapy (CT+RT) vs. radiotherapy(RT) alone in resected stage II and IIIA non-small cell lung cancer (NSCLC)

    International Nuclear Information System (INIS)

    Chang, Geol Lee; Joo, Hang Kim; Kyung, Young Chung; Doo, Yun Lee; Kil, Dong Kim; Won, Young Lee; Sung, Kyu Kim; Sei, Kyu Kim; Gwi, Eon Kim

    1995-01-01

    Objective: A prospective randomized study has been conducted to compare the results of treatment between CT+RT and RT alone as an adjuvant setting in completely resected stage II and IIIA NSCLC. Materials and Methods: Patients who had completely resected stage II and IIIA NSCLC were randomized into a CT+RT arm(arm A) and a RT alone arm(arm B) as an adjuvant setting after stratification according to cell type(squamous vs. non-squamous) and stage(II vs. IIIA). CT(Etoposide 100mg/m2 I.V. infusion d1-3, Cisplatin 20mg/m2 I.V. infusion d1-5, total 6cycles) was started in postop. 3 weeks with a 4 weeks interval. RT(5040cGy/5-6wks, 180cGy/fr) was started in postoperative 5 weeks after the first cycle of CT for group A and in postoperative 4 weeks for group B. A total of 69 patients were registered from Sep. 1990 to Jun. 1993. Sixty five of these patients were evaluable because 4 patients were ineligible due to distant metastasis before adjuvant treatmen