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Sample records for treatise radiotherapy surgery

  1. [Hippocrates' treatise physician].

    Science.gov (United States)

    Frøland, Anders

    2005-01-01

    This small treatise does not appear to have been published in Danish in its entirety. It gives a vivid picture of the physician in ancient Greece. The well known first chapter describes the attitudes and attributes of the doctor. It goes on discussing in some detail how the light should be in the surgery, the instruments to be used, the preparations of bandages and drugs, and the use of cupping instruments. The author stresses both the needs of the patient and the necessity of the physician's dignity and integrity.

  2. 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

  3. Complications of surgery for radiotherapy skin damage

    International Nuclear Information System (INIS)

    Rudolph, R.

    1982-01-01

    Complications of modern surgery for radiotherapy skin damage reviewed in 28 patients who had 42 operations. Thin split-thickness skin grafts for ulcer treatment had a 100 percent complication rate, defined as the need for further surgery. Local flaps, whether delayed or not, also had a high rate of complications. Myocutaneous flaps for ulcers had a 43 percent complication rate, with viable flaps lifting off radiated wound beds. Only myocutaneous flaps for breast reconstruction and omental flaps with skin grafts and Marlex mesh had no complications. The deeper tissue penetration of modern radiotherapy techniques may make skin grafts and flaps less useful. In reconstruction of radiation ulcers, omental flaps and myocutaneous flaps are especially useful, particularly if the radiation damage can be fully excised. The pull of gravity appears detrimental to myocutaneous flap healing and, if possible, should be avoided by flap design

  4. Breast cellulitis after conservative surgery and radiotherapy

    International Nuclear Information System (INIS)

    Rescigno, J.; McCormick, B.; Brown, A.E.; Myskowski, P.L.

    1994-01-01

    Cellulitis is a previously unreported complication of conservative surgery and radiation therapy for early stage breast cancer. Patients who presented with breast cellulitis after conservative therapy are described. Eleven patients that developed cellulitis of the breast over a 38-month period of observation are the subject of this report. Clinical characteristics of patients with cellulitis and their treatment and outcome are reported. Potential patient and treatment-related correlates for the development of cellulitis are analyzed. The risk of cellulitis persists years after initial breast cancer therapy. The clinical course of the patients was variable: some patients required aggressive, long-duration antibiotic therapy, while others had rapid resolution with antibiotics. Three patients suffered from multiple episodes of cellulitis. Patients with breast cancer treated with conservative surgery and radiotherapy are at risk for breast cellulitis. Systematic characterization of cases of cellulitis may provide insight into diagnosis, prevention, and more effective therapy for this uncommon complication. 15 refs., 1 fig., 2 tabs

  5. Radiotherapy Boost Following Conservative Surgery for Locally Advanced Breast Cancer

    International Nuclear Information System (INIS)

    Cendales, Ricardo; Ospino, Rosalba; Torres, Felipe; Cotes, Martha

    2009-01-01

    Nearly half of breast cancer patients in developing countries present with a locally advanced cancer. Treatment is centered on a multimodal approach based on chemotherapy, surgery and radiotherapy. The growing use of neoadjuvant chemotherapy has led to a more conservative surgical approach; nonetheless, it is not yet considered as a standard. There are no clear recommendations on the use of a radiotherapy boost in such situation. A Medline search was developed. Most articles are retrospective series. Survival free of locoregional relapse in patients treated with neoadjuvant chemotherapy, breast conserving surgery and radiotherapy is good. All articles described a boost administered to nearly all patients without regard to their prognostic factors, given that a locally advanced tumor is already considered as a poor prognostic factor. Even tough the poor level of evidence, a recommendation can be made: radiotherapy boost should be administered to all patients with locally advanced breast cancer treated with neoadjuvant chemotherapy and breast conserving surgery.

  6. Malignant gliomas of the brain managed by radiotherapy after surgery

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    Fichardt, T.; Sandison, A.G. (Pretoria Univ. (South Africa). Dept. of Radiotherapy)

    The article reviews the literature and gives an account of the authors' experience during a 20-year period (1960-1980) of the value of radiotherapy after surgery in the management of 76 patients suffering from brain gliomas classified into 3 grades according to the degree of anaplasia present in the histological sections, viz. grades II, III and IV. Radiotherapy was not given to grade I malignant gliomas as they are treated by surgery only. The period is divided into 2 subperiods. The first is from 1960-1972 when part-brain, high-dose irradiation following surgery was used on 33 patients in various age groups. The second period covers whole-brain, low-dose irradiation following surgery and was used on 43 patients in various age groups.

  7. Radiotherapy for Locoregional Recurrent Cervix Cancer after Surgery

    International Nuclear Information System (INIS)

    Yang, Mi Gyoung

    1994-01-01

    Purpose: The role of radiotherapy in the management of patients with locoregional recurrent cervix cancer after radical surgery were retrospectively analyzed. Methods and materials: Twenty-eight patients treated with radiotherapy for locoregional recurrence after primary surgery for carcinoma of the cervix between 1989 and 1993 were analyzed. The median follow-up of survivors was 15 months (ranged 7-43 months). Eight patients had their disease confined to the vagina and 19 patients(68%) had pelvic mass as part of their locoregional recurrent disease. Within 24 months after the initial surgery, 82% of recurrences manifested themselves. All patients had whole pelvic irradiation with or without intracavitary radiotherapy(ICR). Results: Complete response(CR) was achieved in 18 patients(64%). Five of eighteen patients(28%) with initial CR developed second locoregional recurrence. Response to radiotherapy correlated strongly with tumor volume, site of recurrence and total radiation dose. The overall 2 year survival rate was 43% and the disease free survival was 31%. Survival rate was significantly influenced by the factors of interval from operation to recurrence, size and site of recurrent tumor, radiation dose, response of radiotherapy, lymph node status as initial presentation. The principal cause of death was lung metastasis(36%). Conclusion: Radiotherapy is an excellent modality for control of locoregional recurrent cervix cancer. To improve local control and survival rate, whole pelvic external radiotherapy in addition to ICR with more than 75.0Gy at the depth of 1.0cm from vaginal mucosa is needed and frequent follow up and early detection of recurrence is suggested as well

  8. 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.

  9. Not a Treatise, but a Treatise in Verse...

    Directory of Open Access Journals (Sweden)

    Natalia Gorbaniewska

    2012-01-01

    Full Text Available Natalia Gorbaniewska, an acclaimed translator of Polish literature into Russian, remembers her first meeting with Miłosz in Paris, and the reading of Traktat poetycki [Treatise on Poetry], which for her became a real translator’s challenge. The memory, in this case, becomes a pre­text for a discussion of the genre characteristic of the Treatise, and of the melody of Miłosz’s language and the literary tradition, which makes it possible to understand his poems.

  10. Therapeutic challenge in brain metastases: chemotherapy, surgery or radiotherapy

    International Nuclear Information System (INIS)

    Mena, Ivan; Contreras, Manuel; Ceballos Francisco

    1998-01-01

    Metastases to the brain occur in 25 to 35% of patients with systemic cancer. Cerebral metastatic is the most common intracranial tumor in adults and occur up to 10 times more frequently than primary tumors in the central nervous system. Significant advances have occurred in the diagnosis and treatment of metastases to the brain, and the therapeutic nihilism of the past is now no longer warranted for most patients. With the currently available treatments, most patients do not die of their brain metastases and usually experience effective palliation of neurologic symptoms and meaning full extension of life. As a trial to limit the cerebral metastatic disease, many and diverse therapy options have been developed such as: chemotherapy, surgery plus whole-brain radiotherapy, only radiation therapy, therapy with neutron, intersticial brachytherapy and stereotactic radiosurgery. In selected cases, surgery plus whole-brain radiotherapy is the conventional treatment for single metastases. However, recurrence usually limits the quality of life and greatly decrease the patients time life, and the therapy options are scarce. This piece of writing also includes a review of the available therapy forms to manage this kind of lesions. (The author)

  11. Cost-effectiveness of surgery plus radiotherapy versus radiotherapy alone for metastatic epidural spinal cord compression

    International Nuclear Information System (INIS)

    Thomas, Kenneth C.; Nosyk, Bohdan; Fisher, Charles G.; Dvorak, Marcel; Patchell, Roy A.; Regine, William F.; Loblaw, Andrew; Bansback, Nick; Guh, Daphne; Sun, Huiying; Anis, Aslam

    2006-01-01

    Purpose: A recent randomized clinical trial has demonstrated that direct decompressive surgery plus radiotherapy was superior to radiotherapy alone for the treatment of metastatic epidural spinal cord compression. The current study compared the cost-effectiveness of the two approaches. Methods and Materials: In the original clinical trial, clinical effectiveness was measured by ambulation and survival time until death. In this study, an incremental cost-effectiveness analysis was performed from a societal perspective. Costs related to treatment and posttreatment care were estimated and extended to the lifetime of the cohort. Weibull regression was applied to extrapolate outcomes in the presence of censored clinical effectiveness data. Results: From a societal perspective, the baseline incremental cost-effectiveness ratio (ICER) was found to be $60 per additional day of ambulation (all costs in 2003 Canadian dollars). Using probabilistic sensitivity analysis, 50% of all generated ICERs were lower than $57, and 95% were lower than $242 per additional day of ambulation. This analysis had a 95% CI of -$72.74 to 309.44, meaning that this intervention ranged from a financial savings of $72.74 to a cost of $309.44 per additional day of ambulation. Using survival as the measure of effectiveness resulted in an ICER of $30,940 per life-year gained. Conclusions: We found strong evidence that treatment of metastatic epidural spinal cord compression with surgery in addition to radiotherapy is cost-effective both in terms of cost per additional day of ambulation, and cost per life-year gained

  12. The effects of radiotherapy and surgery on the sexual function of women treated for cervical cancer

    International Nuclear Information System (INIS)

    Flay, Linda D.; Matthews, John H.L.

    1995-01-01

    Purpose: This study investigated the short- and medium-term effects of pelvic radiotherapy and surgery on the sexual function of women treated for cervical cancer. Methods and Materials: Sixteen women with Stages I, II, or III disease referred for radiotherapy treatment were assessed. Six had undergone prior hysterectomy. The women were assessed with questionnaires prior to radiotherapy, at completion of radiotherapy, and at 6 weeks and 14 weeks after radiotherapy treatment. The clinical findings at routine follow-up were noted. Results: The study showed significant changes in sexual activity and satisfaction as a result of treatment. This was due to a number of physical and psychological factors. The level of sexual activity was lowest at completion of radiotherapy treatment. A feeling of vaginal shortening was the most frequent reason and was more common in women who were treated with surgery and radiotherapy. Dyspareunia, bleeding, and concern of bleeding and/or recurrence were all significant factors. Conclusions: The questionnaires were an effective way of assessing women's sexual function. Radiotherapy caused sexual dysfunction in one-half of women. Combined treatment with radiotherapy and surgery results in a higher risk than radiotherapy alone. Women with cervical cancer and undergoing radiotherapy treatment require considerable counseling and support

  13. 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)

  14. Neuro-urological consequences of gynaecological surgery (endometriosis, simple hysterectomy, radical colpohysterectomy), colorectal surgery and pelvic radiotherapy

    International Nuclear Information System (INIS)

    Vidait, A.; Mozer, P.; Chartier-Kastler, E.; Ruffion, A.

    2007-01-01

    Apart from damage to bladder innervation, a number of local diseases and treatments such as radiotherapy can induce lower urinary tract functional disorders. Some of these disorders can be treated according to the principles used in the management of neurogenic bladder. The purpose of this review is to report the functional consequences of pelvic endometriosis, radiotherapy, colorectal surgery and urinary incontinence surgery with particular emphasis on situations in which a neurogenic mechanism is suspected. (authors)

  15. Relative significance of surgery and radiotherapy in treatment of brain metastases of lung cancer

    International Nuclear Information System (INIS)

    Yamashita, Junkoh; Ohtsuka, Sinichi; Yamasaki, Toshiki; Gi, Hidefuku; Ha, Young-Soo; Handa, Hajime

    1983-01-01

    One hundred and sixteen cases of brain metastases of lung cancer were retrospectively analysed with special reference to the relative significance of surgery and radiotherapy. The median survival time from diagnosis of brain metastases was 1.2 months in 27 cases without treatment, 2.5 months in 51 cases treated by surgery alone, 4.2 months in 31 cases treated by radiotherapy alone and 6.5 months in 7 cases treated by surgery and radiotherapy. The survival rate in patients treated by radiotherapy was significantly better than in those not treated by radiotherapy. However, the effect of surgery was not significant in prolongation of survival time. On the other hand, the rate of improvement in neurological symptoms assessed at one month after the initiation of treatment was 80.9% in 47 cases treated by surgery and 19.4 % in 31 cases treated by radiotherapy. The result suggested that surgery is superior to radiotherapy in alleviating neurological symptoms. It is important to understand the nature of effect of each treatment. A better result will be anticipated by proper selection or combination of these treatments. (author)

  16. Primary Surgery vs Radiotherapy for Early Stage Oral Cavity Cancer.

    Science.gov (United States)

    Ellis, Mark A; Graboyes, Evan M; Wahlquist, Amy E; Neskey, David M; Kaczmar, John M; Schopper, Heather K; Sharma, Anand K; Morgan, Patrick F; Nguyen, Shaun A; Day, Terry A

    2018-04-01

    Objective The goal of this study is to determine the effect of primary surgery vs radiotherapy (RT) on overall survival (OS) in patients with early stage oral cavity squamous cell carcinoma (OCSCC). In addition, this study attempts to identify factors associated with receiving primary RT. Study Design Retrospective cohort study. Setting National Cancer Database (NCDB, 2004-2013). Subjects and Methods Reviewing the NCDB from 2004 to 2013, patients with early stage I to II OCSCC were identified. Kaplan-Meier estimates of survival, Cox regression analysis, and propensity score matching were used to examine differences in OS between primary surgery and primary RT. Multivariable logistic regression analysis was performed to identify factors associated with primary RT. Results Of the 20,779 patients included in the study, 95.4% (19,823 patients) underwent primary surgery and 4.6% (956 patients) underwent primary RT. After adjusting for covariates, primary RT was associated with an increased risk of mortality (adjusted hazard ratio [aHR], 1.97; 99% confidence interval [CI], 1.74-2.22). On multivariable analysis, factors associated with primary RT included age ≥70 years, black race, Medicaid or Medicare insurance, no insurance, oral cavity subsite other than tongue, clinical stage II disease, low-volume treatment facilities, and earlier treatment year. Conclusion Primary RT for early stage OCSCC is associated with increased mortality. Approximately 5% of patients receive primary RT; however, this percentage is decreasing. Patients at highest risk for receiving primary RT include those who are elderly, black, with public insurance, and treated at low-volume facilities.

  17. Factors influencing time between surgery and radiotherapy : A population based study of breast cancer patients

    NARCIS (Netherlands)

    Katik, S.; Gort, M.; Jobsen, Jan J.; Maduro, John H.; Struikmans, H.; Siesling, S.

    2015-01-01

    This study describes variation in the time interval between surgery and radiotherapy in breast cancer (BC) patients and assesses factors at patient, hospital and radiotherapy centre (RTC) level influencing this variation. To do so, the factors were investigated in BC patients using multilevel

  18. Surgery and radiotherapy in the treatment of cutaneous melanoma

    DEFF Research Database (Denmark)

    Testori, A; Rutkowski, P; Marsden, J

    2009-01-01

    on individual circumstances. Radiotherapy is indicated as a treatment option in select patients with lentigo maligna melanoma and as an adjuvant in select patients with regional metastatic disease. Radiotherapy is also indicated for palliation, especially in bone and brain metastases....

  19. Results of the patterns of care study for esophageal cancer patients treated with radiotherapy and surgery

    International Nuclear Information System (INIS)

    Gomi, Kohtaro; Oguchi, Masahiko; Yamashita Takashi

    2001-01-01

    A Patterns of Care Study examined the records of patients with thoracic esophageal cancer treated with radiotherapy and surgery in 1995 through 1997. Thirty-one percent of patients received preoperative radiotherapy; 61% of these received chemotherapy. Sixty six percent of patients received postoperative radiotherapy. Significant variables for overall survival in multivariate analysis include presence of macroscopic residual tumors (risk ratio=2.66), sex female (0.49), photon energy higher than 4 MV (0.50), Karnofsky performance status greater than 70 (0.55) and the use of chemotherapy (1.64). The value of preoperative concurrent chemotherapy and radiotherapy should be tested in a randomized trial. (author)

  20. Rescue surgery post-failure of the radiotherapy in early glottis carcinoma

    International Nuclear Information System (INIS)

    Dodero, Alberto; Piazza, Carlos; Ugarte, Marcelo; Kulay, Yolanda

    2006-01-01

    The treatment of the laryngeal carcinoma is controversial in the otolaryngology literature; in glottis cancer that can be managed with radiotherapy, conservative laryngeal surgery and micro-endoscope by laser. At present time, the main objective in the treatment of the early glottis cancer is the control of the tumor and preservation of a good voice. In small injuries, the surgery and the radiotherapy offer equivalent cure rates. The handling of the failure of radiotherapy is controversial; the options go from the resection endoscope with laser, to the total laryngectomy, with local controls [es

  1. Adjuvant radiotherapy after breast conserving surgery - a comparative effectiveness research study.

    Science.gov (United States)

    Corradini, Stefanie; Niyazi, Maximilian; Niemoeller, Olivier M; Li, Minglun; Roeder, Falk; Eckel, Renate; Schubert-Fritschle, Gabriele; Scheithauer, Heike R; Harbeck, Nadia; Engel, Jutta; Belka, Claus

    2015-01-01

    The purpose of this retrospective outcome study was to validate the effectiveness of postoperative radiotherapy in breast conserving therapy (BCT) and to evaluate possible causes for omission of radiotherapy after breast conserving surgery (BCS) in a non-trial population. Data were provided by the population-based Munich Cancer Registry. The study included epidemiological data of 30.811 patients diagnosed with breast cancer from 1998 to 2012. The effect of omitting radiotherapy was analysed using Kaplan-Meier-estimates and Cox proportional hazard regression. Variables predicting omission of radiotherapy were analysed using multivariate logistic regression. Use of postoperative radiotherapy after BCS was associated with significant improvements in local control and survival. 10-year loco-regional recurrence-free-survival was 90.8% with postoperative radiotherapy vs. 77.6% with surgery alone (pstudy shows a decrease in local control and a survival disadvantage if postoperative radiotherapy after breast conserving surgery is omitted in an unselected cohort of primary breast cancer patients. Due to its epidemiological nature, it cannot answer the question in whom postoperative radiotherapy can be safely omitted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Epithelioid sarcoma: results of conservative surgery and radiotherapy

    International Nuclear Information System (INIS)

    Callister, Matthew D.; Ballo, Matthew T. M.D.; Pisters, Peter W.T.; Patel, Shreyaskumar R.; Feig, Barry W.; Pollock, Raphael E.; Benjamin, Robert S.; Zagars, Gunar K

    2001-01-01

    Purpose: To determine the outcome and prognostic factors for patients with localized epithelioid sarcoma treated with conservative surgery and radiotherapy (RT). Methods and Materials: The medical records of 24 patients with nonmetastatic epithelioid sarcoma treated with conservative surgery and RT were reviewed. Preoperative RT was given to 3 patients (median 46.4 Gy) and postoperative RT to 21 patients (median 64.5 Gy). A local (limb-sparing) surgical procedure was performed in all patients. Results: At a median follow-up of 131 months, 14 patients had relapsed and 13 patients had died. The actuarial overall and disease-free survival rate at 10 years was 50% and 37%, respectively. Local, nodal, and metastatic failure occurred in 7, 4, and 10 patients, respectively, yielding a 10-year actuarial local, nodal, and metastatic control rate of 63%, 81%, and 56%, respectively. Univariate analysis revealed that size ≤5 cm and extremity location were favorable prognostic factors for overall, disease-free, and metastasis-free survival. The actuarial 5-year overall, disease-free, and metastasis-free survival rate was 79% vs. 25% (p=0.002), 51% vs. 13% (p=0.03), and 79% vs. 13% (p 5 cm. The actuarial 5-year overall, disease-free, and metastasis-free survival rate was 77% vs. 39% (p 0.002), 56% vs. 0% (p=0.01), and 78% vs. 17% (p=0.01), respectively, for extremity vs. nonextremity location. Multivariate analysis of the factors correlating with the overall, disease-free, and metastasis-free survival confirmed the favorable prognostic significance of small lesion size. The prognostic significance of extremity location on univariate analysis was explained by an imbalance in the mean tumor sizes. Conclusions: Epithelioid sarcoma is an aggressive soft-tissue sarcoma, with high rates of local and distant relapse. Local control with conservative surgery and RT compares favorably to published surgical series. The poor outcome for tumors ≥5 cm in size emphasizes the need for

  3. 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

  4. 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.)

  5. A clinical assessment of laser surgery for recurrent tongue cancer following radiotherapy

    International Nuclear Information System (INIS)

    Ishii, Junnosuke; Fujita, Kunio; Komatsubara, Hideki; Umeda, Masahiro; Komori, Takahide

    2004-01-01

    Laser surgery can control intraoperative hemorrhaging and enable lesions to be accurately removed since, unlike an electrotome, it does not effect electrocontractility. It can also reduce postoperative pain and dysfunction. This study investigated the efficacy of laser surgery in recurrent tongue cancer following radiotherapy. Of the total of 105 patients with squamous cell carcinoma of the tongue (T1, T2N0) who underwent radiotherapy at the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, at some point between 1980 and 1998, 24 (22.9%) experienced local recurrence. Sixteen of these patients underwent surgical removal of the tumor. Of these 16 patients, 8 (4 early- and 4 late-stage recurrence) had partial glossectomy by laser surgery. Following laser surgery, 2 (1 early- and 1 late-stage recurrence) of the 8 patients died from neck metastasis and another 2 (early-stage recurrence) died from other diseases. The primary and neck tumors are both under control in 3 (late-stage recurrence) of the remaining 4 patients. Laser surgery for late-stage recurrent tongue cancer following radiotherapy appears to be a suitable treatment, although comprehensive glossectomy with/without radical neck dissection is necessary for early-stage recurrent cases after radiotherapy. (author)

  6. Study of alleviation of peripheral circulation disturbance due to surgery and radiotherapy, 1

    International Nuclear Information System (INIS)

    Tedo, Tohru; Ohnuma, Isao; Hino, Shigeki; Kanetomo, Takafumi

    1979-01-01

    133 Xe-clearance in the branium was measured in order to detect circulatory disturbance following surgery and during and after radiotherapy for breast cancer. In 5 of 10 cases (50%) in which surgery and radiotherapy were performed for breast cancer, lowered circulatory function was noted in the affected side. Lowered function was seen in the non-affected side of the 10 cases in 3 (30%), and normal function was observed in 2 (20%). In 4 of 13 cases (75%), including 3 cases in which radiotherapy was performed, many subjective symptoms were noted. Circulatory function was lowered in 3 of the 4 cases. Generally, cases involving many subjective symptoms were of lowered circulatory function. In the cases in which lowered circulatory function was noted in the non-affected side, there were no subjective symptoms. In all the cases in which radiotherapy was continued or in which radiotherapy had almost been completed, a more or less lowered circulatory function was noted. The onset of lowered function and whether surgery or radiotherapy lowered circulation are unknown. (Ueda, J.)

  7. The influence of radiotherapy on cosmetic outcome after breast conservative surgery

    International Nuclear Information System (INIS)

    McCormick, Beryl; Sacchini, Virgilio; Luini, Alberto; Agresti, Roberto; Greco, Marco; Manzari, Antonella; Mariani, Luigi; Zucali, Roberto

    1995-01-01

    Purpose: The influence of radiotherapy in the cosmetic outcome after conservative surgery for breast cancer was evaluated using an objective method of calculating the asymmetry between the two breasts. Methods and Materials: One hundred and one patients treated with the same conservative surgery were evaluated for cosmetic outcome. Sixty-one of them received external radiotherapy (50 + 10 Gy) to the residual breast; the remaining 40 underwent surgery only. The aspect of the patients' breasts was objectively assessed for symmetry by means of a computerized technique. A subjective assessment of the cosmetic outcome was performed both by physician and patient. These objective and subjective assessments were compared in the two groups treated with or without radiotherapy. Results: The results obtained did not show significant differences in terms of cosmetic outcome in the two groups. Skin telangectasia was noted in two radiotherapy patients, while hypertrophic breast scars were only noted in six nonirradiated patients. Conclusions: We found that standard radiotherapy does not seem to influence the symmetry and the cosmetic results in breast conservative treatment when compared to a similar group of patients with the same quadrantectomy procedure and no radiotherapy

  8. Locally Advanced Oncocytic Carcinoma of the Nasal Cavity Treated With Surgery and Intensity-modulated Radiotherapy

    Directory of Open Access Journals (Sweden)

    Yu-Wen Hu

    2010-03-01

    Full Text Available Oncocytic carcinomas of the nasal cavity are extremely rare. We report 1 patient whose primary tumor and neck lymphadenopathies were under control nearly 2 years after combined surgery and radiotherapy. An 80-year-old man with a history of nasal oncocytoma had received excision twice previously. Computed tomography demonstrated locally advanced recurrent tumor invading the paranasal sinuses and orbit with lymphadenopathies in the right neck. Skull base surgery was performed. Pathological examination revealed oncocytic carcinoma. Positron emission tomography showed hypermetabolic lesions in the surgical bed and right neck. The patient subsequently received intensity-modulated radiotherapy to the primary site and the whole neck. Follow-up computed tomography 4 months later showed marked shrinkage of the neck lymphadenopathies. There was no progression after nearly 2 years. Although these tumors have historically been regarded as radioresistant, the combined treatment of surgery followed by radiotherapy may offer the best chance for control of locally advanced disease.

  9. Radiotherapy Alone is Associated with Improved Outcomes Over Surgery in the Management of Solitary Plasmacytoma.

    Science.gov (United States)

    Li, Qi-Wen; Niu, Shao-Qing; Wang, Han-Yu; Wen, Ge; Li, Yi-Yang; Xia, Yun-Fei; Zhang, Yu-Jing

    2015-01-01

    A moderate dose of radiation is the recommended treatment for solitary plasmacytoma (SP), but there is controversy over the role of surgery. Our study aimed at comparing different treatment modalities in the management of SP. Data from 38 consecutive patients with solitary plasmacytoma, including 16 with bone plasmacytoma and 22 with extramedullary plasmacytoma, were retrospectively reviewed. 15 patients received radiotherapy alone; 11 received surgery alone, and 12 received both. The median radiation dose was 50Gy. All operations were performed as radical resections. Local progression-free survival (LPFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS) and overall survival (OS) were calculated and outcomes of different therapies were compared. The median follow-up time was 55 months. 5-year LPFS, MMFS, PFS and OS were 87.0%, 80.9%, 69.8% and 87.4%, respectively. Univariate analysis revealed, compared with surgery alone, radiotherapy alone was associated with significantly higher 5-year LPFS (100% vs 69.3%, p=0.016), MMFS (100% vs 51.4%, p=0.006), PFS (100% vs 33.7%, p=0.0004) and OS (100% vs 70%, p=0.041). Radiotherapy alone can be considered as a more effective treatment for SP over surgery. Whether a combination of radiotherapy and surgery improves outcomes requires further study.

  10. Salvage definitive chemo-radiotherapy for locally recurrent oesophageal carcinoma after primary surgery: retrospective review

    International Nuclear Information System (INIS)

    Baxi, S. H.; Burmeister, B.; Harvey, J. A.; Smithers, M.; Thomas, J.

    2008-01-01

    Full text: To determine the overall survival and gastrointestinal toxicity for patients treated with salvage definitive chemo-radiotherapy after primary surgery for locoregional relapse of oesophageal carcinoma. A retrospective review of 525 patients who had a resection for oesophageal or oesophagogastric carcinoma at Princess Alexandra Hospital identified 14 patients treated with salvage definitive radiotherapy or chemo-radiotherapy, following localized recurrence of their disease. We analysed the patient and treatment characteristics to determine the median overall survival as the primary end point. Gastrointestinal toxicity was examined to determine if increased toxicity occurred when the stomach was irradiated within the intrathoracic radiotherapy field. The median overall survival for patients treated with curative intent using salvage definitive chemo-radiotherapy was 16 months and the 2-year overall survival is 21%. One patient is in clinical remission more than 5 years after therapy. Age <60 years old and nodal recurrence were favourable prognostic factors. Treatment compliance was 93% with only one patient unable to complete the intended schedule. Fourteen per cent of patients experienced grade 3 or 4 gastrointestinal toxicity. Salvage definitive chemo-radiotherapy should be considered for good performance status patients with oesophageal carcinoma who have a locoregional relapse after primary surgery. The schedule is tolerable with low toxicity and an acceptable median survival

  11. Radiotherapy during surgery. Summarizing progress achieved after 5 years of experience

    International Nuclear Information System (INIS)

    Wannenmacher, M.; Herfarth, C.

    1998-01-01

    Complemental radiotherapy during surgery for ensuring radical removal of multi-invasive and multicentric tumors is an acknowledged principle. Irradiation under the operation permits pin-pointed application of a high, single radiation dose to a sharply defined target area, while movable radiosensitive organs can be optimally protected. The requirements of this treatment call for close interdisciplinary collaboration of surgeons and radiooncologists. Due to the demand for highly experienced personnel and sophisticated technology, application of this type of radiotherapy is restricted so far to a few medical centers. The value of the treatment was analysed and proven by an international multi-center study performed by experienced hospitals. The CD-ROM in hand presents a topical survey of ongoing activities, techniques and developments relating to radiotherapy during surgery at the national and international level and is intended to serve as a source of information and further learning for colleagues wishing to specialize in this field. (orig./CB) [de

  12. Radiotherapy for locally recurrent rectal cancer treated with surgery alone as the initial treatment

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Hidekazu; Yamaguchi, Takahiro; Hachiya, Kae; Okada, Sunaho; Kitahara, Masashi; Matsuyama, Katsuya; Matsuo, Masayuki [Gifu University, Gifu (Japan)

    2017-03-15

    Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0–3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (≥75 Gy10) than for the lower BED group (<75 Gy10). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than 75 Gy10, if the dose to the organ at risk is within acceptable levels.

  13. Hyperfractionated-accelerated radiotherapy followed by radical surgery in locally advanced tumors of the oral cavity

    International Nuclear Information System (INIS)

    Hoeller, U.; Biertz, I.; Tribius, S.; Alberti, W.; Flinzberg, S.; Schmelzle, R.

    2006-01-01

    Purpose: to evaluate the outcome of hyperfractionated-accelerated radiotherapy and subsequent planned primary tumor resection and radical neck dissection in locally advanced tumors of the oral cavity. Patients and Methods: this retrospective analysis evaluates 126 subsequent patients who were treated between 1988 and 1997 for locally advanced tumors of the oral cavity (with extension into the oropharynx in 17 patients), 34 (27%) AJCC stage III and 92 (73%) stage IV. Primary tumor and nodal metastases were irradiated with 1.4 Gy bid to a median total dose of 72.8 Gy (range 58.8-75.6 Gy). Then, planned radical surgery of the primary site according to the initial tumor extent and cervical nodes was performed. Median follow-up of living patients was 6 years (range 1-11 years). Results: 4 weeks after radiotherapy, 14 patients (11%) had complete tumor remission, 92 (73%) partial remission, 15 (12%) no change, and five (4%) progressive disease. Complete resection was achieved in 117 (93%) patients (nine incomplete resections). 5-year locoregional control rate was 62 ± 9%, overall survival 36 ± 9%. Surgery-related morbidity occurred in 42 patients (33%; mainly delayed wound healing and fistulae), overall severe treatment-related morbidity in 46 patients (36%). 24/84 relapse-free patients (29%) required a percutaneous gastrostomy or nasal tube ≥ 1 year after therapy. Conclusion: in this study, the outcome of combined curative radiotherapy and planned surgery of the primary tumor and neck nodes was comparable to reported results of hyperfractionated radiotherapy with or without salvage surgery of the neck nodes with respect to locoregional control and overall survival. Planned surgery carries a substantial risk of morbidity and seems to offer no benefit in comparison to salvage surgery of the neck nodes only. Therefore, salvage surgery is preferred. (orig.)

  14. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    International Nuclear Information System (INIS)

    Junor, E.J.; Paul, J.; Reed, N.S.

    1992-01-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author)

  15. Anaplastic thyroid carcinoma: 91 patients treated by surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Junor, E.J.; Paul, J.; Reed, N.S. (Beatson Oncology Centre, Glasgow (United Kingdom))

    1992-04-01

    Ninety-one patients with histologically proven anaplastic carcinoma of the thyroid were referred to the Beatson Oncology Centre between 1961 and 1986. The female:male ratio was 2.4:1 and the median age at presentation was 70 (range 38-92) years. All patients had a thyroid mass at presentation and the most common symptoms were dyspnoea, dyspnagia and dysphonia. Five patients had a total thyroidectomy and 28 partial thyroidectomy. Ninety five per cent of patients received external beam radiotherapy. Results show dyspnoea to be the only symptom strongly influencing survival. Total or partial thyroidectomy is associated with increased survival. This association is most marked for patients presenting without dyspnoea. Eighty per cent of patients responded to radiotherapy. (Author).

  16. Intraoperative Boost Radiotherapy during Targeted Oncoplastic Breast Surgery: Overview and Single Center Experiences

    Directory of Open Access Journals (Sweden)

    Wolfram Malter

    2014-01-01

    Full Text Available Breast-conserving surgery followed by whole-breast irradiation is the standard local therapy for early breast cancer. The international discussion of reduced importance of wider tumor-free resection margins than “tumor not touching ink” leads to the development of five principles in targeted oncoplastic breast surgery. IORT improves local recurrence risk and diminishes toxicity since there is less irradiation of healthy tissue. Intraoperative radiotherapy (IORT can be delivered in two settings: an IORT boost followed by a conventional regimen of external beam radiotherapy or a single IORT dose. The data from TARGIT-A and ELIOT reinforce the conviction that intraoperative radiotherapy during breast-conserving surgery is a reliable alternative to conventional postoperative fractionated irradiation, but only in a carefully selected population at low risk of local recurrence. We describe our experiences with IORT boost (50 kV energy X-rays; 20 Gy in combination with targeted oncoplastic breast surgery in a routine clinical setting. Our experiences demonstrate the applicability and reliability of combining IORT boost with targeted oncoplastic breast surgery in breast-conserving therapy of early breast cancer.

  17. Radiotherapy or surgery for T2N0M0 glottic carcinoma?

    International Nuclear Information System (INIS)

    Stalpers, L.J.A.; Daal, W.A.J. van; Verbeek, A.L.M.

    1989-01-01

    Decision analysis was used to evaluate the results of treatment of T 2 N 0 M 0 glottic carcinoma as presented in the literature. Based on mean values for recurrence, salvage eligibility after recurrence and salvage success, the 5-year survival after radiotherapy and surgery proved to be almost identical, 85 and 86%. If the recurrence rates and the salvage rates were varied, a marginal advantage for surgery in small tumours and a major advantage in more extended tumours was seen if only survival is considered. To take the quality of speech into account, a utility analysis was performed. A utility scale was defined ranging from 0.0 as the value for death, to 1.0 for a successfully irradiated patient with preservation of normal speech. A utility of 0.99 or less for the laryngectomized patient would favour radiotherapy over surgery for all T 2 tumours. In patients with T 2b tumours and in extreme circumstances, e.g. if failure rates of radiotherapy are extremely low, an exact assessment of patient utilities may be pivotal. Under normal circumstances radiotherapy is preferred for T 2 N 0 M 0 glottic carcinoma if both survival and the quality of speech are taken into account. (author). 39 refs.; 5 figs.; 1 tab

  18. Cosmetic outcome and curative effect of radiotherapy for early breast cancer after conservative surgery

    International Nuclear Information System (INIS)

    Ma Changuo; Ma Yuanyuan; Zhao Shuhong; Wang Hong

    2007-01-01

    Objective: To study the cosmetic outcome and curative effect of 6 MV X-ray tangential field radiotherapy for early stage breast cancer after conservative surgery. Methods: The eligible criteria were single tumor ≤3 cm in diameter, surgical margin negative and lymph node negative. The exclusive criteria were inflammatory carcinoma or male breast cancer. After conservative surgery, 42 patients with stage 0, I or II breast cancer were treated with conventional radiotherapy with a total dose of 50 Gy to the whole breast and 10 Gy boost to the tumor bed. The efficacy and the cosmetic outcome of radiotherapy were evaluated every 3 months for the first 2 years and every 6 months after that and every 12 months after 5 years. Results: The follow up time was 19-90 months (median 56 months). Two patients died of metastasis after 16 months and 36 months, which was diagnosed by CT scan. Excellent or good cosmetic outcome was > 93% at 36 months. The local control rate was 100%. The 1- and 3-year survival rates was 100% and 98%, respectively. Conclusions: Tangential field radiotherapy for early breast cancer after conservative surgery has a satisfied result in both tumor control and cosmetic outcome, which can definitely improve the life quality of the patients. (authors)

  19. Recent advances in radiotherapy: Partial Breast Irradiation (PBI) in breast cancer patients after breast conserving surgery

    International Nuclear Information System (INIS)

    Niwinska, A.

    2003-01-01

    The interest in accelerated partial breast irradiation (PBI) after conservative surgery has increased over the past decade as a result of many factors, including clinical and pathological data questioning the efficacy of whole breast irradiation in highly selected patients, as well as factors related to patient's convenience. High dose rate and low dose rate brachytherapy, brachytherapy MammoSite, Electron Intraoperative Therapy - ELIOT and Targeted Intraoperative Radiotherapy - TARGIT are the subject of investigation. The tolerability and efficacy of the treatment are of special interest. In this review article, methods of accelerated PBI, eligibility criteria, techniques of radiotherapy, early results and side effects are reviewed. (author)

  20. 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

  1. Surgery vs. primary radiotherapy in early-stage oropharyngeal cancer

    Directory of Open Access Journals (Sweden)

    Catia Pedro

    2018-02-01

    Conclusions: Longer follow-up still does not show a significant difference in OS and LRFS between both treatments. Because most patients submitted to surgery required adjuvant RT and since its side-effects were not negligible, further studies are warranted to better suit the first treatment for each patient and to prevent the need for adjuvant treatment and the risk of toxicity.

  2. Lactation following conservation surgery and radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Varsos, G.; Yahalom, J.

    1991-01-01

    A 38-year-old woman with early stage invasive breast cancer was treated with wide excision of the tumor, axillary lymph node dissection, and breast irradiation. Three years later, she gave birth to a normal baby. She attempted breast feeding and had full lactation from the untreated breast. The irradiated breast underwent only minor changes during pregnancy and postpartum but produced small amounts of colostrum and milk for 2 weeks postpartum. There are only a few reports of lactation after breast irradiation. These cases are reviewed, and possible factors affecting breast function after radiotherapy are discussed. Because of scant information available regarding its safety for the infant, nursing from the irradiated breast is not recommended

  3. 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

  4. Forecast factors for global survival in patients with sarcomas of soft parts treated with surgery and radiotherapy

    International Nuclear Information System (INIS)

    Vera Merino, V.; Winter, C.; Schnitman, F.; Caussa, L.; Brocca, C.; Basquiera, A.L.; Zunino, S.

    2007-01-01

    The task of this work is to study the characteristics of the patient (age, sex) and of the tumor (locating, histology, size, histological degree, deepness, margins commitment ) and the delay between surgery and radiotherapy relating to global survival [es

  5. Treatment outcome after adjuvant radiotherapy following surgery for patients with stage I endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Young; Lee, Kyung Ja; Park, Kyung Ran [Dept. of Radiation Oncology, Ewha Womans University School of Medicine, Seoul (Korea, Republic of); and others

    2016-12-15

    The purpose of this study is to evaluate the treatment outcomes of adjuvant radiotherapy using vaginal brachytherapy (VB) with a lower dose per fraction and/or external beam radiotherapy (EBRT) following surgery for patients with stage I endometrial carcinoma. The subjects were 43 patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I endometrial cancer who underwent adjuvant radiotherapy following surgery between March 2000 and April 2014. Of these, 25 received postoperative VB alone, while 18 received postoperative EBRT to the whole pelvis; 3 of these were treated with EBRT plus VB. The median EBRT dose was 50.0 Gy (45.0–50.4 Gy) and the VB dose was 24 Gy in 6 fractions. Tumor dose was prescribed at a depth of 5 mm from the cylinder surface and delivered twice per week. The median follow-up period for all patients was 57 months (range, 9 to 188 months). Five-year disease-free survival (DFS) and overall survival (OS) for all patients were 92.5% and 95.3%, respectively. Adjuvant radiotherapy was performed according to risk factors and stage IB, grade 3 and lymphovascular invasion were observed more frequently in the EBRT group. Five-year DFS for EBRT and VB alone were 88.1% and 96.0%, respectively (p = 0.42), and 5-year OS for EBRT and VB alone were 94.4% and 96%, respectively (p = 0.38). There was no locoregional recurrence in any patient. Two patients who received EBRT and 1 patient who received VB alone developed distant metastatic disease. Two patients who received EBRT had severe complications, one each of grade 3 gastrointestinal complication and pelvic bone insufficiency fracture. Adjuvant radiotherapy achieved high DFS and OS with acceptable toxicity in stage I endometrial cancer. VB (with a lower dose per fraction) may be a viable option for selected patients with early-stage endometrial cancer following surgery.

  6. Fractionated stereotactic conformal radiotherapy following conservative surgery in the control of craniopharyngiomas

    International Nuclear Information System (INIS)

    Minniti, Giuseppe; Saran, Frank; Traish, Daphne; Soomal, Rubin; Sardell, Susan; Gonsalves, Adam; Ashley, Susan; Warrington, Jim; Burke, Kevin; Mosleh-Shirazi, Amin; Brada, Michael

    2007-01-01

    Purpose: To describe the technique and results of stereotactically guided conformal radiotherapy (SCRT) in patients with craniopharyngioma after conservative surgery. Methods and materials: Thirty-nine patients with craniopharyngioma aged 3-68 years (median age 18 years) were treated with SCRT between June 1994 and January 2003. All patients were referred for radiotherapy after undergoing one or more surgical procedures. Treatment was delivered in 30-33 daily fractions over 6-6.5 weeks to a total dose of 50 Gy using 6 MV photons. Outcome was assessed prospectively. Results: At a median follow-up of 40 months (range 3-88 months) the 3- and 5-year progression-free survival (PFS) was 97% and 92%, and 3- and 5-year survival 100%. Two patients required further debulking surgery for progressive disease 8 and 41 months after radiotherapy. Twelve patients (30%) had acute clinical deterioration due to cystic enlargement of craniopharyngioma following SCRT and required cyst aspiration. One patient with severe visual impairment prior to radiotherapy had visual deterioration following SCRT. Seven out of 10 patients with a normal pituitary function before SCRT had no endocrine deficits following treatment. Conclusion: SCRT as a high-precision technique of localized RT is suitable for the treatment of incompletely excised craniopharyngioma. The local control, toxicity and survival outcomes are comparable to results reported following conventional external beam RT. Longer follow-up is required to assess long-term efficacy and toxicity, particularly in terms of potential reduction in treatment related late toxicity

  7. The strategy of therapy of the axilla in early cancer. Surgery or radiotherapy

    International Nuclear Information System (INIS)

    Izuo, Masaru

    1998-01-01

    The therapy of the axillary lymph node in early breast cancer was assessed perspectively. Recently, axillary irradiation was carried out and compared with surgery. Radiotherapy was not evaluated more successful. To carry out in accordance with the present guide line, so called ''modern technique'' or ''modern dosage schedule'', radiotherapy of the axilla is effective as well as surgery. We have many agreements that the rate of incidence of complication associated with irradiation was decreased in accordance with ''modern technique''. It is reasonable to radiate additionally after the selection by the ''node sampling'' in the sense of decreasing unnecessary irradiation. But it is not sufficient in their reliability, it is hard to expect this method getting more popular than now. We cannot find any difference in the effect of the treatment itself between present dissection and radiotherapy. However we have many agreements that axillary dissection may give the information about n-stage, and the contribution to the suitable selection to the prognosis factor and adjuvant chemotherapy was not so less even in early cancer. Some early cancers (non-invasive carcinoma or micro carcinoma) will not need the axillary therapy. It is one of the options ''to combine mastectomy under local anesthesia and radiotherapy'' in close cooperation with the skilled radiologist. (K.H.) 120 refs

  8. Methods and clinical utility of intraoperative radiotherapy (IORT) in breast-conserving surgery

    International Nuclear Information System (INIS)

    Miyauchi, Mitsuru; Yamamoto, Naoto; Fujita, Yoshihiro; Honda, Ichiro; Hatano, Kazuo; Sekiya, Yuichi; Suzuki, Masato; Nakajima, Nobuyuki.

    1996-01-01

    We have developed an intraoperative radiotherapy technique in breast-conserving surgery. Following lumpectomy and axillary dissection up to Level II, the subcutaneous fat layer was lifted from the gland over the entire breast. Electron beams of 25 Gy were irradiated within cylinder, avoiding the skin and subcutaneous tissue. The surface of the gland was covered with cotton swabs saturated with normal saline to equalize the energy depth to the chest wall. This technique has so far been applied to 8 patients, all of whom went through a successful postoperative period without serious complications. The cosmetic results were satisfactory from immediately after the operation. Intraoperative radiotherapy combined with breast-conserving surgery may be helpful in improving the QOL of patients by eliminating the adverse effects associated radiation injury to the skin of the breast and long-term postoperative follow-up. (author)

  9. 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

  10. The frequency and cause of anxiety and depression amongst patients with malignant brain tumours between surgery and radiotherapy.

    Science.gov (United States)

    Kilbride, Lynn; Smith, Graeme; Grant, Robin

    2007-09-01

    Between surgery and radiotherapy patients with a malignant glioma may encounter a number of psychosocial issues that could invoke an anxious or depressive response. This study explored the frequency, severity and cause of anxiety and depression in patients with presumed malignant brain tumours in the period between their surgery and radiotherapy. A prospective study of 51 patients used mixed methods to measure anxiety and depression at three time points; post surgery, three weeks post surgery and pre radiotherapy. Analysis was undertaken using statistical and content analysis of the Hospital Anxiety and Depression (HAD) scores and unstructured interviews respectively. Analysis of HAD scores indicated a heightened level of anxiety in patients pre radiotherapy. This anxiety is more prevalent in younger patients and is not related to the patients change in functional state. Five patients had a significant depression at one or more time points between surgery and radiotherapy. Four of the five patients who reported scores consistent with depression had past histories of depression. Content analysis of unstructured interviews indicated that the HAD scores underestimated the presence of anxiety and depression amongst this group of patients. Anxiety was more common in younger patients. Anxiety was slightly more frequent pre-radiotherapy. A past medical history of depression is a predictor of significant depression in the post-operative period. The HAD scale although useful is not an adequate measurement tool for detecting anxiety and depression amongst all patients and health care professionals should adopt other means to monitor for these signs and symptoms.

  11. Gothic pedagogy and Victorian reform treatises.

    Science.gov (United States)

    Kehler, Grace

    2008-01-01

    This paper considers the work of bodily affect in three Victorian reform treatises about the industrial working classes: Kay's The Moral and Physical Condition of the Working Classes Employed in the Cotton Manufacture in Manchester, Chadwick's Report on the Sanitary Condition of the Labouring Population of Great Britain, and Engels's The Condition of the Working Class in England. Employing a gothic technology that graphically illustrates and appeals to the sensations, these treatises provide a striking instance of the extent to which Victorian attempts at social reform were routed through the visceral, sensible knowledge of the body. Since, however, the gothic tends toward the excessive, a second crucial feature of its technology entails the arousal of conflicting sensations that problematize class relations.

  12. Radiotherapy in addition to radical surgery in rectal cancer: evidence for a dose-response effect favoring preoperative treatment

    International Nuclear Information System (INIS)

    Glimelius, Bengt; Isacsson, Ulf; Jung, Bo; Paahlman, Lars

    1997-01-01

    Purpose: This study explored the relationship between radiation dose and reduction in local recurrence rate after preoperative and postoperative radiotherapy in rectal cancer. Methods and Materials: All randomized trials initiated prior to 1988 comparing preoperative and postoperative radiotherapy with surgery alone or with each other were included. Local failure rates were available in 5626 randomized patients. The linear quadratic formula was used to compensate for different radiotherapy schedules. Results: For preoperative radiotherapy, a clear dose-response relationship could be established. For postoperative radiotherapy, the range of doses was narrow, and a dose-response relationship could not be demonstrated. At similar doses, preoperative radiotherapy appeared to be more efficient in reducing local failure rate than postoperative. The only trial comparing preoperative with postoperative radiotherapy confirms this notion. A 15-20 Gy higher dose may be required postoperatively than preoperatively to reach similar efficacy. Neither approach alone significantly influences survival, although it is likely that a small survival benefit may be seen after preoperative radiotherapy. Conclusions: The information from the entire randomized experience suggests that preoperative radiotherapy may be more dose efficient than postoperative radiotherapy

  13. 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.

  14. Clinical Outcome of Sacral Chordoma With Carbon Ion Radiotherapy Compared With Surgery

    International Nuclear Information System (INIS)

    Nishida, Yoshihiro; Kamada, Tadashi; Imai, Reiko; Tsukushi, Satoshi; Yamada, Yoshihisa; Sugiura, Hideshi; Shido, Yoji; Wasa, Junji; Ishiguro, Naoki

    2011-01-01

    Purpose: To evaluate the efficacy, post-treatment function, toxicity, and complications of carbon ion radiotherapy (RT) for sacral chordoma compared with surgery. Methods and Materials: The records of 17 primary sacral chordoma patients treated since 1990 with surgery (n = 10) or carbon ion RT (n = 7) were retrospectively analyzed for disease-specific survival, local recurrence-free survival, complications, and functional outcome. The applied carbon ion dose ranged from 54.0 Gray equivalent (GyE) to 73.6 GyE (median 70.4). Results: The mean age at treatment was 55 years for the surgery group and 65 years for the carbon ion RT group. The median duration of follow-up was 76 months for the surgery group and 49 months for the carbon ion RT group. The local recurrence-free survival rate at 5 years was 62.5% for the surgery and 100% for the carbon ion RT group, and the disease-specific survival rate at 5 years was 85.7% and 53.3%, respectively. Urinary-anorectal function worsened in 6 patients (60%) in the surgery group, but it was unchanged in all the patients who had undergone carbon ion RT. Postoperative wound complications requiring reoperation occurred in 3 patients (30%) after surgery and in 1 patient (14%) after carbon ion RT. The functional outcome evaluated using the Musculoskeletal Tumor Society scoring system revealed 55% in the surgery group and 75% in the carbon ion RT group. Of the six factors in this scoring system, the carbon ion RT group had significantly greater scores in emotional acceptance than did the surgery group. Conclusion: Carbon ion RT results in a high local control rate and preservation of urinary-anorectal function compared with surgery.

  15. Radiotherapy after surgery to dermato-fibrosarcoma protuberans of large dimension. Review of the literature and case report

    International Nuclear Information System (INIS)

    Bastos, Erika Malheiros; Santos, Ivan Dunshee de Abranches Oliveira; Ferreira, Lydia Masako; Paiva, Geruza Rezende; Brunstein, Flavia; Lima, Alessandra Haddad de; Segreto, Roberto

    2004-01-01

    Dermato-fibrosarcoma protuberans is a low incidence skin neoplasia of difficult management due to its high recurrence rate. Usual treatment consists of a large resection, some times causing functional and aesthetics impairment, and despite these efforts, published data point to a recurrence rate of 11% to 53%. Recently, radiotherapy has been used modifying the unreal course of this tumor, decreasing drastically the recurrence rate when compared to surgery only. We reviewed these treatment modalities and related three cases of large recurrent tumors treated in our plastic surgery department with surgery and adjuvant radiotherapy, without recurrences after 2 years follow up. (author)

  16. The role of neck surgery in patients with primary oropharyngeal cancer treated by radiotherapy

    International Nuclear Information System (INIS)

    Peters, Lester J.; Weber, Randal S.; Morrison, William H.; Byers, Robert M.; Garden, Adam S.; Goepfert, Helmuth

    1996-01-01

    Purpose: The role of neck surgery in node- positive patients whose primary tumours are treated by definitive radiotherapy is controversial. A planned neck dissection following radiotherapy is frequently recommended regardless of response of the neck nodes to treatment. This analysis was undertaken to assess the risk of withholding planned neck dissection in patients who obtain a complete nodal response to irradiation. Materials and Methods: The analysis is based on all 100 patients treated using the concomitant boost protocol described below who presented between 1984 and 1993 with primary squamous cell carcinomas of the oropharynx and clinically positive cervical lymphadenopathy. There were 73 males and 27 females with a median age of 59. Primary disease site was base of tongue 39, tonsil 40, soft palate 14 and pharyngeal wall 7. Nodal stages were N1: 35, N2: 51 and N3: 15. Nodal size varied from 1 - 9 cm with a median of 3 cm. Radiotherapy consisted of 54 Gy in 30 fractions over 6 weeks to large fields with a boost to gross disease of 18 Gy in 12 fractions being delivered as a second daily fraction during the last 2.4 weeks of treatment. Seventy-five patients had their nodal disease treated definitively by radiotherapy; those who had complete clinical resolution of all nodal disease (62) had no planned surgery, while the remaining 13 underwent neck dissection for presumed residual disease. Twenty-five patients had either node excision (8) or neck dissection (17) prior to radiotherapy. Results: There were 8 cases of isolated neck failure of which 3 occurred in the 62 patients who had no planned neck surgery, 0 in the 13 patients who were operated for presumed residual disease (pathologically negative in 7) and 5 in the 25 patients who had initial neck surgery. Of the 62 patients who had a complete response to radiotherapy, the two year probability of neck control was 87% if the initial nodal size was ≤ 3 cm versus 85% for nodes > 3 cm. However the likelihood of

  17. Response of pulmonary artery intimal sarcoma to surgery, radiotherapy and chemotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Long Hong-qing

    2008-06-01

    Full Text Available Abstract Introduction Pulmonary artery intimal sarcoma is a rare disease with no characteristic symptoms. It is difficult to diagnose early and is frequently misdiagnosed as a pulmonary embolism. Case presentation Here we report a case of pulmonary artery intimal sarcoma in a 54-year-old woman presenting with complaints of shortness of breath on exertion. Echocardiography and a computed tomography scan showed that the right pulmonary artery trunk was blocked by a low-density mass. The patient was diagnosed with pulmonary artery intimal sarcoma by pathology and a complete mass resection was performed. After experiencing 10 months of disease-free survival, she was re-admitted because of the recurrence and metastasis of the tumor. Radiotherapy and chemotherapy were performed; however, only limited success was achieved. The patient died 15 months after the initial onset of symptoms. Conclusion Some patients with intimal sarcoma of the pulmonary artery can benefit from radiotherapy and chemotherapy as well as surgery.

  18. Long-Term Results of Targeted Intraoperative Radiotherapy (Targit) Boost During Breast-Conserving Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Vaidya, Jayant S., E-mail: jayant.vaidya@ucl.ac.uk [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Baum, Michael [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Tobias, Jeffrey S. [Department of Radiation Oncology, University College London Hospitals, London (United Kingdom); Wenz, Frederik [Radiation Oncology and Gynaecology, University Medical Centre of Mannheim (Germany); Massarut, Samuele [Surgery and Radiation Oncology, Centro di Riferimento Oncologico (CRO), Aviano (Italy); Keshtgar, Mohammed [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Hilaris, Basil [Radiation Oncology, Our Lady of Mercy, New York Medical College, New York (United States); Saunders, Christobel [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Williams, Norman R.; Brew-Graves, Chris [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Corica, Tammy [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Roncadin, Mario [Surgery and Radiation Oncology, Centro di Riferimento Oncologico (CRO), Aviano (Italy); Kraus-Tiefenbacher, Uta; Suetterlin, Marc [Radiation Oncology and Gynaecology, University Medical Centre of Mannheim (Germany); Bulsara, Max [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Joseph, David [Radiation Oncology, Sir Charles Gairdner Hospital and School of Surgery, University of Western Australia, Perth (Australia)

    2011-11-15

    Purpose: We have previously shown that delivering targeted radiotherapy to the tumour bed intraoperatively is feasible and desirable. In this study, we report on the feasibility, safety, and long-term efficacy of TARGeted Intraoperative radioTherapy (Targit), using the Intrabeam system. Methods and Materials: A total of 300 cancers in 299 unselected patients underwent breast-conserving surgery and Targit as a boost to the tumor bed. After lumpectomy, a single dose of 20 Gy was delivered intraoperatively. Postoperative external beam whole-breast radiotherapy excluded the usual boost. We also performed a novel individualized case control (ICC) analysis that computed the expected recurrences for the cohort by estimating the risk of recurrence for each patient using their characteristics and follow-up period. Results: The treatment was well tolerated. The median follow up was 60.5 months (range, 10-122 months). Eight patients have had ipsilateral recurrence: 5-year Kaplan Meier estimate for ipsilateral recurrence is 1.73% (SE 0.77), which compares well with that seen in the boosted patients in the European Organization for Research and Treatment of Cancer study (4.3%) and the UK STAndardisation of breast RadioTherapy study (2.8%). In a novel ICC analysis of 242 of the patients, we estimated that there should be 11.4 recurrences; in this group, only 6 recurrences were observed. Conclusions: Lumpectomy and Targit boost combined with external beam radiotherapy results in a low local recurrence rate in a standard risk patient population. Accurate localization and the immediacy of the treatment that has a favorable effect on tumour microenvironment may contribute to this effect. These long-term data establish the long-term safety and efficacy of the Targit technique and generate the hypothesis that Targit boost might be superior to an external beam boost in its efficacy and justifies a randomized trial.

  19. A comparison of radiotherapy with radiotherapy plus surgery for brain metastases from urinary bladder cancer. Analysis of 62 patients

    Energy Technology Data Exchange (ETDEWEB)

    Engenhart-Cabillic, Rita [Dept. of Radiotherapy and Radiation Oncology, Philipps Univ. Marburg (Germany); Fokas, Emmanouil; Henzel, Martin

    2010-10-15

    Purpose: To evaluate the role of radiotherapy (RT) and prognostic factors in 62 patients with brain metastases from transitional cell carcinoma (TCC) of the urinary bladder. Patients and Methods: 62 patients received either RT (n = 49), including whole-brain radiotherapy (WBRT) and/or stereotactic radiosurgery (SRS), or surgery (OP) combined with WBRT (n = 13). Overall survival (OS), intracerebral control (ICC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to RT. Results: Median OS and ICC for the entire cohort were 9 and 7 months. No significant difference between RT and OP + RT was found for OS (p = 0.696) and ICC (p = 0.996). On multivariate analysis, improved OS was associated with lack of extracerebral metastases (p < 0.001) and RPA class (p < 0.001), and ICC with the latter (p < 0.001). SRS-incorporating RT resulted in 1-, 2-, and 3-year LC probability of 78%, 66%, and 51%. No association between LC and any of the potential prognostic factors was observed. The results of the subgroup RPA class analyses were similar to the entire cohort. Conclusion: Patient outcome for the RT-alone arm was not significantly different from OP + RT. SRS-incorporating treatment offers excellent LC rates. RPA class and the presence of extracerebral metastases demonstrated a significant prognostic role for survival. The latter should be used as stratification factors in randomized trials and can help define the cohort of patients that may benefit from more aggressive therapies. (orig.)

  20. 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)

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

    International Nuclear Information System (INIS)

    MacLeod, C.; O'Donnell, A.; Tattersall, M.H.N.; Dalrymple, C.; Firth, I.

    2001-01-01

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

  2. 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

  3. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma.

    Science.gov (United States)

    Pierie, Jean-Pierre E N; Muzikansky, Alona; Gaz, Randall D; Faquin, William C; Ott, Mark J

    2002-01-01

    Anaplastic thyroid carcinoma (ATC) is an aggressive rare tumor. We analyzed our experience for prognosis and the effect of surgery and radiotherapy on patients with ATC. We conducted a retrospective review of all patients (n = 67) with ATC treated at a tertiary care center from 1969 to 1999. Survivor median follow-up was 51 months. Tumor and patient characteristics and therapy were assessed for effect on survival by multivariate analysis. Patients presented with a neck mass (99%), change of voice (51%), dysphagia (33%), and dyspnea (28%). Surgery was performed in 44 of 67 patients, with 12 complete resections. The 6-month and 1- and 3-year survival rates were 92%, 92%, and 83% after complete resection; 53%, 35%, and 0% after debulking; and 22%, 4%, and 0% after no resection, respectively (P 45 Gy improved survival as compared with a lower dose (P = .02). Multivariate analysis showed that age 45 Gy improves outcome.

  4. Treatment of Early Stage Non-Small Cell Lung Cancer: Surgery or Stereotactic Ablative Radiotherapy?

    Directory of Open Access Journals (Sweden)

    Esengül Koçak Uzel

    2015-03-01

    Full Text Available The management of early-stage Non-small Cell Lung Cancer (NSCLC has improved recently due to advances in surgical and radiation modalities. Minimally-invasive procedures like Video-assisted thoracoscopic surgery (VATS lobectomy decreases the morbidity of surgery, while the numerous methods of staging the mediastinum such as endobronchial and endoscopic ultrasound-guided biopsies are helping to achieve the objectives much more effectively. Stereotactic Ablative Radiotherapy (SABR has become the frontrunner as the standard of care in medically inoperable early stage NSCLC patients, and has also been branded as tolerable and highly effective. Ongoing researches using SABR are continuously validating the optimal dosing and fractionation schemes, while at the same time instituting its role for both inoperable and operable patients.

  5. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    Energy Technology Data Exchange (ETDEWEB)

    Couto, Henrique Lima, E-mail: enriquecouto@hotmail.com [Santa Fe Women' s and Maternity Hospital, Belo Horizonte, MG (Brazil); Amorim, Washington Cancado; Guimaraes, Rodrigo [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital Geral; Ramires, Leandro Cruz; Castilho, Marcus Simoes [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Fac. de Medicina; Dominguez, Lorena Lima Coto [Universidade Estacio de Sa (UNESA), Rio de Janeiro, EJ (Brazil)

    2014-07-15

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  6. Vertical mammaplasty associated with accelerated partial breast radiotherapy: how oncoplastic surgery techniques associated with modern techniques of radiotherapy can improve the aesthetic outcome in selected patients

    International Nuclear Information System (INIS)

    Couto, Henrique Lima; Amorim, Washington Cancado; Guimaraes, Rodrigo

    2014-01-01

    Breast cancer is the second most common type of cancer in the world, being the most common among women, responsible for 22% of new cases each year. It's surgical and radiation treatment evolved from radical procedures (Halsted radical mastectomy and total external breast radiotherapy) to less radical and more conservative procedures. With the use of modern oncoplastic surgery techniques and accelerated partial breast radiotherapy, selected patients can benefit with better aesthetic results, fewer side effects, and more comfortable and brief treatments. (author)

  7. 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

  8. Swallowing assessment in early laryngeal cancer patients treated either with surgery or radiotherapy

    International Nuclear Information System (INIS)

    Celedon L, Carlos; Gambi A, Galo; Royer F, Michel; Esquivel C, Patricia; Arteaga J, Patricia; Valdes P, Constanza

    2008-01-01

    Swallowing is a complex neuromuscular process that requires anatomical indemnity and an adequate coordination of several organs. Laryngeal cancer treatment may cause swallowing disorders. Traditionally, a high frequency of this type of disorder after surgery has been reported, but no actual data concerning its incidence in patients undergoing radiotherapy for early laryngeal cancer has been published. Aim. To compare swallowing disorders frequency posterior to treatment in early laryngeal cancer patients. Material and Method. Two groups of early laryngeal cancer patients were transversally studied, one treated with vertical partial surgery (CP), and the other treated exclusively with radiotherapy. Each patient had otorhinolaryngological, nasofibroscopic and video fluoroscopic evaluations after treatment. Differences between groups were compared using the - square test. Results. Twenty patients per group were entered in this study, predominantly males of similar age. Both groups presented a high incidence of aspiration symptoms (55% in RT and 35% in CP). There were no significant differences between both groups. Discussion and Conclusion. A high incidence of swallowing disorders in patients treated for early laryngeal cancer was found. It should then be considered as a frequent alteration in this group of patients, either treated with RT or CP

  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. Long-term outcomes of surgery and radiotherapy for secreting and non-secreting pituitary adenoma

    International Nuclear Information System (INIS)

    Kim, Mi Young; Kim, Jin Hee; Oh, Young Kee; Kim, El

    2016-01-01

    To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma

  11. Long-term outcomes of surgery and radiotherapy for secreting and non-secreting pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Young; Kim, Jin Hee; Oh, Young Kee; Kim, El [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2016-06-15

    To investigate treatment outcome and long term complication after surgery and radiotherapy (RT) for pituitary adenoma. From 1990 to 2009, 73 patients with surgery and RT for pituitary adenoma were analyzed in this study. Median age was 51 years (range, 25 to 71 years). Median tumor size was 3 cm (range, 1 to 5 cm) with suprasellar (n = 21), cavernous sinus extension (n = 14) or both (n = 5). Hormone secreting tumor was diagnosed in 29 patients; 16 patients with prolactin, 12 patients with growth hormone, and 1 patient with adrenocorticotrophic hormone. Impairment of visual acuity or visual field was presented in 33 patients at first diagnosis. Most patients (n = 64) received RT as postoperative adjuvant setting. Median RT dose was 45 Gy (range, 45 to 59.4 Gy). Median follow-up duration was 8 years (range, 3 to 22 years). In secreting tumors, hormone normalization rate was 55% (16 of 29 patients). For 25 patients with evaluable visual field and visual acuity test, 21 patients (84%) showed improvement of visual disturbance after treatment. The 10-year tumor control rate for non-secreting and secreting adenoma was 100% and 58%, respectively (p < 0.001). Progression free survival rate at 10 years was 98%. Only 1 patient experienced endocrinological recurrence. Following surgery, 60% (n = 44) suffered from pituitary function deficit. Late complication associated with RT was only 1 patient, who developed cataract. Surgery and RT are very effective and safe in hormonal and tumor growth control for secreting and non-secreting pituitary adenoma.

  12. 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)

  13. Surgery or stereotactic body radiotherapy for elderly stage I lung cancer? A propensity score matching analysis.

    Science.gov (United States)

    Miyazaki, Takuro; Yamazaki, Takuya; Nakamura, Daisuke; Sato, Shuntaro; Yamasaki, Naoya; Tsuchiya, Tomoshi; Matsumoto, Keitaro; Kamohara, Ryotaro; Hatachi, Go; Nagayasu, Takeshi

    2017-12-01

    The aim of this study was to compare the outcomes of surgery and stereotactic body radiotherapy (SBRT) for elderly clinical stage I non-small cell lung cancer (NSCLC) patients. Patients ≥80 years of age with clinical stage I NSCLC between August 2008 and December 2014 were treated either surgery or SBRT. Propensity score matching was performed to reduce bias in various clinicopathological factors. Surgery was performed in 57 cases and SBRT in 41 cases. In the surgery group, the operations included 34 lobectomies and 23 sublobar resections. In the SBRT group, 27 cases were given 48 Gy in 4 fractions, and 14 were given 60 Gy in 10 fractions. Similar characteristics were identified in age (82 years), gender (male:female ratio 2:1), tumor size (2.2 cm), carcinoembryonic antigen (3.6 ng/ml), Charlson comorbidity index (1), Glasgow prognostic scale (0), and forced expiratory volume in 1 s (1.7 L) after matching. Before matching, the 5-year overall survival (OS) in surgery (68.3%) was significantly better than that in SBRT (47.4%, p = 0.02), and the 5-year disease-specific survival (DSS) (94.1%, 78.2%, p = 0.17) was not significantly different between the groups. The difference in the 5-year OS became non-significant between the matched pairs (57.0%, 49.1%, p = 0.56). The outcomes of surgery and SBRT for elderly patients with the early stage NSCLC were roughly the same.

  14. Do elderly patients benefit from surgery in addition to radiotherapy for treatment of metastatic spinal cord compression?

    International Nuclear Information System (INIS)

    Rades, D.; Huttenlocher, S.; Evers, J.N.; Bajrovic, A.; Karstens, J.H.; Rudat, V.; Schild, S.E.

    2012-01-01

    Treatment of elderly cancer patients has gained importance. One question regarding the treatment of metastatic spinal cord compression (MSCC) is whether elderly patients benefit from surgery in addition to radiotherapy? In attempting to answer this question, we performed a matched-pair analysis comparing surgery followed by radiotherapy to radiotherapy alone. Data from 42 elderly (age > 65 years) patients receiving surgery plus radiotherapy (S + RT) were matched to 84 patients (1:2) receiving radiotherapy alone (RT). Groups were matched for ten potential prognostic factors and compared regarding motor function, local control, and survival. Additional matched-pair analyses were performed for the subgroups of patients receiving direct decompressive surgery plus stabilization of involved vertebrae (DDSS, n = 81) and receiving laminectomy (LE, n = 45). Improvement of motor function occurred in 21% after S + RT and 24% after RT (p = 0.39). The 1-year local control rates were 81% and 91% (p = 0.44), while the 1-year survival rates were 46% and 39% (p = 0.71). In the matched-pair analysis of patients receiving DDSS, improvement of motor function occurred in 22% after DDSS + RT and 24% after RT alone (p = 0.92). The 1-year local control rates were 95% and 89% (p = 0.62), and the 1-year survival rates were 54% and 43% (p = 0.30). In the matched-pair analysis of patients receiving LE, improvement of motor function occurred in 20% after LE + RT and 23% after RT alone (p = 0.06). The 1-year local control rates were 50% and 92% (p = 0.33). The 1-year survival rates were 32% and 32% (p = 0.55). Elderly patients with MSCC did not benefit from surgery in addition to radiotherapy regarding functional outcome, local control of MSCC, or survival. (orig.)

  15. 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

  16. 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

  17. 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

  18. 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.

  19. Results of salvage radiotherapy after inadequate surgery in invasive cervical carcinoma patients: A retrospective analysis

    International Nuclear Information System (INIS)

    Saibishkumar, Elantholi P.; Patel, Firuza D.; Ghoshal, Sushmita; Kumar, Vinay; Karunanidhi, Gunaseelan; Sharma, Suresh C.

    2005-01-01

    Purpose: To evaluate the results of salvage radiotherapy (RT) after inadequate surgery in patients with invasive carcinoma of the cervix. Methods and Materials: Between 1996 and 2001, 105 invasive cervical carcinoma patients were treated at our center with external beam RT with or without intracavitary RT after having undergone total/subtotal hysterectomy at outside institutions. Results: The median follow-up was 34 months. The gap between surgery and RT was 23-198 days (median, 80). Clinically visible residual disease was present in 81 patients (77.1%). Total hysterectomy had been done in 82 patients (78%) and subtotal hysterectomy in 23 patients (22%). The 5-year overall survival, disease-free survival, and pelvic control rates of all patients were 55.2%, 53.3%, and 72.4%, respectively. On univariate analysis, older age, total hysterectomy, hemoglobin level >10 g% before RT, nonsquamous histologic type, use of intracavitary RT, a shorter gap between surgery and RT, and the absence of, or a small volume of, residual disease favorably affected the outcome. The 5-year actuarial rate of late toxicity (Radiation Therapy Oncology Group Criteria) was 19% in the rectum, 4.8% in the bladder, 24.8% in the skin, and 14.3% in the small intestine. Conclusions: Inadequate and inappropriate surgery in invasive cervical cancer with resulting gross residual disease is common in India. Factors such as the use of intracavitary RT, the correction of anemia, and a shorter gap between surgery and RT will enable postoperative RT to achieve acceptable results with minimal morbidity

  20. Effect of integrated surgery + radiotherapy + chemotherapy treatment on survival status and serum indexes in patients with gallbladder carcinoma

    Directory of Open Access Journals (Sweden)

    Zhi-Li Wei

    2016-12-01

    Full Text Available Objective: To study the effect of integrated surgery + radiotherapy + chemotherapy treatment on the survival status and serum indexes in patients with gallbladder carcinoma. Methods: A total of 68 patients with gallbladder carcinoma were divided into observation group (received integrated surgery + radiotherapy + chemotherapy treatment and control group (received surgery + radiotherapy according to different treatments. Differences in the content of tumor markers, growth factors and adhesion molecules in serum as well as the median survival time and survival rate in 5 years of follow-up were compared between the two groups 1 month after treatment. Results: Tumor markers β2-MG, CA19-9, CA242, CA125, CA724, CEA and AFP content in serum of observation group after treatment were significantly lower than those of control group; growth factors VEGF, FGF, EGFR and HER2 content in serum were significantly lower than those of control group while IGFBP-2 and IGFBP-3 content were significantly higher than those of control group; adhesion molecules E-selectin, ICAM-1, VCAM-1 and sE-Cd content in serum were significantly lower than those of control group; the median survival time of 5-year follow-up as well as 1-, 3- and 5-year survival rate were significantly greater than those of control group. Conclusions: Integrated treatment of surgery + radiotherapy + chemotherapy can optimize the short-term and long-term curative effect in patients with gallbladder carcinoma.

  1. Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer

    NARCIS (Netherlands)

    N. Verstegen (Naomi); A.W.P.M. Maat (Alex); F.J. Lagerwaard (Frank); M.A. Paul (Marinus); M. Versteegh (Michel); J.J. Joosten (Joris); W. Lastdrager (Willem); E.F. Smit (Egbert); B.J. Slotman (Ben); J.J.M.E. Nuyttens (Joost); S. Senan (Suresh)

    2016-01-01

    markdownabstract__Introduction:__ The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence

  2. 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.

  3. 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

  4. Soft Tissue Sarcoma: A Prognostic Variables and Treatment Outcomes after Chemo - Radiotherapy and Conservative Surgery

    International Nuclear Information System (INIS)

    Abaza, A.; El-Shanshoury, H.

    2015-01-01

    Soft tissue sarcomas (STS) constitute a group of rare and heterogeneous cancers, that diverse a wide spectrum of histology and varied clinical behavior. The aim was to study, retrospectively the clinico-epidemiologic manifestation, response to therapy and prognostic factors of retroperitoneal (RPS), extremity and other STS patients treated with conservative surgery plus chemo - radiotherapy (CRT) attending the Pediatric Oncology Clinic, National Cancer Institute (NCI), Cairo University during 6 years period (inclusive). Files of 66 STS patients were revised for history, staging, investigations, treatment modalities and outcome of therapy. Their ages ranged from 6 months to 21 years. The male to female ratio was 1.87:1. Most of the patients belong to stage 3 and 1. Radiotherapy (RTH) and surgery remains the backbone of the multi - modality treatment plan. Complete remission (CR) was obtained in 80.3% of STS patients. Meanwhile, 6% of cases had disease progression and 6% died. The 2 - years overall survival rate (OS) and Disease - free survivals (DFS) we re 74.2% and 57.6% respectively. However, 20.8% of patients develop relapse>2 years after the end of treatment. Age at diagnosis, stage of the disease, tumor mass, pathological subtype and the RTH used were statistically significant prognostic variables affecting survival. Finally, the use of RTH in the treatment of STS gives positive impact on the survival of patients. Recommendation regarding further studies would be required to identify methods of increasing the radiation dose selectively. Also, using the newly developed radiation technologies to make dose escalation and sparing normal tissue

  5. Clinical outcome and cosmetics in breast cancer patients treated with conservative surgery and radiotherapy

    International Nuclear Information System (INIS)

    Li Rongqing; Jin Yening; Wang Yajie

    2005-01-01

    Objective: To evaluate the effectiveness and the cosmetics result of radiotherapy after conservative surgery for early breast cancer. Methods: Altogether 109 patients were treated by post-operative whole-breast irradiation and a tumor bed boost from May, 1995 to December, 2002. Among them 79 cases received a brachytherapy boost ( 192 Ir HDR implant Nucletron ) of 10-12 Gy(DB) by single plan of implantation with 1.5 cm between the needles for T1 and double plan for T2-4 tumors, and 30 cases received an electron beam boost with 15 Gy. External beam irradiation was applied to the whole breast with 45-52 Gy(mean 48.6 Gy) in 25 fractions over 5 weeks followed or concurrently with chemotherapy (CMF or CEF) and hormonotherapy. The cosmetic result was scored by a doctor and patients via questionnaire. Results: The median follow-up time was 52 months. The actuarial 5-year overall survival rate was 93.8% using Kaplan-Meier method and the within breast recurrence rate was 6.5%. No radiation- induced ulcer in the breast occurred except acute inflammation of skin around the pinholes in 5 patients. Cosmetic results were scored to be good by patients and the doctor (81% and 87%, respectively) for 75 followed-up cases, and good cosmetic rate was reported by the doctor for 82% (39/48) of the cases treated with brachytherapy boost and 85.2%(23/27) for those treated with external beam boost. There was no difference in cosmetic results between these two groups(P>0.05). Conclusion: In patients at high risk for local recurrence, tumor-bed boost with brachytherapy or electron beam carried out after limited surgery and external radiotherapy can provide satisfactory local control without morbidity. Cosmetic result may not be influenced by the boost technique. (authors)

  6. 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

  7. Radiotherapy With or Without Surgery for Patients With Idiopathic Sclerosing Orbital Inflammation Refractory or Intolerant to Steroid Therapy

    International Nuclear Information System (INIS)

    Lee, Jong Hoon; Kim, Yeon-Sil; Yang, Suk Woo; Cho, Won-Kyung; Lee, Sang Nam; Lee, Kyung Ji; Ryu, Mi-Ryeong; Jang, Hong Seok

    2012-01-01

    Purpose: To evaluate the outcomes of patients with idiopathic sclerosing orbital inflammation (ISOI) treated with radiotherapy with or without surgery. Methods and Materials: We retrospectively reviewed 22 patients with histopathologically confirmed ISOI who had been refractory or intolerant to steroid therapy and treated with radiation with or without surgery. The radiation dose ranged from 20 to 40 Gy (median, 20 Gy) at 2 Gy per fraction. Presenting signs and treatment outcomes were assessed. Results: Proptosis was the most common sign at presentation, seen in 19 (86.3%) patients, followed by restriction of extraocular movements in 10 (45.4%) patients. Response to radiotherapy was complete in 15 (68.1%) patients, partial in 3 (13.6%) patients, and none in 4 (18.2%) patients. At the median follow-up of 34 months, 14 (63.6%) patients had progression-free state of symptoms and signs, with the progression-free duration ranging from 3 to 75 months (median, 41.5 months), whereas 8 (36.4%) patients had recurrent or persistent disease although they had received radiotherapy. Of the 14 progression-free patients, 6 underwent a bimodality treatment of debulking surgery of ocular disease and radiotherapy. They had had no recurrent disease. Cataract was the most common late complications, and 2 patients experienced a Grade 3 cataract. Conclusion: Our study suggests that for patients with ISOI who are refractory or intolerant to steroid therapy, 20 Gy of radiotherapy appears to be effective for the control of disease with acceptable complications, especially when it is combined with surgery.

  8. Factors influencing survival in patients with brain tumors treated with surgery and radiotherapy

    International Nuclear Information System (INIS)

    Chi Ramirez, Daysi; Chon Rivas, Ivonne; Leon Gonzalez, Roberto; Diaz Martinez, Jose Ramon; Silva, Jose; Pestana, Elia; Portilla, Ivette

    2006-01-01

    Factors influencing survival (SV) in patients with brain tumors (BT) have a predictive value and are an angle of study in neuro-oncology and biomedical research. A retrospective study was carried out in 59 consecutive between 16 and 70 years old patients, with histological diagnoses of BT who received external fractioned radiotherapy (RT), from December 1997 to February 2002. The main diagnoses were characterized and a statistical analysis was employed to correlate SV (in week) with age, histology, localization, tumor resection percentage, time between surgery and RT, doses, technique and duration of RT, and Karnofsky Performance Score at the end of RT. Mean SV of BT was 94,3 wks (gliomas 97,9 wks; hypophysis adenomas 163,2 wks and medulloblatomas 104,2 wks). Low grade gliomas had higher SV (129,7 wks) than high grade gliomas (57,1 wks). Histology (p=0.0004) and age (the younger the better SV) (p=0.036) were variables influencing SV. Conclusion: SV in patients with BT alter RT was influenced by histology and age in this study, but tumor resection percentage, time between surgery and RT doses, technique and duration of RT and Karnofsky Performance Sore at the end of RT did not influence in SV for these patients. (The author)

  9. 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)

  10. 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

  11. Malignant fibrous histiocytoma: outcome and prognostic factors following conservation surgery and radiotherapy

    International Nuclear Information System (INIS)

    Zagars, Gunar K.; Mullen, John R.; Pollack, Alan

    1996-01-01

    Purpose: Malignant fibrous histiocytoma is the most common type of soft tissue sarcoma. This communication presents an analysis of outcome and prognostic factors based on a retrospective review of patients with this disease treated by conservation surgery and radiotherapy. Methods and Materials: From 1966 to 1991, 271 consecutive patients with malignant fibrous histiocytoma were treated with conservation surgery and radiotherapy. The outcome with local control, metastatic relapse, and survival as end points was evaluated by univariate and multivariate statistics to delineate independently significant prognostic factors. Results: Postoperative radiation at a mean dose of 62.8 Gy was used in 195 patients and preoperative radiation at a mean dose of 50 Gy was used in 76 patients. At a median follow-up of 7.3 years, 123 patients (45%) developed disease relapse at some site. Fifty-seven (21%) developed local recurrence leading to an actuarial local relapse rate of 26% at 10 years, 83 (31%) developed metastatic relapse for a 10-year actuarial metastatic rate of 33%, and the 5-, 10-, and 15-year survival rates were 68, 60, and 46%, respectively. For local control, prior local recurrence (in 53 patients) was identified as an adverse factor, yielding a 10-year recurrence rate of 42% compared to 22% for 218 patients without prior disease (p 5 cm), and histology (myxoid vs. nonmyxoid) were not significant determinants of local outcome. For metastatic relapse, the major determinants of outcome were histology (myxoid vs. nonmyxoid) and tumor size. Myxoid tumors (59 patients) had a low metastatic propensity (13% 10-year metastatic rate) compared to nonmyxoid tumors (212 patients) (40% 10-year metastatic rate) (p 5 cm) were the only independent determinants of outcome. Conclusion: Malignant fibrous histiocytoma is a heterogeneous disease and its myxoid variant must be recognized as a distinct entity. Both variants are locally aggressive and require equally aggressive local

  12. Analysis of whole Breast Radiotherapy Methods for Treatment of Early Stage Breast Cancer after Conserving Surgery

    International Nuclear Information System (INIS)

    Utehina, O.; Popovs, S.; Berzins, J.

    2007-01-01

    Introduction. At present moment breast cancer in Latvia is at second place for whole population and at first place among women. In year 2004 there were 1012 new breast cancer cases discovered. There was growth in number of breast cancer patients from 58.6 per 100 000 inhabitants in 1995 to 80.4 per 100 000 inhabitants in 2004. This growth is primarily attributed to breast cancer screening program which is nowadays active in Latvia. Breast cancer is third death cause among cancers in Latvia, - in 1995 there where 27.4 deaths per 100 000 inhabitants and in 2004 - 36.2 deaths per 100 000 inhabitants. Due to screening program there is increasing number of patients with stage I and II breast cancer. In 2004 toe where 9884 women with breast cancer registered in Latvian Cancer Registry and among them 79 percent were presented as stage I or II. Breast conservative surgery with adjuvant radiotherapy as standard part of it plays great role in breast cancer treatment in our Center. In year 2004 there were 103 breast conservative surgeries performed in our Center. Radiotherapy is a standard part of treatment in modem breast saving operations for early stage breast cancer, At present, only whole breast postoperative irradiation is performed in Latvia. For selected group of patients this treatment can be substituted with other radiotherapy methods in order to reduce acute reactions and/or late toxicity, maintaining the same tumor control. Aim of this work is to show that during whole breast irradiation dose maximum and tissue volume which receives doses more than 105% from prescribed dose, is linked with size of treated volume (treated volume - tissue volume receiving > 95% from prescribed dose), which is strictly linked with breast volume. Because of this for large breast volumes there is higher complication probability performing whole breast irradiation, and it seems to be meaningful to use Intensity Modulated Radiotherapy or Accelerated Partial Breast Irradiation for

  13. Subgame consistent cooperation a comprehensive treatise

    CERN Document Server

    Yeung, David W K

    2016-01-01

    Strategic behavior in the human and social world has been increasingly recognized in theory and practice. It is well known that non-cooperative behavior could lead to suboptimal or even highly undesirable outcomes. Cooperation suggests the possibility of obtaining socially optimal solutions and the calls for cooperation are prevalent in real-life problems. Dynamic cooperation cannot be sustainable if there is no guarantee that the agreed upon optimality principle at the beginning is maintained throughout the cooperation duration. It is due to the lack of this kind of guarantees that cooperative schemes fail to last till its end or even fail to get started. The property of subgame consistency in cooperative dynamic games and the corresponding solution mechanism resolve this “classic” problem in game theory. This book is a comprehensive treatise on subgame consistent dynamic cooperation covering the up-to-date state of the art analyses in this important topic. It sets out to provide the theory, solution tec...

  14. Long-term results of salvage radiotherapy for the treatment of recurrent cervical carcinoma after prior surgery

    International Nuclear Information System (INIS)

    Haasbeek, Cornelis J.A.; Uitterhoeve, Apollonia L.J.; Velden, Jacobus van der; Gonzalez, Dionisio Gonzalez; Stalpers, Lukas J.A.

    2008-01-01

    Abstarct: Background and purpose: Tumor recurrence after surgery for cervical carcinoma is associated with high fatality and morbidity, forming a major therapeutic challenge. This paper presents our experience with treatment of this patient group by salvage radiotherapy with curative intent. Materials and methods: Thirty-five patients with a pelvic recurrence after hysterectomy received high-dose radiotherapy. A retrospective analysis of long-term outcome and prognostic factors was performed. Results: After a median follow-up period of 12.1 years, actuarial 2-,5- and 10-year overall survival rates were 66%, 43% and 33%; disease-free survival rates were 62%, 45% and 41%, respectively. Pelvic control rates at 2-,5- and 10-years were 77%, 69% and 62%. Unfavorable prognostic factors on univariate analysis for survival were: recurrence extending to the pelvic wall versus central recurrence, early recurrence after surgery, external boost versus brachytherapy boost, low total dose and high age. Only a brachytherapy boost and a long interval between surgery and recurrence were significant on multivariate analysis. Severe complications (≥grade 3) were seen in 6 patients (17%; actuarial after 5 years, 21%). Conclusions: Salvage radiotherapy for recurrent cervical carcinoma following surgery may result in 40-50% long-term disease-free survival and an acceptable risk of severe treatment complications, even in patient with recurrences extending to the pelvic wall

  15. Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

    International Nuclear Information System (INIS)

    Choi, Yunseon; Ahn, Ki Jung; Park, Sung Kwang; Cho, Heung Lae; Lee, Ji Young

    2017-01-01

    This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was 22.8 kg/m2 (range, 17.7 to 35.9 kg/m2). The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, BMI ≥ 23 kg/m2) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes

  16. Endoscopic Transsphenoidal Salvage Surgery for Symptomatic Residual Cystic Craniopharyngioma after Radiotherapy.

    Science.gov (United States)

    Emanuelli, Enzo; Frasson, Giuliana; Cazzador, Diego; Borsetto, Daniele; Denaro, Luca

    2018-04-01

    Objectives  Ideal treatment of craniopharyngiomas is still controversial. Radiotherapy (RT) is considered effective for recurrences or after subtotal tumor removal (STR). About 40 to 50% of patients may experience tumor cyst expansion soon after RT; in these cases, the role of salvage surgery is debated. Design  Operative video. Setting  Tertiary care center. Participants  An 11-year-old boy diagnosed with persistent craniopharyngioma. In 2015, the patient underwent right frontotemporal craniotomy for STR at another center, complicated by panhypopituitarism. Two years later, fractionated 54-Gy RT was performed on growing residual tumor. After 3 months, he was admitted to our hospital due to persistent malaise, vomiting, pulsating headache, and epistaxis. Ophthalmologic evaluation evidenced left homonymous hemianopsia. Results  A contrast-enhanced magnetic resonance imaging (MRI) showed a 27-mm cystic component enlarging from the cranial end of the persistent craniopharyngioma lesion, extending into the third ventricle. Biventricular hydrocephalus and brain midline shift to the right were present. Compared with the early post-RT MRI, the cystic component of the tumor demonstrated growth. The patient underwent external ventricular drainage placement for emergent treatment of hydrocephalus and endoscopic transsphenoidal surgery. After cystic content drainage, the lesion was completely removed with its capsule. A "gasket seal" technique was performed for skull base reconstruction, with autologous fascia lata, septal bone, and mucoperiosteum from inferior turbinate. Histologic examination confirmed the craniopharyngioma diagnosis. Postoperative MRI showed resolution of the hydrocephalus and complete tumor removal. Conclusion  Although shrinkage of cystic components of craniopharyngioma residuals may occur within 5 to 6 months after RT, salvage surgery is indicated in symptomatic patients. The link to the video can be found at https://youtu.be/4x6Qe76bf60 .

  17. Subclinical ductal carcinoma in situ of the breast: treatment with conservative surgery and radiotherapy.

    Science.gov (United States)

    Amichetti, M; Caffo, O; Richetti, A; Zini, G; Rigon, A; Antonello, M; Roncadin, M; Coghetto, F; Valdagni, R; Fasan, S; Maluta, S; Di Marco, A; Neri, S; Vidali, C; Panizzoni, G; Aristei, C

    1999-01-01

    In spite of the fact that ductal carcinoma in situ (DCIS) of the breast is a frequently encountered clinical problem, there is no consensus about the optimal treatment of clinically occult (i.e., mammographic presentation only) DCIS. Interest in breast conservation therapy has recently increased. Few data are available in Italy on the conservative treatment with surgery and adjuvant postoperative radiotherapy. A retrospective multi-institutional study was performed in 15 Radiation Oncology Departments in northern Italy involving 112 women with subclinical DCIS of the breast treated between 1982 and 1993. Age of the patients ranged between 32 and 72 years (median, 50 years). All of them underwent conservative surgery: quadrantectomy in 89, tumorectomy in 11, and wide excision in 12 cases. The most common histologic subtype was comedocarcinoma (37%). The median pathologic size was 10 mm (range 1 to 55 mm). Axillary dissection was performed in 83 cases: all the patients were node negative. All the patients received adjunctive radiation therapy with 60Co units (77%) or 6 MV linear accelerators (23%) for a median total dose to the entire breast of 50 Gy (mean, 49.48 Gy; range, 45-60 Gy). Seventy-six cases (68%) received a boost to the tumor bed at a dose of 8-20 Gy (median 10 Gy) for a minimum tumor dose of 58 Gy. At a median follow-up of 66 months, 8 local recurrences were observed, 4 intraductal and 4 invasive. All recurrent patients had a salvage mastectomy and are alive and free of disease at this writing. The 10-year actuarial overall, cause-specific, and recurrence-free survival was of 98.8%, 100%, and 91%, respectively. The retrospective multicentric study, with a local control rate of more than 90% at 10 years with 100% cause-specific survival, showed that conservative surgery and adjuvant radiation therapy is a safe and efficacious treatment for patients with occult, non-palpable DCIS.

  18. 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.

  19. Clinical outcomes in patients treated with radiotherapy after surgery for cervical cancer

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    Yang, Kyung Mi; Park, Won; Huh, Seung Jae; Bae, Duk Soo; Kim, Byoung Gie; Lee, Jeong Won [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-03-15

    The purpose of this study was to analyze clinical outcomes from cervical cancer and stratify patients into risk groups for prognostic factors for early-stage disease. We retrospectively reviewed patients with stage IB or IIA cervical cancer treated with adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) following primary surgery at Samsung Medical Center from 2001 to 2011. Adjuvant RT was added for patients with intermediate-risk factors, and adjuvant CCRT was performed on high-risk patients after surgery. We reviewed 247 patients—149 in the high-risk group and 98 in intermediate-risk group. The median follow-up was 62 months. Loco-regional failure (LRF) alone occurred in 7 patients (2.8%), distant metastasis alone in 37 patients (15.0%) and LRF with DM in 4 patients (1.6%). The 5-year disease-free survival (DFS) and overall survival (OS) rates for both groups were 79.7% and 87.6%, respectively. In the high-risk group, the 5-year DFS and OS probabilities were 72.5% and 81.9%, respectively. Histologic type, pathologic tumor size, and the number of pelvic lymph node (PLN) metastasis were significant prognostic factors for DFS and OS. We suggest a scoring system (0–3) using these prognostic factors to predict poor prognosis in high-risk patients. Using this system, patients with higher scores have higher recurrence and lower survival rates. In the high-risk cervical-cancer group who received primary surgery and adjuvant CCRT, non-squamous type, large tumor size and the number of PLN metastasis were significant prognostic factors, and the number of these factors was associated with survival rates.

  20. Adverse effect of excess body weight on survival in cervical cancer patients after surgery and radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yunseon; Ahn, Ki Jung; Park, Sung Kwang; Cho, Heung Lae; Lee, Ji Young [Inje University Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2017-03-15

    This study aimed to assess the effects of body mass index (BMI) on survival in cervical cancer patients who had undergone surgery and radiotherapy (RT). We retrospectively reviewed the medical records of 70 cervical cancer patients who underwent surgery and RT from 2007 to 2012. Among them, 40 patients (57.1%) had pelvic lymph node metastases at the time of diagnosis. Sixty-seven patients (95.7%) had received chemotherapy. All patients had undergone surgery and postoperative RT. Median BMI of patients was 22.8 kg/m2 (range, 17.7 to 35.9 kg/m2). The median duration of follow-up was 52.3 months (range, 16 to 107 months). Twenty-four patients (34.3%) showed recurrence. Local failure, regional lymph nodal failure, and distant failure occurred in 4 (5.7%), 6 (8.6%), and 17 (24.3%) patients, respectively. The 5-year actuarial pelvic control rate was 83.4%. The 5-year cancer-specific survival (CSS) and disease-free survival (DFS) rates were 85.1% and 65.0%, respectively. The presence of pelvic lymph node metastases (n = 30) and being overweight or obese (n = 34, BMI ≥ 23 kg/m2) were poor prognostic factors for CSS (p = 0.003 and p = 0.045, respectively). Of these, pelvic lymph node metastasis was an independent prognostic factor (p = 0.030) for CSS. Overweight or obese cervical cancer patients showed poorer survival outcomes than normal weight or underweight patients. Weight control seems to be important in cervical cancer patients to improve clinical outcomes.

  1. Integration of surgery with fractionated stereotactic radiotherapy for treatment of nonfunctioning pituitary macroadenomas

    International Nuclear Information System (INIS)

    Paek, Sun Ha; Downes, M. Beverly; Bednarz, Greg; Keane, William M.; Werner-Wasik, Maria; Curran, Walter J.; Andrews, David W.

    2005-01-01

    Objective: To evaluate the efficacy of fractionated stereotactic radiotherapy (FSRT) after surgery in the management of residual or recurrent nonfunctioning pituitary adenomas with respect to tumor control and the development of complications. Methods and materials: The clinical records of patients with nonfunctioning pituitary adenomas who underwent FSRT were retrospectively analyzed. For newly diagnosed tumors, transsphenoidal surgery was performed, and, if residual tumor was identified at 3 months, FSRT was performed. If significant tumor volume persisted, transcranial surgery was performed before FSRT. We originally initiated FSRT with 2-Gy fractions to 46 Gy. We escalated the dose to 50.4 Gy thereafter. As a final modification, we dropped the daily dose to 1.8-Gy fractions delivered within 6 weeks. High-dose conformality and homogeneity was achieved with arc beam shaping and differential beam weighting. The radiographic, endocrinologic, and visual outcomes after FSRT were evaluated. Results: The 68 patients included 36 males and 32 females with an age range of 15-81 years. The median follow-up was 30 months (range, 2-82 months), and the median tumor volume was 6.2 cm 3 . Of the 68 patients, 20 were treated to 46 Gy and 48 to 50-52.2 Gy. Most were treated to 50.4 Gy. Eleven patients had recurrent tumors, 54 had residual tumors, and no surgery was performed in 3 patients before FSRT. We noted no radiation-induced acute or late toxicities, except for radiation-induced optic neuropathy in 2 patients. At latest follow-up, the tumor had decreased in size in 26 patients and remained stable in 41 of the 42 remaining patients. Of the 68 patients, 4 (6%) developed hypopituitarism at 6, 11, 12, and 17 months after FSRT. Reviewing available serial Humphrey visual fields, visual fields were objectively improved in 28 patients, and remained stable in 24 patients, and worsened in 2 patients. Conclusion: The findings of this analysis support the use of surgery followed by

  2. Comparing the effects of conventional and hypofractionated radiotherapies on early skin toxicity and cosmetic outcomes after breast cancer conserving surgery

    Directory of Open Access Journals (Sweden)

    Amouzegar Hashemi F

    2012-12-01

    Full Text Available Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method.Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0 who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment (dose: 50 Gy in 25 fractions with subsequent electron boost or a short-course hypofractionated radiotherapy (dose: 42.5 Gy in 16 fractions and a subsequent electron boost.Results: There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups.Conclusion: Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results.

  3. Retrospective study on therapy options of brain metastases: surgery versus stereotactic radiotherapy with the linear accelerator

    International Nuclear Information System (INIS)

    Fortunati, M.K.S.

    2001-04-01

    Background: in the therapy of brain metastases there has been a great progress in the last years. It was shown, that more aggressive therapies can not only extend the survival of the patients, but also improve quality of life. The major question of this study was, whether surgery or stereotactic radiotherapy with the linear accelerator show better results in behalf of the survival. Beside this major question many parameters regarding the patient or his primary cancer were examined. Methods: from the 1st of January 1995 until the 30th of June 2000 233 patients with one or more brain metastases have been treated in the Wagner Jauregg Landesnervenkrankenhaus Oberoesterreich (WJ LNKH OeO). The LINAC has been established on the 1st of July 1997. The patients have been distributed in three groups: 1. LINAC-group: 81 patients have been treated from the 1st of July 1997 until the 30th of June 2000 with the LINAC. 2. Surgery-group: 81 patients have been operated from the 1st of July 1997 until the 30th June 2000. 3 Control-group: 71 patients have been operated from the 1st of January 1995 until the 30th of June 1997, before the LINAC has been established on the 1st of July 1997. Results: There are shown the mean survival times. Therapy options (0,05): LINAC-group: 377 days. Surgery-group: 195 days. Control-group: 285 days. Primary cancer (0,05): unknown primary: 203 days. Cancer of the colon tract: 218 days. Breast cancer: 314 days. Melanoma: 162 days. Kidney: 466 days. Lung 261 days. Others: 439 days. Metastases in one/in both hemispheres (0,05): in one hemisphere 310 days, in both 184 days. All the other parameters (age, sex, Karnofsky-Index, period between diagnose of the primary and the brain metastases, primary cancer therapy, extra cerebral metastases, number of metastases, localization of metastases supra- or infratentoriell, dose/effect relationship in the LINAC-group, whole brain radiotherapy) showed interesting differences, but the results were not statistically

  4. Relationship between interval from surgery to radiotherapy and local recurrence rate in patients with endometrioid-type endometrial cancer: a retrospective mono-institutional Italian study.

    Science.gov (United States)

    Fabrini, Maria Grazia; Gadducci, Angiolo; Perrone, Franco; La Liscia, Concetta; Cosio, Stefania; Moda, Stefano; Guerrieri, Maria Elena; Grandinetti, Antonella; Greco, Carlo

    2012-01-01

    To assess the relationship between the timing of radiotherapy and the risk of local failure in patients with endometrioid-type endometrial cancer who had undergone surgery and adjuvant external pelvic radiotherapy (with or without brachytherapy), but not chemotherapy. One hundred and seventy seven patients were analyzed in this study. The median follow-up of the survivors was 72 months. Radiotherapy was delivered after a median time of 14.6 weeks from surgery and the median overall treatment time was 6.4 weeks. The tumor relapsed in 32 (18.1%) patients after a median time of 21 months. The local recurrence (vaginal or central pelvic) occurred in 11 patients. The local recurrence rate was associated with tumor grade (p=0.02), myometrial invasion (p=0.046), FIGO stage (p=0.003), pathological node status (p=0.037) and time interval from surgery to radiotherapy using 9 weeks as the cut-off value (p=0.046), but not with the overall treatment time. All the local relapses occurred in patients who received adjuvant irradiation after an interval from surgery >9 weeks. The time interval from surgery to radiotherapy might affect the local recurrence rate in patients not receiving chemotherapy. Every possible effort should be made to start radiotherapy within 9 weeks, when radiotherapy only is deemed necessary as adjuvant treatment.

  5. 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

  6. Sphincter-sparing surgery after preoperative radiotherapy for low rectal cancers: feasibility, oncological results, and quality of life outcomes

    International Nuclear Information System (INIS)

    Allal, A.S.; Soravia, C.; Gertsch, P.; Bieri, S.; Sprangers, M.A.G.

    1999-01-01

    In cancers of the distal rectum, preoperative radiotherapy is often associated with low anterior resection. This study assesses the choice of surgical procedure, oncological results, and quality of life outcomes in a retrospective cohort of patients with low-lying rectal cancers. The results obtained reinforce the notion of the feasibility, in routine practice, of sphincter-sparing surgery after preoperative radiotherapy in a significant proportion of low rectal cancers. The oncological results seem to be unaffected by the choice of surgical procedure. However, with the possible exception of body image and sexual aspects in males, quality of life parameters were not necessarily better in the restorative surgery group. Prospective studies are mandatory to clarify the putative quality of life advantages of sphincter-conserving procedures in this context. (author)

  7. Targeted intraoperative radiotherapy tumour bed boost during breast-conserving surgery after neoadjuvant chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kolberg, Hans-Christian; Akpolat-Basci, Leyla; Stephanou, Miltiades [Marienhospital Bottrop gGmbH, Department of Gynecology and Obstetrics, Bottrop (Germany); Loevey, Gyoergy [BORAD, Bottrop (Germany); Fasching, Peter A. [University of Erlangen, Erlangen (Germany); Untch, Michael [Helios Klinikum Berlin-Buch, Berlin (Germany); Liedtke, Cornelia [University Hospital Schleswig-Holstein/Campus Luebeck, Luebeck (Germany); Bulsara, Max [University of Notre Dame, Fremantle (Australia); University College, London (United Kingdom); Vaidya, Jayant S. [University College, London (United Kingdom)

    2017-01-15

    The use of targeted intraoperative radiotherapy (TARGIT-IORT) as a tumour bed boost during breast-conserving surgery (BCS) for breast cancer has been reported since 1998. We present its use in patients undergoing breast conservation following neoadjuvant therapy (NACT). In this retrospective study involving 116 patients after NACT we compared outcomes of 61 patients who received a tumour bed boost with IORT during lumpectomy versus 55 patients treated in the previous 13 months with external (EBRT) boost. All patients received whole breast radiotherapy. Local recurrence-free survival (LRFS), disease-free survival (DFS), distant disease-free survival (DDFS), breast cancer mortality (BCM), non-breast cancer mortality (NBCM) and overall mortality (OS) were compared. Median follow up was 49 months. The differences in LRFS, DFS and BCM were not statistically significant. The 5-year Kaplan-Meier estimate of OS was significantly better by 15% with IORT: IORT 2 events (96.7%, 95%CI 87.5-99.2), EBRT 9 events (81.7%, 95%CI 67.6-90.1), hazard ratio (HR) 0.19 (0.04-0.87), log rank p = 0.016, mainly due to a reduction of 10.1% in NBCM: IORT 100%, EBRT 89.9% (77.3-95.7), HR (not calculable), log rank p = 0.015. The DDFS was as follows: IORT 3 events (95.1%, 85.5-98.4), EBRT 12 events (69.0%, 49.1-82.4), HR 0.23 (0.06-0.80), log rank p = 0.012. IORT during lumpectomy after neoadjuvant chemotherapy as a tumour bed boost appears to give results that are not worse than external beam radiotherapy boost. These data give further support to the inclusion of such patients in the TARGIT-B (boost) randomised trial that is testing whether IORT boost is superior to EBRT boost. (orig.) [German] Die intraoperative Radiotherapie (TARGIT-IORT) als vorgezogener Boost im Rahmen der brusterhaltenden Therapie (BET) ist seit 1998 Gegenstand der wissenschaftlichen Diskussion. Wir praesentieren Daten zum Einsatz der IORT bei der BET nach neoadjuvanter Therapie (NACT). In diese retrospektive Analyse

  8. CT planning of boost irradiation in radiotherapy of breast cancer after conservative surgery

    International Nuclear Information System (INIS)

    Messer, Peter M.; Kirikuta, Ion C.; Bratengeier, Klaus; Flentje, Michael

    1997-01-01

    Background and purpose: A study was performed to compare the accuracy of clinical treatment set-up and CT planning of boost irradiation in radiotherapy of breast cancer. Material and methods: Between September 1993 and October 1994, 45 women who underwent breast conserving surgery and irradiation containing a boost to the tumour bed were investigated. Prospective evaluation of CT planning of the boost was carried out. The target volume/boost field, electron energy and treatment set-up had been defined on the basis of clinical examination, initial and postsurgical mammograms by one radiotherapist. Next, a planning CT was performed in treatment position and a CT-based treatment plan was calculated according to a target volume defined by another radiotherapist. The clinical treatment set-up was imported into our computer planning system and the resulting isodose plots were compared with those from CT planning and reviewed critically. Results: The clinically defined treatment set-up had to be modified in 80% of the patients. Most discrepancies observed were related to the size of the boost field itself and the chosen electron energy. Minor changes had to be made with respect to angle of table and gantry. Conclusions: Critical review of the isodose plots from both methods showed clear advantages for CT planning. Guidelines for target definition in CT planning of boost irradiation and subgroups of patients benefiting from this technique are described

  9. Metastatic tumor of thoracic and lumbar spine: prospective study comparing the surgery and radiotherapy vs external immobilization with radiotherapy

    International Nuclear Information System (INIS)

    Falavigna, Asdrubal; Ioppi, Ana Elisa Empinotti; Grasselli, Juliana

    2007-01-01

    Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.(author)

  10. The prognostic significance of tracheostomy in carcinoma of the larynx treated with radiotherapy and surgery for salvage

    International Nuclear Information System (INIS)

    MacKenzie, Robert; Franssen, Edmee; Balogh, Judith; Birt, Derek; Gilbert, Ralph

    1998-01-01

    Purpose: To determine retrospectively the prognostic significance of airway compromise necessitating tracheostomy in carcinoma of the larynx managed with radical radiotherapy and surgery for salvage (RRSS). Methods and Materials: The charts of 270 patients managed with RRSS at the Toronto-Sunnybrook Regional Cancer Centre between June 1980 and December 1990 were reviewed. Airway compromise necessitating tracheostomy was documented in 26 patients prior to radiotherapy and 3 patients during radiotherapy. Of 29, 27 had T3T4 primaries. Patients have been followed for a median of 5 years. Results: Patients managed without tracheostomy had a 2-year disease-free survival of 74% compared to 41% for those managed with tracheostomy. The adverse impact of airway compromise was more marked in patients with glottic primaries (78% vs. 32%, p = 0.0001) than those with supraglottic primaries (64% vs. 47%, p = 0.18). Tracheostomy was identified in univariate analysis, but not in multivariate analysis, as having a statistically significant impact on local control and local-regional control. Radiotherapy controlled disease above the clavicles in 185 of 267 (69%) evaluable patients. 83% of isolated local-regional failures underwent salvage surgery. Among those managed without tracheostomy, ultimate local-regional control (LRC) was achieved in 161 (94%) of 172 glottic primaries and 54 (81%) of 67 supraglottic primaries. Among those managed with tracheostomy, ultimate LRC was achieved in 9 (69%) of 13 glottic primaries and 12 (80%) of 15 supraglottic primaries. In a subset analysis of 76 patients with T3T4 primaries, there was no statistically significant difference in larynx preservation, disease-free survival, or cause-specific survival between those managed with and without tracheostomy. Conclusion: Airway compromise necessitating tracheostomy is an adverse prognostic factor in patients with carcinoma of the larynx. However, larynx preservation is possible in over 40% of those

  11. Dr John Nottingham's 1854 Landmark Treatise on Conical Cornea Considered in the Context of the Current Knowledge of Keratoconus.

    Science.gov (United States)

    Gokul, Akilesh; Patel, Dipika V; McGhee, Charles N J

    2016-05-01

    John Nottingham has been widely credited with the first accurate description of keratoconus in his treatise on conical cornea, published in 1854. Contained within the 270-page treatise are accounts and theories of keratoconus postulated by authors such as Scarpa, von Carion, von Ammon, and Mackenzie, synthesized by Nottingham in a treatise containing his own original observations. Nottingham's work delves deeply into keratoconus, with coverage reminiscent of a modern review, albeit in a far less succinct manner. He extensively describes the epidemiology, clinical presentation, underlying cause, and treatment of keratoconus. However, the concepts put forth are limited largely by the contemporary lack of understanding of the underlying anatomy and physiology of the eye, and the observations, by technological limitations. He postulates a similar treatment algorithm to that used today; optical devices being the management option of choice in the mild stages with surgery being a last resort. None of the surgical methods discussed are used in the modern era, but he does make reference to the possible efficacy of corneal transplantation. Nottingham's treatise was published over 160 years ago, yet his ideas and observations are surprisingly accurate. It is very possible that he was the first person to publish an accurate, comprehensive description of keratoconus.

  12. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands : a population-based study

    NARCIS (Netherlands)

    van Maaren, Marissa C.; de Munck, Linda; de Bock, Geertruida H.; Jobsen, Jan J.; van Dalen, Thijs; Linn, Sabine C.; Poortmans, Philip; Strobbe, Luc J A; Siesling, Sabine

    Background Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving surgery

  13. Tumour bed boost radiotherapy for women after breast-conserving surgery.

    Science.gov (United States)

    Kindts, Isabelle; Laenen, Annouschka; Depuydt, Tom; Weltens, Caroline

    2017-11-06

    Breast-conserving therapy, involving breast-conserving surgery followed by whole-breast irradiation and optionally a boost to the tumour bed, is a standard therapeutic option for women with early-stage breast cancer. A boost to the tumour bed means that an extra dose of radiation is applied that covers the initial tumour site. The rationale for a boost of radiotherapy to the tumour bed is that (i) local recurrence occurs mostly at the site of the primary tumour because remaining microscopic tumour cells are most likely situated there; and (ii) radiation can eliminate these causative microscopic tumour cells. The boost continues to be used in women at high risk of local recurrence, but is less widely accepted for women at lower risk. Reasons for questioning the boost are twofold. Firstly, the boost brings higher treatment costs. Secondly, the potential adverse events are not negligible. In this Cochrane Review, we investigated the effect of the tumour bed boost on local control and side effects. To assess the effects of tumour bed boost radiotherapy after breast-conserving surgery and whole-breast irradiation for the treatment of breast cancer. We searched the Cochrane Breast Cancer Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (January 1966 to 1 March 2017), Embase (1980 to 1 March 2017), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov on 1 March 2017. We also searched the European Society of Radiotherapy and Oncology Annual Meeting, the St Gallen Oncology Conferences, and the American Society for Radiation Oncology Annual Meeting for abstracts. Randomised controlled trials comparing the addition and the omission of breast cancer tumour bed boost radiotherapy. Two review authors (IK and CW) performed data extraction and assessed risk of bias using Cochrane's 'Risk of bias' tool, resolving any disagreements through discussion. We entered data into Review Manager 5 for

  14. Cosmetic Evaluation of long term results following intraoperative radiotherapy (IORT) of conservative surgery for breast carcinoma

    International Nuclear Information System (INIS)

    Fussl, C. M.

    2009-01-01

    Introduction In breast conserving therapy (BCT) of breast cancer, cosmetic results have become next to tumor-related outcome parameters a criterion of increasing awareness. The aim of this study is the evaluation of long term cosmetic results after conservative surgery and intraoperative radiotherapy with 10 Gy electrons (IOERT), followed by whole breast radiotherapy (WBRT) with 50-54 Gy. Patients and Methods From October 1998 to October 2005, 818 patients (median age 57.89 years) were treated by IOERT during breast conserving surgery, 12 of them for bilateral cancer. 32 patients were referred to mastectomy within primary treatment, 50 were reported as dead at the beginning of the study, 4 patients had developed an in-breast-recurrence and had been salvaged by secondary mastectomy, and in 41 cases an intercurrent dissemination was noted. All 679 remaining patients were invited in written form to participate in the cosmesis study. 403 of them (59.4%) have answered and were object of the evaluation (August 2006 to April 2007). To provide reproducible examination conditions, a standardized photo-documentation in four positions (frontal, loose-hanging and elevated arms; left and right lateral, elevated arms) was accomplished. Patients and treating physicians evaluated the cosmetic results separately within a 5-point-score (Excellent, Good, Moderate, Bad, Complications). Patient-, tumor- and treatment-related factors were investigated with regard to possible impact on the cosmetic outcome in all patients (group 1). A separate subgroup analysis was carried out for 261 patients with a follow-up of at least three years after completion of local treatment (group 2). For computation of the statistic correlation between the variables and the cosmetic evaluation the rank correlation coefficients Kendall's τ Spearman's ρ were used. A correlation is significant below a p-value of 0.05. Results The self-assessment of the patients in group 1 yielded around 69% excellent, 25

  15. [A study of treatise on medicine by King Sejo].

    Science.gov (United States)

    Hwang, Im-kyung; Hwang, Sang-lk

    2003-12-01

    This paper explores historical backgrounds and contents of Treatise on Medicine written by King Sejo (r. 1455-1468) including his views on traditional medicine and pharmacy in the early Chosen period. The Treatise declared by King Sejo in 1463 has been considered as an important and unique manual of medicine because it was the exclusive example written by the king of Chosen. It was the King Sejo' s era when the medical milieu in both social and medical aspects was highly encouraged thanks to the previous achievements by King Sejong the Great (r.1418-1450). King Sejo, in particular, who was much interested in practical learning called 'Miscellaneous Studies', emphasized on court medicine. His writing can be understood in such historical frame. Another reason why he wrote the Treatise can be said that he felt necessary for establishing the medical ethic codes for inefficient court medicine-officials. In personal background, he tried to find available remedies since he had been suffered from some chronic diseases. The contents of the Treatise can be broadly fallen to the clinical and ethical aspects. In the former one, the Treatise focuses on treatment without hesitation through the sharp and exact diagnosis by medical doctors. In the latter one, eight categories of medical doctors are discussed according to their moral degrees: sim'eui, sik'eui, yak'eui, hon'eui, kwang eui, mang'eui, sa'eui, and sal'eui. Finally, musim' ji-eui was supplemented. Among them, sal'eui, medicine-official lacking both medical ability and ethical attitude, was classified as the lowest degree; sim'eui, medicine-official sincerely making his all efforts for patients, was thought to be a paragon of medical morality. In conclusion, the Treatise on Medicine by King Sejo played an important role as a manual for the principle of medical practice and for the instruction to enhance ethical attitude among medicine-officials.

  16. Effectiveness of surgery and individualized high-dose hyperfractionated accelerated radiotherapy on survival in clinical stage I non-small cell lung cancer. A propensity score matched analysis

    International Nuclear Information System (INIS)

    Jimenez, Marcelo F.; Baardwijk, Angela van; Aerts, Hugo J.W.L.; De Ruysscher, Dirk; Novoa, Nuria M.; Varela, Gonzalo; Lambin, Philippe

    2010-01-01

    Background and purpose: Surgery is considered the treatment of choice for early-stage non-small cell lung cancer (NSCLC). Patients with poor pulmonary function or other comorbidities are treated with radiotherapy. The objective of this investigation is to compare the 3-year survival of two early-stage NSCLC populations treated in two different hospitals, either by surgical resection (lobectomy) or by individualized high-dose accelerated radiotherapy, after matching patients by propensity scoring analysis. Methods: A retrospective comparative study has been performed on two series of consecutive patients with cytohistological diagnosis of NSCLC, clinically staged IA by means of PET-scan (radiotherapy group) and pathologically staged IA (surgery group). Results: A total of 157 cases were initially selected for the analysis (110 operated and 47 treated by radiotherapy). Patients in the radiotherapy group were older, with higher comorbidity and lower FEV1% with 3-years probability of survival for operated patients higher than that found for patients treated by radiotherapy. After matching by propensity scoring (using age and FEV1%), differences disappear and 3-years probability of survival had no statistical differences. Conclusions: Although this is a non-randomized retrospective analysis, we have not found 3-years survival differences after matching cases between surgery and radiotherapy. Nevertheless, data presented here support the continuous investigation for non-surgical alternatives in this disease.

  17. Human papilloma virus and survival of oropharyngeal cancer patients treated with surgery and adjuvant radiotherapy.

    Science.gov (United States)

    Broglie, Martina A; Soltermann, Alex; Haile, Sarah R; Huber, Gerhard F; Stoeckli, Sandro J

    2015-07-01

    Impact of p16 protein, a surrogate marker for human papilloma virus induced cancer, p53 and EGFR as well as clinical factors on survival in a patient cohort with oropharyngeal squamous cell carcinoma (OPSCC) treated by surgical resection and adjuvant radiotherapy (RT) ± concomitant chemotherapy (CT). This is a retrospective analysis of patient's charts and tumor tissue. 57 patients were consecutively included and their tumor tissue assembled on a tissue microarray following immunohistochemical analysis. Survival times were estimated by means of Kaplan-Meier analysis. The importance of clinical and immunohistochemical factors for outcome was estimated by cox proportional hazard models. With 88% 5-year overall survival, 91% 5-year disease-specific survival and 91% 5-year disease-free survival, respectively, we found excellent survival rates in this surgically treated patient cohort of mainly advanced OPSCC (93% AJCC stage III or IV). The only factors positively influencing survival were p16 overexpression as well as p53 negativity and even more pronounced the combination of those biomarkers. Survival analysis of patients classified into three risk categories according to an algorithm based on p16, smoking, T- and N-category revealed a low, intermediate and high-risk group with significant survival differences between the low and the high-risk group. Patients with OPSCC can be successfully treated by surgery and adjuvant RT ± CT with a clear survival benefit of p16 positive, p53 negative patients. We recommend considering a combination of immunohistochemical (p16, p53) and clinical factors (smoking, T- and N-category) for risk stratification.

  18. T1-2 glottic cancer treated with radiotherapy and/or surgery

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    Shelan, Mohamed; Bojaxhiu, Beat; Dal Pra, Alan; Aebersold, Daniel M.; Elicin, Olgun [University of Bern, Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern (Switzerland); Anschuetz, Lukas; Schubert, Adrian D.; Giger, Roland [University of Bern, Department of Otorhinolaryngology - Head and Neck Surgery, Inselspital, Bern University Hospital, Bern (Switzerland); Behrensmeier, Frank [University of Bern, Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern (Switzerland); Radiation-Oncology-Centre, Biel - Seeland - Berner Jura, Biel (Switzerland)

    2017-12-15

    The optimal treatment strategy for stage I-II glottic squamous cell carcinoma (SCC) is not well-defined. This study analyzed treatment results and prognostic factors. This is a single-institution retrospective analysis of 244 patients with T1-2 glottic SCC who underwent normofractionated radiotherapy (RT) and/or surgery between 1990 and 2013. The primary endpoint was relapse-free survival (RFS). Median age was 65 years (range: 36-92 years), the majority (82%) having stage I disease. Definitive RT was used in 82% (median dose: 68 Gy, 2 Gy per fraction). Median follow-up was 59 months. The 5-year RFS rates were 83 and 75% (p = 0.05) for stage I and 62 and 50% (p = 0.47) for stage II in the RT and surgery groups, respectively. Multivariate analyses indicate T1 vs. T2 and RT vs. surgery as independent prognostic factors for RFS, with hazard ratios of 0.38 (95% confidence interval, CI: 0.21-0.72) and 0.53 (95% CI: 0.30-0.99), respectively (p < 0.05). The 5-year overall and cause-specific survival rates in the whole cohort were 92 and 96%, respectively, with no significant differences between treatment groups. Anterior commissure involvement was neither a prognostic nor a predictive factor. The incidence of secondary malignancies was not significantly different between patients treated with and without RT (22 vs. 9% at 10 years, respectively, p = 0.18). Despite a possible selection bias, our series demonstrates improved RFS with RT over surgery in stage I glottic SCC. (orig.) [German] Die optimale Behandlungsstrategie fuer ein Plattenepithelkarzinom (SCC) der Stimmbaender im Stadium I-II ist nicht gut definiert. In dieser Studie wurden Behandlungsergebnisse und prognostische Faktoren untersucht. In dieser retrospektiv unizentrischen Studie wurden 244 Patienten mit einem fruehen Glottis-SCC (T1-2) zwischen 1990 und 2013 strahlentherapeutisch (RT) und/oder chirurgisch behandelt. Primaerer Endpunkt war das rezidivfreie Ueberleben (RFS). Das mediane Alter betrug 65 Jahre

  19. Fibrotic changes after postmastectomy radiotherapy and reconstructive surgery in breast cancer. A retrospective analysis in 109 patients

    International Nuclear Information System (INIS)

    Classen, Johannes; St. Vincentius-Kliniken, Karlsruhe; Nitzsche, Sibille; Wallwiener, Diethelm; Brucker, Sara; Kristen, Peter; Souchon, Rainer; Bamberg, Michael

    2010-01-01

    The purpose of this study was to analyze the probability and time course of fibrotic changes in breast reconstruction before or after postmastectomy radiotherapy (PMRT). Between 1995 and 2004, 109 patients were treated with PMRT at Tuebingen University and underwent heterologous (HL) or autologous (AL) breast reconstruction prior or subsequent to radiation therapy. Fibrosis of the reconstructed breast after radiotherapy was assessed using the Baker score for HL reconstructions and the Common Terminology Criteria for Adverse Events (CTCAE) for all patients. Actuarial rates of fibrosis were calculated for the maximum degree acquired during follow- up and at the last follow-up visit documented. Median time to follow-up was 34 months (3-227 months). Radiotherapy was applied with a median total dose of 50.4 Gy. A total of 44 patients (40.4%) received a boost treatment with a median dose of 10 Gy. Breast reconstruction was performed with AL, HL, or combined techniques in 20, 82, and 7 patients, respectively. The 3-year incidence of ≥ grade III maximum fibrosis was 20% and 43% for Baker and CTCAE scores, respectively. The corresponding figures for fibrosis at last follow-up visit were 18% and 2%. The 3-year rate of surgical correction of the contralateral breast was 30%. Initially unplanned surgery of the reconstructed breast was performed in 39 patients (35.8%). Boost treatment and type of cosmetic surgery (HL vs. AL) were not significantly associated with the incidence of fibrosis. We found severe fibrosis to be a frequent complication after PMRT radiotherapy and breast reconstruction. However, surgical intervention can ameliorate the majority of high grade fibrotic events leading to acceptable long-term results. No treatment parameters associated with the rate of fibrosis could be identified. (orig.)

  20. Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non-Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery?

    Energy Technology Data Exchange (ETDEWEB)

    Onishi, Hiroshi, E-mail: honishi@yamanashi.ac.jp [School of Medicine, Yamanashi University, Yamanashi (Japan); Shirato, Hiroki [School of Medicine, Hokkaido University, Sapporo (Japan); Nagata, Yasushi [School of Medicine, Hiroshima University, Hiroshima (Japan); Hiraoka, Masahiro [School of Medicine, Kyoto University, Kyoto (Japan); Fujino, Masaharu [School of Medicine, Hokkaido University, Sapporo (Japan); School of Medicine, Yamanashi University, Yamanashi (Japan); Gomi, Kotaro [Cancer Institute Suwa Red-Cross Hospital, Suwa (Japan); Karasawa, Katsuyuki [Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Hayakawa, Kazushige; Niibe, Yuzuru [Kitasato University, Kanagawa (Japan); Takai, Yoshihiro [School of Medicine, Hirosaki University, Hirosaki (Japan); Kimura, Tomoki [School of Medicine, Kagawa University, Hiroshima (Japan); Takeda, Atsuya [Ofuna Chuo Hospital, Kanagawa (Japan); Ouchi, Atsushi [Keijinkai Hospital, Sapporo (Japan); Hareyama, Masato [Sapporo Medical University, Sapporo (Japan); Kokubo, Masaki [Institute of Biomedical Research and Innovation, Kobe (Japan); Kozuka, Takuyo [School of Cancer Institute Ariake Hospital, Tokyo (Japan); Arimoto, Takuro [Kitami Red Cross Hospital, Kitami (Japan); Hara, Ryusuke [National Institute of Radiological Science, Chiba (Japan); Itami, Jun [National Cancer Center, Tokyo (Japan); Araki, Tsutomu [School of Medicine, Yamanashi University, Yamanashi (Japan)

    2011-12-01

    Purpose: To review treatment outcomes for stereotactic body radiotherapy (SBRT) in medically operable patients with Stage I non-small-cell lung cancer (NSCLC), using a Japanese multi-institutional database. Patients and Methods: Between 1995 and 2004, a total of 87 patients with Stage I NSCLC (median age, 74 years; T1N0M0, n = 65; T2N0M0, n = 22) who were medically operable but refused surgery were treated using SBRT alone in 14 institutions. Stereotactic three-dimensional treatment was performed using noncoplanar dynamic arcs or multiple static ports. Total dose was 45-72.5 Gy at the isocenter, administered in 3-10 fractions. Median calculated biological effective dose was 116 Gy (range, 100-141 Gy). Data were collected and analyzed retrospectively. Results: During follow-up (median, 55 months), cumulative local control rates for T1 and T2 tumors at 5 years after SBRT were 92% and 73%, respectively. Pulmonary complications above Grade 2 arose in 1 patient (1.1%). Five-year overall survival rates for Stage IA and IB subgroups were 72% and 62%, respectively. One patient who developed local recurrences safely underwent salvage surgery. Conclusion: Stereotactic body radiotherapy is safe and promising as a radical treatment for operable Stage I NSCLC. The survival rate for SBRT is potentially comparable to that for surgery.

  1. Stereotactic Body Radiotherapy (SBRT) for Operable Stage I Non–Small-Cell Lung Cancer: Can SBRT Be Comparable to Surgery?

    International Nuclear Information System (INIS)

    Onishi, Hiroshi; Shirato, Hiroki; Nagata, Yasushi; Hiraoka, Masahiro; Fujino, Masaharu; Gomi, Kotaro; Karasawa, Katsuyuki; Hayakawa, Kazushige; Niibe, Yuzuru; Takai, Yoshihiro; Kimura, Tomoki; Takeda, Atsuya; Ouchi, Atsushi; Hareyama, Masato; Kokubo, Masaki; Kozuka, Takuyo; Arimoto, Takuro; Hara, Ryusuke; Itami, Jun; Araki, Tsutomu

    2011-01-01

    Purpose: To review treatment outcomes for stereotactic body radiotherapy (SBRT) in medically operable patients with Stage I non–small-cell lung cancer (NSCLC), using a Japanese multi-institutional database. Patients and Methods: Between 1995 and 2004, a total of 87 patients with Stage I NSCLC (median age, 74 years; T1N0M0, n = 65; T2N0M0, n = 22) who were medically operable but refused surgery were treated using SBRT alone in 14 institutions. Stereotactic three-dimensional treatment was performed using noncoplanar dynamic arcs or multiple static ports. Total dose was 45–72.5 Gy at the isocenter, administered in 3–10 fractions. Median calculated biological effective dose was 116 Gy (range, 100–141 Gy). Data were collected and analyzed retrospectively. Results: During follow-up (median, 55 months), cumulative local control rates for T1 and T2 tumors at 5 years after SBRT were 92% and 73%, respectively. Pulmonary complications above Grade 2 arose in 1 patient (1.1%). Five-year overall survival rates for Stage IA and IB subgroups were 72% and 62%, respectively. One patient who developed local recurrences safely underwent salvage surgery. Conclusion: Stereotactic body radiotherapy is safe and promising as a radical treatment for operable Stage I NSCLC. The survival rate for SBRT is potentially comparable to that for surgery.

  2. Comparison of metastatic disease after local tumour treatment with radiotherapy or surgery in various tumour models

    International Nuclear Information System (INIS)

    Ruiter, J. de; Cramer, S.J.; Lelieveld, P.; Putten, L.M. van

    1982-01-01

    Spontaneous metastases in lymph nodes and/or the lung were obtained after tumour cell inoculation of four mouse tumours and one rat tumour into the foot-pads of syngeneic animals or their F 1 hybrids. Following local radiotherapy with doses of 45-80 Gy, significantly more mice died with metastases than following local amputation of the tumour-bearing foot when the 2661 carcinoma was involved. No significant difference was observed after these treatments for the other tumours. The enhancement of metastatic growth after local radiotherapy in the 2661 carcinoma seems not to be due to incomplete killing of tumour cells in the foot. The presence of irradiated normal structures and tumour tissue after radiotherapy promoted the outgrowth of 2661 carcinoma cells which were outside the radiation field at the time of treatment. Evidently, even under similar experimental conditions, radiotherapy may enhance the growth of metastases from some tumours and not from others. (author)

  3. Surgery or radiotherapy for the treatment of bone hydatid disease: a retrospective case series

    Directory of Open Access Journals (Sweden)

    Zengru Xie

    2015-04-01

    Conclusion: This retrospective case series describes, for the first time, the clinical outcomes in a series of patients treated with radiotherapy for bone hydatid disease. Although no direct comparison between the treatment groups could be made due to methodological limitations of the study design, this study indicates that well-designed prospective randomized controlled clinical trials assessing radiotherapy may be warranted in patients with inoperable hydatid disease of the bones.

  4. Pre-surgery radiotherapy of rectal cancer; Radioterapia pre-operatoria no cancer de reto

    Energy Technology Data Exchange (ETDEWEB)

    Lopes-Paulo, Francisco [Universidade do Estado do Rio de Janeiro, (UERJ), RJ (Brazil)

    2005-04-15

    High indexes of loco-regional recurrence in patients with rectal cancer have stimulated the search of complementary therapy. Since the sixties, neo adjuvant radiotherapy has gained space in order to reduce local recurrence and to increase the survival of these patients. Recently some publications have pointed out the importance of associating chemotherapy and total excision of mesorectum to the radiotherapy in the same way. The results of large prospective researches are expected to determine the exact role of this association. (author)

  5. 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

  6. 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)

  7. A patient with angiosarcoma of the breast after breast-conserving surgery and radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Yasuoka, Rie; Mitsuo, Manabu; Hanioka, Keisuke

    2014-01-01

    An 89-year-old woman underwent breast-conserving surgery and axillary lymph node dissection (right AC region, T2N0M0, stage 2A, invasive ductal carcinoma, papillotubular type) for right breast cancer in February 2005. She received postoperative radiotherapy to the residual breast. She then developed marked edema of the right arm and right breast. A mass developed in the right breast in March 2011 and March 2013. This was originally suspected to be an ipsilateral breast recurrence of the cancer, but turned to be angiosarcoma after developing recurrent mass in March 2013, which histopathology was proved to be showed angiosarcoma of the breast. The patient subsequently had repeated intradermal and subcutaneous metastases and recurrence. She is currently receiving chemotherapy with docetaxel (30 mg/m 2 biweekly). This interesting case of angiosarcoma of the breast after breast-conserving surgery for breast cancer is reported. (author)

  8. Preoperative irradiation and surgery for recurrent rectal cancer. Will intraoperative radiotherapy (IORT) be of additional benefit? A prospective study

    International Nuclear Information System (INIS)

    Wiig, Johan Nicolay; Tveit, Kjell Magne; Poulsen, Jan Peter; Olsen, Dag Rune; Giercksky, Karl-Erik

    2002-01-01

    Background: The therapeutic gain of surgery for recurrent rectal cancer is not clear, particularly with regard to the addition of intraoperative radiotherapy (IORT). Methods: Patients (107) with isolated pelvic recurrence of rectal cancer received preoperative external radiotherapy of 46-50 in 2 Gy fractions. At surgery 59 patients had IORT 12-18 Gy. Survival and local recurrence was analysed with regard to surgical resection stages and IORT. Results: Patients (44) had R0- and 39 R1-resections, 24 R2-resections or exploratory laparotomy. IORT was given most often after R1-resections, least in R0-patients. Estimated 5-year survival was overall around 30%, around 60% in the R0-, around 25% for R1- and 0% in R2-patients. Local recurrence was around 30% in the R0- and around 65% in R1-stage patients. R0-/R1-stage patients survived statistically significantly longer than the R2-group otherwise there was no statistical significant difference between IORT and non-IORT groups in any R-stages regarding overall survival or local recurrence. Conclusions: Macroscopic removal of the recurrence improves survival. Whether R0- is better than R1-resections is not clear. The effect of IORT is not a major one. IORT need be evaluated in randomised controlled trials

  9. Intensity-Modulated Whole Abdominal Radiotherapy After Surgery and Carboplatin/Taxane Chemotherapy for Advanced Ovarian Cancer: Phase I Study

    International Nuclear Information System (INIS)

    Rochet, Nathalie; Sterzing, Florian; Jensen, Alexandra D.; Dinkel, Julien; Herfarth, Klaus K.; Schubert, Kai; Eichbaum, Michael H.; Schneeweiss, Andreas; Sohn, Christof; Debus, Juergen; Harms, Wolfgang

    2010-01-01

    Purpose: To assess the feasibility and toxicity of consolidative intensity-modulated whole abdominal radiotherapy (WAR) after surgery and chemotherapy in high-risk patients with advanced ovarian cancer. Methods and Materials: Ten patients with optimally debulked ovarian cancer International Federation of Gynecology and Obstetrics Stage IIIc were treated in a Phase I study with intensity-modulated WAR up to a total dose of 30 Gy in 1.5-Gy fractions as consolidation therapy after adjuvant carboplatin/taxane chemotherapy. Treatment was delivered using intensity-modulated radiotherapy in a step-and-shoot technique (n = 3) or a helical tomotherapy technique (n = 7). The planning target volume included the entire peritoneal cavity and the pelvic and para-aortal node regions. Organs at risk were kidneys, liver, heart, vertebral bodies, and pelvic bones. Results: Intensity-modulated WAR resulted in an excellent coverage of the planning target volume and an effective sparing of the organs at risk. The treatment was well tolerated, and no severe Grade 4 acute side effects occurred. Common Toxicity Criteria Grade III toxicities were as follows: diarrhea (n = 1), thrombocytopenia (n = 1), and leukopenia (n = 3). Radiotherapy could be completed by all the patients without any toxicity-related interruption. Median follow-up was 23 months, and 4 patients had tumor recurrence (intraperitoneal progression, n = 3; hepatic metastasis, n = 1). Small bowel obstruction caused by adhesions occurred in 3 patients. Conclusions: The results of this Phase I study showed for the first time, to our knowledge, the clinical feasibility of intensity-modulated whole abdominal radiotherapy, which could offer a new therapeutic option for consolidation treatment of advanced ovarian carcinoma after adjuvant chemotherapy in selected subgroups of patients. We initiated a Phase II study to further evaluate the toxicity of this intensive multimodal treatment.

  10. Intensity-modulated whole abdominal radiotherapy after surgery and carboplatin/taxane chemotherapy for advanced ovarian cancer: phase I study.

    Science.gov (United States)

    Rochet, Nathalie; Sterzing, Florian; Jensen, Alexandra D; Dinkel, Julien; Herfarth, Klaus K; Schubert, Kai; Eichbaum, Michael H; Schneeweiss, Andreas; Sohn, Christof; Debus, Juergen; Harms, Wolfgang

    2010-04-01

    To assess the feasibility and toxicity of consolidative intensity-modulated whole abdominal radiotherapy (WAR) after surgery and chemotherapy in high-risk patients with advanced ovarian cancer. Ten patients with optimally debulked ovarian cancer International Federation of Gynecology and Obstetrics Stage IIIc were treated in a Phase I study with intensity-modulated WAR up to a total dose of 30 Gy in 1.5-Gy fractions as consolidation therapy after adjuvant carboplatin/taxane chemotherapy. Treatment was delivered using intensity-modulated radiotherapy in a step-and-shoot technique (n = 3) or a helical tomotherapy technique (n = 7). The planning target volume included the entire peritoneal cavity and the pelvic and para-aortal node regions. Organs at risk were kidneys, liver, heart, vertebral bodies, and pelvic bones. Intensity-modulated WAR resulted in an excellent coverage of the planning target volume and an effective sparing of the organs at risk. The treatment was well tolerated, and no severe Grade 4 acute side effects occurred. Common Toxicity Criteria Grade III toxicities were as follows: diarrhea (n = 1), thrombocytopenia (n = 1), and leukopenia (n = 3). Radiotherapy could be completed by all the patients without any toxicity-related interruption. Median follow-up was 23 months, and 4 patients had tumor recurrence (intraperitoneal progression, n = 3; hepatic metastasis, n = 1). Small bowel obstruction caused by adhesions occurred in 3 patients. The results of this Phase I study showed for the first time, to our knowledge, the clinical feasibility of intensity-modulated whole abdominal radiotherapy, which could offer a new therapeutic option for consolidation treatment of advanced ovarian carcinoma after adjuvant chemotherapy in selected subgroups of patients. We initiated a Phase II study to further evaluate the toxicity of this intensive multimodal treatment.

  11. Salvage surgery for local failures after stereotactic ablative radiotherapy for early stage non-small cell lung cancer

    International Nuclear Information System (INIS)

    Verstegen, Naomi E.; Maat, Alexander P. W. M.; Lagerwaard, Frank J.; Paul, Marinus A.; Versteegh, Michel I; Joosten, Joris J.; Lastdrager, Willem; Smit, Egbert F.; Slotman, Ben J.; Nuyttens, Joost J. M. E.; Senan, Suresh

    2016-01-01

    The literature on surgical salvage, i.e. lung resections in patients who develop a local recurrence following stereotactic ablative radiotherapy (SABR), is limited. We describe our experience with salvage surgery in nine patients who developed a local recurrence following SABR for early stage non-small cell lung cancer (NSCLC). Patients who underwent surgical salvage for a local recurrence following SABR for NSCLC were identified from two Dutch institutional databases. Complications were scored using the Dindo-Clavien-classification. Nine patients who underwent surgery for a local recurrence were identified. Median time to local recurrence was 22 months. Recurrences were diagnosed with CT- and/or 18FDG-PET-imaging, with four patients also having a pre-surgical pathological diagnosis. Extensive adhesions were observed during two resections, requiring conversion from a thoracoscopic procedure to thoracotomy during one of these procedures. Three patients experienced complications post-surgery; grade 2 (N = 2) and grade 3a (N = 1), respectively. All resection specimens showed viable tumor cells. Median length of hospital stay was 8 days (range 5–15 days) and 30-day mortality was 0 %. Lymph node dissection revealed mediastinal metastases in 3 patients, all of whom received adjuvant therapy. Our experience with nine surgical procedures for local recurrences post-SABR revealed two grade IIIa complications, and a 30-day mortality of 0 %, suggesting that salvage surgery can be safely performed after SABR

  12. Axillary radiotherapy in conservative surgery for early-stage breast cancer (stage I and II).

    Science.gov (United States)

    García Novoa, Alejandra; Acea Nebril, Benigno; Díaz, Inma; Builes Ramírez, Sergio; Varela, Cristina; Cereijo, Carmen; Mosquera Oses, Joaquín; López Calviño, Beatriz; Seoane Pillado, María Teresa

    2016-01-01

    Several clinical studies analyze axillary treatment in women with early-stage breast cancer because of changes in the indication for axillary lymph node dissection. The aim of the study is to analyze the impact of axillary radiotherapy in disease-free and overall survival in women with early breast cancer treated with lumpectomy. Retrospective study in women with initial stages of breast carcinoma treated by lumpectomy. A comparative analysis of high-risk women with axillary lymph node involvement who received axillary radiotherapy with the group of women with low risk without radiotherapy was performed. Logistic regression was used to determine factors influencing survival and lymphedema onset. A total of 541 women were included in the study: 384 patients (71%) without axillary lymph node involvement and 157 women (29%) with 1-3 axillary lymph node involvement. Patients with axillary radiotherapy had a higher number of metastatic lymph node compared to non-irradiated (1.6±0.7 vs. 1.4±0.6, P=.02). The group of women with axillary lymph node involvement and radiotherapy showed an overall and disease-free survival at 10 years similar to that obtained in patients without irradiation (89.7% and 77.2%, respectively). 3 lymph nodes involved multiplied by more than 7 times the risk of death (HR=7.20; 95% CI: 1.36 to 38.12). The multivariate analysis showed axillary lymph node dissection as the only variable associated with the development of lymphedema. The incidence of axillary relapse on stage I and II breast cancer is rare. In these patients axillary radiotherapy does not improve overall survival, but contributes to regional control in those patients with risk factors. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Stage T1-2 prostate cancer with pretreatment PSA 10 ng/ml or less: radiotherapy or surgery?

    International Nuclear Information System (INIS)

    Keyser, Douglas; Kupelian, Patrick; Zippe, Craig; Klein, Eric

    1996-01-01

    Purpose: Presently, patients with pretreatment PSA levels ≤10 ng/ml constitute the majority of cases presenting for definitive treatment. Our aim was to determine whether the type of treatment (radiotherapy versus surgery) affected biochemical failure rates in this group of patients. This study is based on 389 patients treated at a single institution. Material and Methods: The charts of all patients treated with either radiotherapy or prostatectomy alone between 1987 and 1993 were reviewed (n=811). Patients with clinical stage T1 or T2 disease, and a pretreatment PSA level (iPSA) of 10.0 or less were analyzed (n=389). Two hundred forty nine (64%) received radical prostatectomy and 140 (36%) received radiotherapy (median dose 66.6 Gy). Pretreatment patient characteristics including clinical stage, biopsy Gleason score (GS) and iPSA level were not significantly different between the radiation and surgery groups (Table 1). The patients treated with radiation were significantly older (median age 70 years vs. 64 years, p<0.05). A total of 37% of the prostatectomy patients had a positive margin. The median follow-up time was 33 months; 1458 follow-up PSA levels were available for analysis. Biochemical failure was defined as a rise in PSA level of 1.0 ng/ml above the nadir PSA level in radiotherapy cases, or any value above 0.2 ng/ml in the prostatectomy cases. Results: The overall 5 year actuarial biochemical relapse free survival (bRFS) rate was 70%. The 5-year bRFS rates for prostatectomy and radiotherapy were identical (70%) (Fig.1). The significant factors affecting bRFS rates were iPSA level (≤4 vs. 4-10 ng/ml) and Gleason score (≤6 vs. ≥7) (Table 2). The 5-year bRFS rates of patients with iPSA ≤4 vs. iPSA 4-10 ng/ml were 92% vs. 61% respectively, p<0.01. The 5-year clinical relapse free survival was 93%. All clinical failures were preceded by biochemical failure. Patients with positive surgical margins did significantly worse than those with negative

  14. Factors influencing treatment results of definitive radiotherapy following transurethral surgery for muscle-invasive bladder cancer

    International Nuclear Information System (INIS)

    Abe, Tatsuyuki; Kanehira Chihiro

    1999-01-01

    To determine the prognostic factors influencing the outcome of bladder cancer patients treated with definitive radiotherapy following transurethral tumor resection (TURBT). From March 1977 through August 1991, 83 patients with muscle-invasive bladder cancer were treated with TURBT (as thoroughly as possible) and definitive radiotherapy (median total dose: 64 Gy, median fractional dose: 2 Gy). Cystectomy was performed when possible for the residual or recurrent invasive cancer following radiotherapy. The median follow-up period was 76 months. The overall survival (OS) and bladder-preserving survival (BPS) rates at 5 years were 38% and 28%, respectively. Univariate analysis indicated that depth of invasion (T2 vs T3), tumor diameter (<3 cm vs. ≥3 cm), and visible (R1) or not visible (R0) residual tumor after TURBT influenced both OS and BPS. In multivariate analysis, absence of visible residual tumor after TURBT was the only significant prognostic factor related to OS (p<0.001) and BPS (p=0.002). Five-year OS and BPS were 54% and 43% in T2-3R0 and 14% and 7% in T2-3R1, respectively. Absence of visible residual tumor after TURBT was significantly associated with better overall survival and bladder-preserving survival for muscle-invasive bladder cancer patients treated with definitive radiotherapy following TURBT. (author)

  15. Neoadjuvant concurrent chemoradiotherapy followed by definitive high-dose radiotherapy or surgery for operable thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Masao, Murakami; Yasumasa, Kuroda; Yosiaki, Okamoto; Koichi, Kono; Eisaku, Yoden; Fusako, Kusumi; Kiyoshi, Hajiro; Satoru, Matsusue; Hiroshi, Takeda

    1997-01-01

    Purpose: A prospective clinical trial was undertaken to investigate the feasibility of concurrent chemoradiotherapy for the esophageal carcinoma. Materials and Methods: Between June 1989 and May 1996, forty patients with operable squamous cell carcinoma of the thoracic esophagus (stage 0 to III: UICC 1987), aged 45 to 78 (mean:64), were enrolled in a study of neoadjuvant concurrent chemoradiotherapy followed by definitive high-dose radiotherapy (CRT group) or surgery (CRT-S group). Neoadjuvant chemoradiotherapy consisted of 44Gy in 40 fractions for 4 weeks (2.2Gy/2Fr./day) through 10MVX rays, with one or two courses of cisplatin (80-150mg/body, mean:90mg/m 2 , day 1, bolus injection) and 5-fluorouracil (500-1500mg/body/day, mean:600mg/m 2 , day 1-4, continuous infusion). After completion of neoadjuvant chemoradiotherapy, clinical complete response (CR) was observed in 16 patients, partial response (PR) in 22, and no change (NC) in 2. Thirty responding patients (CR:16, PR:14) entered in CRT group, and 10 non-responding patients (PR:8, NC:2) followed by surgery (CRT-S group). A cumulative median dose of 66Gy for Tis,T1 and 71Gy for T2-T4 tumor with/without high-dose-rate intraluminal brachytherapy, and one to three courses of chemotherapy were delivered in CRT group. Intraoperative radiotherapy for abdominal lymphatic system and postoperative supraclavicular irradiation were added in CRT-S group. Results: Clinical CR rate at the completion of treatment showed 90% in CRT group, and pathological CR rate 10% in CRT-S group. The overall median survival was 45 months, survival at 1, 2, 3 years being 100%, 72%, 56%, respectively. Loco-regional failure was observed in 7 patients (all in CRT group), distant failure in 6 (3 in CRT group, 3 in CRT-S group) and loco-regional with distant failure in 1 (CRT group). Four patients of loco-regional recurrence in CRT group were salvaged by surgery. Overall survival at 2-, 3-years for CRT vs. CRT-S group was 72%, 64% vs. (1(1)); 100

  16. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands : a population-based study

    NARCIS (Netherlands)

    van Maaren, Marissa C.; de Munck, Linda; de Bock, Geertruida H.; Jobsen, Jan J.; van Dalen, Thijs; Linn, Sabine C.; Poortmans, Philip; Strobbe, Luc J. A.; Siesling, Sabine

    BACKGROUND: Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving

  17. 10 year survival after breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer in the Netherlands: a population-based study

    NARCIS (Netherlands)

    Maaren, M.C. van; Munck, L.; Bock, G.H. de; Jobsen, J.J.; Dalen, T. van; Linn, S.C.; Poortmans, P.; Strobbe, L.J.A.; Siesling, S.

    2016-01-01

    BACKGROUND: Investigators of registry-based studies report improved survival for breast-conserving surgery plus radiotherapy compared with mastectomy in early breast cancer. As these studies did not present long-term overall and breast cancer-specific survival, the effect of breast-conserving

  18. Radiotherapy in bladder cancer

    International Nuclear Information System (INIS)

    Rozan, R.

    1992-01-01

    In 1992, the problem of the vesical radiotherapy is not resolved. The author presents the situation and the different techniques of radiotherapy in bladder cancers: external radiotherapy, only and associated with surgery, interstitial curietherapy and non-classical techniques as per operative radiotherapy, neutron therapy and concurrent radiotherapy with chemotherapy. In order to compare their efficiency, the five-year survival are given in all cases.(10 tabs)

  19. Pattern of failures in gastric cancer patients with lymph node involvement treated by surgery, intraoperative and external beam radiotherapy

    International Nuclear Information System (INIS)

    Glehen, O.; Peyrat, P.; Beaujard, A.C.; Chapet, O.; Romestaing, P.; Sentenac, I.; Francois, Y.; Vignal, J.; Gerard, J.P.; Gilly, F.N.

    2003-01-01

    Aims: High local failure rates in gastric cancer have been reported, up to 67%. To achieve a better local control, we evaluated intraoperative radiotherapy (IORT) and external beam radiotherapy (EBRT) in association with surgery for gastric cancer patients with lymph node involvement. We report here the analysis of the patterns of failure for patients involved in this IORT protocol. Material and methods: Forty-two positive lymph node (N+) gastric cancer patients were operated on (31 total, three subtotal and eight extended gastrectomies) with IORT procedure between 1985 and 1997 (33 males, nine females, mean age 61.3 years). IORT was focused on coeliac area (mean dose 15 Gy), followed by EBRT (46 Gy) in 36 patients. Ten patients were pN1 and 32 were pN2. A concurrent systemic chemotherapy (five Fluoro-Uracil and Cisplatinum) was performed in 14 patients. Results: One patient died postoperatively. Actuarial pN+ 10 year survival rate was 44.8%. The 5 year actuarial local control and disease-free survival rates were 78.8 and 47.5%, respectively. As far as patterns of failure were explored, 5 patients have a local coeliac recurrence (12%) and 12 have distant metastases with no evidence of coeliac recurrence. Conclusion: This retrospective analysis suggests a potential effect of IORT and/or EBRT in promoting local control and long-term survival in gastric cancer patients with lymph node involvement

  20. Carotid body paragangliomas : a systematic study on management with surgery and radiotherapy

    NARCIS (Netherlands)

    Suarez, Carlos; Rodrigo, Juan P.; Mendenhall, William M.; Hamoir, Marc; Silver, Carl E.; Gregoire, Vincent; Strojan, Primoz; Neumann, Hartmut P. H.; Obholzer, Rupert; Offergeld, Christian; Langendijk, Johannes A.; Rinaldo, Alessandra; Ferlito, Alfio

    The definitive universally accepted treatment for carotid body tumors (CBT) is surgery. The impact of surgery on cranial nerves and the carotid artery has often been underestimated. Alternatively, a few CBTs have been followed without treatment or irradiation. The goal of this study is to summarize

  1. Radiotherapy as adjunct to surgery for malignant carotid body paragangliomas presenting with lymph node metastases

    International Nuclear Information System (INIS)

    Mayer, R.; Poschauko, J.; Fruhwirth, J.; Beham, A.; Groell, R.

    2000-01-01

    Between 1985 and 1994, 3 female patients (51 to 65 years of age) were referred for postoperative radiotherapy after complete (2) or incomplete (1) surgical excision of a malignant carotid paraganglioma (Shamblin III). Preoperative angiographic embolization of the tumor-supplying arteries was performed in all cases. In 2 patients resection of the internal carotid artery and reconstruction by saphenous vein graft was necessary. Continuous course radiotherapy of the tumor bed (50 to 56 Gy/2 Gy) and regional lymph nodes (50 Gy) using photon beams was delivered in 2 patients. The third patient having had incomplete resection cancelled radiotherapy after 4 Gy. Results: Within an observation time of 110 and 119 months no evidence of recurrence was obtained in both patients irradiated postoperatively. The third patient died of progressive disease. Twelve months after the withdrawn irradiation she presented with a tumor progression into the brain and an ulcerated mass on the right side of the neck and was irradiated consecutively for palliation. In none of the patients severe acute or late radiation-induced complications were observed. (orig.) [de

  2. 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.

  3. 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

  4. 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.

  5. Neutron scattering treatise on materials science and technology

    CERN Document Server

    Kostorz, G

    1979-01-01

    Treatise on Materials Science and Technology, Volume 15: Neutron Scattering shows how neutron scattering methods can be used to obtain important information on materials. The book discusses the general principles of neutron scattering; the techniques used in neutron crystallography; and the applications of nuclear and magnetic scattering. The text also describes the measurement of phonons, their role in phase transformations, and their behavior in the presence of crystal defects; and quasi-elastic scattering, with its special merits in the study of microscopic dynamical phenomena in solids and

  6. Neoadjuvant intra-arterial chemotherapy combined with radiotherapy and surgery in patients with advanced maxillary sinus cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Tae; Kim, Yong Kan; Lee, Ju Hye; Kim, Dong Hyun; Park, Dahl; Cho, Kyu Sup; Kim, Dong Won [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of); Nam, Ji Ho; Roh, Hwan Jung [Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan (Korea, Republic of)

    2013-09-15

    The optimal treatment of advanced maxillary sinus cancer has been challenging for several decades. Intra-arterial chemotherapy (IAC) for head and neck cancer has been controversial. We have analyzed the long-term outcome of neoadjuvant IAC followed by radiation therapy (RT) and surgery. Twenty-seven patients with advanced maxillary sinus cancer were treated between 1989 and 2002. Five-fluorouracil (5-FU, 500 mg/m2) was infused intra-arterially, and followed by RT (total 50.4 Gy/28 fractions). A planned surgery was performed 3 to 4 weeks after completion of IAC and RT. At a median follow-up of 77 months (range, 12 to 169 months), the 5-year rates of overall survival in all patients were 63%. The 5-year rates of overall survival of stage T3/T4 patients were 70.0% and 58.8%, respectively. Seven of fourteen patients with disease recurrence had a local recurrence alone. The 5-year actuarial local control rates in patients with stage T3/T4, and in all patients were 20.0%, 32.3%, and 27.4%, respectively. Overall response rate after the completion of IAC and RT was 70.3%. During the follow-up, seven patients (25.9%) showed mild to moderate late complications. The tumor extent (i.e., the involvement of either orbit and/or base of skull) appeared to be related with local recurrence. Neoadjuvant IAC with 5-FU followed by RT and surgery may be effective to improve local tumor control in the patients with advanced maxillary sinus cancer. However, local failure was still the major cause of death. Further investigations are required to determine the optimal treatment schedule, radiotherapy techniques and chemotherapy regimens.

  7. Preoperative hyperfractionated accelerated radiotherapy and radical surgery in advanced head and neck cancer: A prospective phase II study

    International Nuclear Information System (INIS)

    Lindholm, Paula; Valavaara, Ritva; Aitasalo, Kalle; Kulmala, Jarmo; Laine, Juhani; Elomaa, Liisa; Sillanmaeki, Lauri; Minn, Heikki; Grenman, Reidar

    2006-01-01

    Background and purpose: To evaluate whether preoperative hyperfractionated accelerated radiotherapy (RT) combined with major radical surgery is feasible and successful in the treatment of advanced primary head and neck cancer. Patients and methods: Ninety four patients with histologically confirmed head and neck squamous cell cancer (HNSCC) in the oral cavity (41/96; 43%), supraglottis (14/96; 15%), glottis (5/96; 5%), oropharynx (16/96; 17%), nasal cavity/paranasal sinuses (8/96; 8%), nasopharynx (3/96; 3%), hypopharynx (7/96; 7%) and two (2%) with unknown primary tumour and large cervical lymph nodes entered into the study. 21/96 patients (22%) had stage II, 17/96 (18%) stage III and 58/96 patients (60%) stage IV disease. The patients received preoperative hyperfractionated RT 1.6 Gy twice a day, 5 days a week to a median tumour dose of 63 Gy with a planned break for 11 days (median) after the median dose of 37 Gy. Then, after a median of 27 days the patients underwent major radical surgery of the primary tumour and metastatic lymph nodes including reconstructions with pedicled or microvascular free flaps when indicated as a part of the scheduled therapy. 12/96 patients had only ipsilateral or bilateral neck dissections. Results: After a median follow-up time of 37.2 mos 77/96 (80.2%) patients had complete locoregional control. All but 2 patients had complete histological remission after surgery. 40/96 pts were alive without disease, two of them after salvage surgery. 32/96 patients had relapsed; 15 had locoregional and 13 distant relapses, 4 patients relapsed both locoregionally and distantly. Fifty patients have died; 29 with locoregional and/or distant relapse, eight patients died of second malignancy, and 19 had intercurrent diseases. Disease-specific and overall survival at 3 years was 67.7 and 51%, respectively. Acute grade three mucosal reactions were common, but transient and tolerable. Late grade 3-4 adverse effects were few. Conclusions: Preoperative

  8. 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.

  9. Jugular and vagal paragangliomas: Systematic study of management with surgery and radiotherapy

    NARCIS (Netherlands)

    Suarez, C.; Rodrigo, J.P.; Bodeker, C.C.; Llorente, J.L.; Silver, C.E.; Jansen, J.C.; Takes, R.P.; Strojan, P.; Pellitteri, P.K.; Rinaldo, A.; Mendenhall, W.M.; Ferlito, A.

    2013-01-01

    BACKGROUND: The definitive treatment for head and neck paraganglioma (PG) is surgical excision. Unfortunately, surgery, particularly of vagal paraganglioma (VPG; "glomus vagale") and foramen jugulare ("glomus jugulare") tumors, may be complicated by injuries to the lower cranial nerves, a high price

  10. Conservative surgery and radiotherapy in the treatment of breast cancer. Preliminary results of 148 patients

    International Nuclear Information System (INIS)

    Faria, S.L.; Chiminazzo Junior, H.; Koseki, N.; Oliveira Filho, J.A. de

    1986-01-01

    The combination of tumoral resection and radiotherapy with preservation of the breast is called conservative treatment of breast cancer. The literature considers this treatment a good option if used by an experient team and with appropriate equipment. This paper shows the results of 148 cases of breast cancer treated by this conservative approach at Centro de Oncologia Campinas. Follow-up varied from 3 to 87 months (mean 28) considered by the histological diagnosis. Overall actuarial survival of 5 years was 77% disease-free survival 55%. Twelve patients (8%) presented local relapse and 13 (9%) had distant metastases as the first therapeutic failure. Cosmetic results were considered good and fair in 89% of patients. These results are similar to others published in the literature (Author) [pt

  11. Small scale photon beams measurement and modeling for Intensity-modulated radiotherapy and radio-surgery

    International Nuclear Information System (INIS)

    Abdul Hadi, Talal

    2017-01-01

    The advanced techniques of radiotherapy use very small fields in case small tumors such as in the brain to irradiate precisely the lesion. This work concerns the measurement absorbed dose in small field of 0.5 x 0.5 cm"2 to 3 x 3 cm"2. However, the measurement dose in small fields is characterized by high gradient dose and a leak of lateral electronic equilibrium. That requires use a detector having an adapted sensitive volume and adapted spatial resolution. The detectors marketed are not perfectly compatible with these conditions. Actually, there is no international methodological consensus, nor a metrological reference for measurement dose in small fields. The IAEA (International Atomic Energy Agency) protocol 398 used to calculate the absorbed dose at 10 cm x 10 cm is not suitable for small fields. In absence a referenced detector, the dosimetric data measurement is verified using a Gafchromic films due to its excellent spatial resolution. We measure using conventional detectors (ionization chambers and/or Gafchromic films) the leakage dose at a point outside of irradiated field. The dosimetric data such as output factor (OF), percentage depth dose (PDD) and off-axis ratio (OAR) were also carried out by the diode. The correlation between the on-axis dose and off-axis dose is the subject of our study. This study proposes an experimental method to calculate the on-axis dose in small field for stereotactic radiotherapy. The method is based on the out of field leakage measurement. This model can be used to validate dose and output factor measurement. The experimental validation of the present method was performed for square and rectangular fields with sizes ranging from 0.5 cm x 0.5 cm to 10 cm x 10 cm. (author) [fr

  12. Does radiotherapy after surgery affect outcomes in Ewing's sarcoma of the pelvis?

    Directory of Open Access Journals (Sweden)

    Ajay Puri

    2018-01-01

    Full Text Available Background: The impact of postoperative radiotherapy (PORT on outcomes has been a matter of debate after adequate resection in Ewing's sarcoma of the pelvis. We evaluated our cases after surgical excision in pelvic Ewing's sarcoma and assessed local control and overall survival (OS with respect to PORT and chemotherapy-induced percentage necrosis. Materials and Methods: Forty four surgically operated patients (June 2002–November 2014 of localized Ewing's sarcoma were retrospectively reviewed. There were 31 males and 13 females. Age ranged from 2 to 53 years. All patients received institutional chemotherapy protocol. No patient received preoperative radiotherapy. Specimen was analyzed for margins and chemotherapy-induced percentage necrosis. PORT was offered to patients on case-by-case basis. Presence of a large preoperative soft-tissue component, margin evaluation, and percentage necrosis were factors considered. At time of the last followup, 29 patients were alive, 11 died, and 4 were lost to followup. Survivors had a minimum followup of 2 years (range: 31–118 months, mean = 69 months. Results: One of twenty (5% patients with PORT had a local recurrence as against 2 of 24 (8% without PORT. OS of all patients was 76% at 5 years. Twelve patients with 90% necrosis had OS of 83% (P = 0.040. OS of patients with PORT was 74%, without PORT was 78% (P = 0.629. Conclusions: The decision to offer PORT after surgical excision in pelvic Ewing's sarcoma is multifactorial; the absence of PORT in selected cases is not detrimental to local control. Poor responders to chemotherapy had poorer survival while PORT did not impact on outcomes.

  13. Does Radiotherapy after Surgery Affect Outcomes in Ewing's Sarcoma of the Pelvis?

    Science.gov (United States)

    Puri, Ajay; Gulia, Ashish; Crasto, Saniya; Vora, Tushar; Khanna, Nehal; Laskar, Siddharth

    2018-01-01

    The impact of postoperative radiotherapy (PORT) on outcomes has been a matter of debate after adequate resection in Ewing's sarcoma of the pelvis. We evaluated our cases after surgical excision in pelvic Ewing's sarcoma and assessed local control and overall survival (OS) with respect to PORT and chemotherapy-induced percentage necrosis. Forty four surgically operated patients (June 2002-November 2014) of localized Ewing's sarcoma were retrospectively reviewed. There were 31 males and 13 females. Age ranged from 2 to 53 years. All patients received institutional chemotherapy protocol. No patient received preoperative radiotherapy. Specimen was analyzed for margins and chemotherapy-induced percentage necrosis. PORT was offered to patients on case-by-case basis. Presence of a large preoperative soft-tissue component, margin evaluation, and percentage necrosis were factors considered. At time of the last followup, 29 patients were alive, 11 died, and 4 were lost to followup. Survivors had a minimum followup of 2 years (range: 31-118 months, mean = 69 months). One of twenty (5%) patients with PORT had a local recurrence as against 2 of 24 (8%) without PORT. OS of all patients was 76% at 5 years. Twelve patients with 90% necrosis had OS of 83% ( P = 0.040). OS of patients with PORT was 74%, without PORT was 78% ( P = 0.629). The decision to offer PORT after surgical excision in pelvic Ewing's sarcoma is multifactorial; the absence of PORT in selected cases is not detrimental to local control. Poor responders to chemotherapy had poorer survival while PORT did not impact on outcomes.

  14. 18F-fluoromisonidazole (FMISO) and 18F-fluorodeoxyglucose (FDG) PET in patients undergoing radiotherapy or chemotherapy following surgery for high-grade glioma

    International Nuclear Information System (INIS)

    Lee, S. T.

    2009-01-01

    Full text:Background: Tumour hypoxia is associated with disease progression and resistance to therapy. High grade cerebral gliomas have a poor outcome despite advancements in chemotherapy and radiotherapy. 18F-fluoromisonidazole (18F-FMISO) concentrates in hypoxic cells and is associated with tumour grade in gliomas. The aim of this study was to compare the patterns of uptake of 18F-FDG PET and 18F-FMISO PET post-surgery with MRI and areas of recurrence post-radiotherapy. Methods: Patients with high grade cerebral glioma were recruited into this prospective study. All patients had post-surgical, pre-radiotherapy 18F-FDG, 18F-FMISO and MRI scans, which were all repeated 4-6 weeks post-completion to radiotherapy. The patients were followed-up clinically three monthly and re-imaged if indicated. Results: Ten patients were enrolled in this study, mean age 62 years (range 55-69 years), who all had pre-radiotherapy scans performed. Seven patients had scans done pre- and post-radiotherapy, with 3 patients with only pre-therapy scans. Nine patients had significant FMISO uptake and 8 patients demonstrated abnormal FDG uptake. The areas of FMISO uptake on pre-radiotherapy scans correlated with the most abnormal areas of contrast-enhancement on pre-treatment MRI and areas of locally recurrent disease on post-treatment MRI in eight patients. Nine patients had locally recurrent disease on follow-up MRI. FMISO was more predictive of tumour recurrence compared to FDG. Conclusion: Post-surgical 18F-FMISO PET in patients with cerebral glioma is more predictive of areas of recurrent disease compared to 18F-FDG PET.

  15. The Relationship Between Local Recurrence and Radiotherapy Treatment Volume for Soft Tissue Sarcomas Treated With External Beam Radiotherapy and Function Preservation Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Dickie, Colleen I., E-mail: Colleen.dickie@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Griffin, Anthony M. [Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto (Canada); University of Toronto, Toronto (Canada); Parent, Amy L. [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); Chung, Peter W.M.; Catton, Charles N. [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); University of Toronto, Toronto (Canada); Svensson, Jon [AngliaRuskin University, Cambridge (United Kingdom); Ferguson, Peter C.; Wunder, Jay S.; Bell, Robert S. [Division of Orthopaedic Surgery, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, Toronto (Canada); University of Toronto, Toronto (Canada); Sharpe, Michael B.; O' Sullivan, Brian [Radiation Medicine Program, Princess Margaret Hospital, Toronto (Canada); University of Toronto, Toronto (Canada)

    2012-03-15

    Purpose: To examine the geometric relationship between local recurrence (LR) and external beam radiotherapy (RT) volumes for soft-tissue sarcoma (STS) patients treated with function-preserving surgery and RT. Methods and Materials: Sixty of 768 (7.8%) STS patients treated with combined therapy within our institution from 1990 through 2006 developed an LR. Thirty-two received preoperative RT, 16 postoperative RT, and 12 preoperative RT plus a postoperative boost. Treatment records, RT simulation images, and diagnostic MRI/CT data sets of the original and LR disease were retrospectively compared. For LR location analysis, three RT target volumes were defined according to the International Commission on Radiation Units and Measurements 29 as follows: (1) the gross tumor or operative bed; (2) the treatment volume (TV) extending 5 cm longitudinally beyond the tumor or operative bed unless protected by intact barriers to spread and at least 1-2 cm axially (the TV was enclosed by the isodose curve representing the prescribed target absorbed dose [TAD] and accounted for target/patient setup uncertainty and beam characteristics), and (3) the irradiated volume (IRV) that received at least 50% of the TAD, including the TV. LRs were categorized as developing in field within the TV, marginal (on the edge of the IRV), and out of field (occurring outside of the IRV). Results: Forty-nine tumors relapsed in field (6.4% overall). Nine were out of field (1.1% overall), and 2 were marginal (0.3% overall). Conclusions: The majority of STS tumors recur in field, indicating that the incidence of LR may be affected more by differences in biologic and molecular characteristics rather than aberrations in RT dose or target volume coverage. In contrast, only two patients relapsed at the IRV boundary, suggesting that the risk of a marginal relapse is low when the TV is appropriately defined. These data support the accurate delivery of optimal RT volumes in the most precise way using advanced

  16. The Relationship Between Local Recurrence and Radiotherapy Treatment Volume for Soft Tissue Sarcomas Treated With External Beam Radiotherapy and Function Preservation Surgery

    International Nuclear Information System (INIS)

    Dickie, Colleen I.; Griffin, Anthony M.; Parent, Amy L.; Chung, Peter W.M.; Catton, Charles N.; Svensson, Jon; Ferguson, Peter C.; Wunder, Jay S.; Bell, Robert S.; Sharpe, Michael B.; O’Sullivan, Brian

    2012-01-01

    Purpose: To examine the geometric relationship between local recurrence (LR) and external beam radiotherapy (RT) volumes for soft-tissue sarcoma (STS) patients treated with function-preserving surgery and RT. Methods and Materials: Sixty of 768 (7.8%) STS patients treated with combined therapy within our institution from 1990 through 2006 developed an LR. Thirty-two received preoperative RT, 16 postoperative RT, and 12 preoperative RT plus a postoperative boost. Treatment records, RT simulation images, and diagnostic MRI/CT data sets of the original and LR disease were retrospectively compared. For LR location analysis, three RT target volumes were defined according to the International Commission on Radiation Units and Measurements 29 as follows: (1) the gross tumor or operative bed; (2) the treatment volume (TV) extending 5 cm longitudinally beyond the tumor or operative bed unless protected by intact barriers to spread and at least 1–2 cm axially (the TV was enclosed by the isodose curve representing the prescribed target absorbed dose [TAD] and accounted for target/patient setup uncertainty and beam characteristics), and (3) the irradiated volume (IRV) that received at least 50% of the TAD, including the TV. LRs were categorized as developing in field within the TV, marginal (on the edge of the IRV), and out of field (occurring outside of the IRV). Results: Forty-nine tumors relapsed in field (6.4% overall). Nine were out of field (1.1% overall), and 2 were marginal (0.3% overall). Conclusions: The majority of STS tumors recur in field, indicating that the incidence of LR may be affected more by differences in biologic and molecular characteristics rather than aberrations in RT dose or target volume coverage. In contrast, only two patients relapsed at the IRV boundary, suggesting that the risk of a marginal relapse is low when the TV is appropriately defined. These data support the accurate delivery of optimal RT volumes in the most precise way using advanced

  17. Short-course radiotherapy, with elective delay prior to surgery, in patients with unresectable rectal cancer who have poor performance status or significant co-morbidity

    International Nuclear Information System (INIS)

    Hatfield, Paul; Hingorani, Mohan; Radhakrishna, Ganesh; Cooper, Rachel; Melcher, Alan; Crellin, Adrian; Kwok-Williams, Michelle; Sebag-Montefiore, David

    2009-01-01

    Background and purpose: Standard treatment for rectal cancer which threatens the expected plane of resection on MRI imaging is long-course, pre-operative chemoradiotherapy (1.8-2 Gy, 25-28 fractions). Not all patients are suitable for this because of age, poor performance status or co-morbidities. We describe our experience of short-course (5 x 5 Gy) pre-operative radiotherapy with planned, delayed surgery (SCPRT-delay) in this patient group. Materials and methods: Between April 2001 and October 2007, 43 patients were selected for SCPRT-delay. The clinical records were retrospectively evaluated. Results: Median age was 82 (range 58-87). Forty-one patients had radiotherapy of which 26 (61%) were subsequently able to have surgery. Of these, R0, R1 and R2 resections were performed in 22, 2 and 2 patients, respectively. Treatment was well tolerated, although two patients required hospital admission for management of diarrhoea and one developed significant late small bowel toxicity, attributable to radiotherapy. In those undergoing R0 or R1 resection there have been no local recurrences (median follow-up 18 months). Median survival for the whole group was 23 months, although this was 44 months in those undergoing surgery. Conclusions: SCPRT-delay appears to be a useful alternative to long-course pre-operative chemoradiotherapy in this high-risk group of patients.

  18. A case of delayed anastomotic fistula occurred nine years after adjuvant radiotherapy following rectal cancer surgery

    International Nuclear Information System (INIS)

    Matsumoto, Tomoko; Fukao, Takashi; Kuriyama, Shiho; Ohtawa, Yasuyuki; Waku Toshihiko

    2017-01-01

    The patient was a 72-year-old man who underwent a low anterior resection for rectal cancer in 2007 (RbRa, pT4a, pN1, cM0, pStage 3a). With the surgically stripped surface testing positive, the pelvic cavity was subjected to 50 Gy of radiation as part of adjuvant radiotherapy. In December 2015, the patient presented with anal pain and bloody stool.A CT scan revealed a pelvic abscess accompanied by gas patterns around the anastomotic site, and a colonoscopy detected formation of a fistula at the anastomotic site. Although CT-guided drainage was performed in response, a new abscess was formed promptly. In April 2016, laparoscopic colostomy with double orifices was performed on the transverse colon. Thereafter the abscesses in the buttocks required four sessions of incision and drainage. The condition improved with no purulent discharge after December 2016. As of 11 months after the colostomy, the pelvic abscess is gradually contracting, though some fistulas have remained. The patient has been followed up on an ambulatory basis.This case is considered to be of an intrapelvic abscess associated with the delayed anastomotic fistula occurred after a lapse of 9 years following irradiation. (author)

  19. Radiotherapy as an alternative to surgery in elderly patients with resectable lung cancer

    International Nuclear Information System (INIS)

    Noordijk, E.M.; Poest Clement, E. v.d.; Hermans, J.; Wever, A.M.J.; Leer, J.W.H.

    1988-01-01

    From 1978 to 1983, 50 patients with a peripherally located non-small cell tumor of the lung were irradiated with curative intent. These patients were not operated upon because of poor cardiac or pulmonary condition, old age or refusal to operate. Mean age was 74 years, 40 patients being over 70 years of age. All patients had T 1-2 N 0 M 0 tumors according to the AJC classification and received 60 Gy to the primary tumor only. The overall response rate was 90%, with 50% complete responses in tumors smaller than 4 cm. The crude overall survival rates were 56% at 2 years and 16% at 5 years, with a median survival of 27 months. Age did not influence survival. There was a strong correlation of survival to tumour size. These results compared favorably to a group of 86 patients over 70 years of age who were selected for operation in the same hospital. The authors conclude that in patients over 70 years of age with resectable lung cancer, radiotherapy with curative intent should be offered as an alternative to operation, especially if the tumor is not larger than 4 cm. The wait-and-see policy in operable patients of this age group must be abandoned. 13 refs.; 6 figs.; 4 tabs

  20. Ten-year results of treatment of ductal carcinoma in situ (DCIS) of the breast with conservative surgery and radiotherapy.

    Science.gov (United States)

    Amichetti, M; Caffo, O; Richetti, A; Zini, G; Rigon, A; Antonello, M; Arcicasa, M; Coghetto, F; Valdagni, R; Maluta, S; Di Marco, A

    1997-09-01

    The optimal treatment of ductal carcinoma in situ (DCIS) of the breast has not yet been established. The effectiveness of adjuvant postoperative radiotherapy after conservative surgery is debated. Few data are available in Italy on the combined treatment. A collaborative multi-institutional study on this issue in 10 radiation oncology departments of the north-east of Italy was conducted. One hundred and thirty nine women with DCIS of the breast were treated between 1980 and 1990. Age ranged between 28 and 88 years (median 50 years). Surgical procedures were: quadrantectomy in 108, lumpectomy in 22 and wide excision in 9 cases. The axilla was surgically staged in 97 cases: all the patients were node-negative. Radiation therapy was delivered with 60Co units (78%) or 6 MV linear accelerators (22%) for a median total dose to the entire breast of 50 Gy (mean 49.48 Gy; range 45-60 Gy). The tumour bed was boosted in 109 cases (78%) at a dose of 4-30 Gy (median 10 Gy) for a minimum tumour dose of 58 Gy. Median follow-up was 81 months. Thirteen local recurrences were recorded, 7 intraductal and 6 invasive. All recurrent patients had a salvage mastectomy and are alive and free of disease. Actuarial overall, cause-specific and recurrence-free survival at 10 years are of 93%, 100% and 86%, respectively. The results of this retrospective multicentric study substantiate the favourable data reported in the literature and confirm the efficacy of the breast-conserving treatment of DCIS employing conservative surgery and adjuvant radiation therapy.

  1. Sites of local recurrence after surgery, with or without chemotherapy, for rectal cancer: implications for radiotherapy field design

    International Nuclear Information System (INIS)

    Hruby, George; Barton, Michael; Miles, Sharon; Carroll, Susan; Nasser, Elias; Stevens, Graham

    2003-01-01

    Purpose: To examine the sites of pelvic recurrence in patients with rectal cancer previously untreated with radiotherapy to determine the relative frequency and location of recurrence within the pelvis. Methods and Materials: The records of patients with locally recurrent rectal cancer referred to three radiation oncology departments between 1984 and 1997 were reviewed. The data collected included the date and type of the initial resection and the pathologic findings. The site of recurrence within the pelvis, presence of metastasis, and date of recurrence were documented. Results: A total of 269 patients were included. Tumor had invaded through the muscularis in 74% and involved other organs in 9%. Fifty-two percent of patients were node positive at initial surgery. The median time to local recurrence from surgery was 18 months (range 15-20) and from local recurrence to death was 14 months (range 12-17). Both the initial tumor stage and the resection type influenced the recurrence location within the pelvis (p<0.01). T4 tumors comprised only 9% of initial T stage tumors but accounted for 38% of anterior central pelvic recurrences (p<0.01). All perineal recurrences occurred after abdominoperineal resection. The sites of recurrence within the pelvis were the posterior central pelvis (47%) and anastomotic (21%). Conclusion: If those patients with T4 tumors at presentation were excluded, 89% had local recurrence at, or posterior to, the anastomosis. Furthermore, if we exclude both patients who underwent abdominoperineal resection and those with T4 tumors at presentation, the rate increases to 93%. The rate of recurrence anteriorly (7%) does not justify routine radiation of the anterior pelvis beyond that required to adequately cover the anastomotic site

  2. Treatises “On Virtues and Vices”: Translation from the Greek into Russian and commentary

    Directory of Open Access Journals (Sweden)

    Alexander Sanzhenakov

    2016-06-01

    Full Text Available This paper is divided into three sections: an introduction, a translation of Pseudo-Aristotelian treatise “On Virtues and Vices” (De virtutibus et vitiis, and a commentary to this text. In the introduction, the author briefly describes textual tradition, critical editions and available translations of the treatise in European languages. The major issue, discussed in the introduction, concerns the question of authenticity and authorship of the treatise. Arguments by E. Zeller, C. Schuchhardt, F. Susemihl, E. Schmidt, who seriously questioned the authenticity of the text, are contrasted with the opinion of P. Simpson, who insisted on its authenticity. The author of the present work is inclined to think that the treatise is a later composition. Respective arguments are presented in length in the commentary, where the author attempts to place the treatise in the context of the ethical works of the Corpus Aristotelicum, on the one hand, and this of the later Hellenistic developments, on the other.

  3. Gold and not so real gold in Medieval treatises

    Directory of Open Access Journals (Sweden)

    Srebrenka Bogovic-Zeskoski

    2015-01-01

    Full Text Available The aim of this study is to evidence diverse materials and processes used by artisans (and alchemists required to synthesize a visually viable replacement for gold. The emphasis of the research is upon the production of mosaic gold or porporina, a pigment that has survived into modern times, which was used as ink and as paint. Base metals, mostly tin, but also alloys were used both into foils coated with glazes and varnishes and as pigment. The research focuses upon recipes documented in treatises dating from Antiquity to the late Medieval period (ca. 1500 and an attempt is made to answer two questions. In the first place, why was there a need for a surrogate? Secondly, why are there so few tangible examples detected on surviving artifacts? In conclusion, an argument is offered pointing out that, although much can be learned by scientific examination of artifacts, textual analysis is equally important and necessary to unravel mysteries of ancient technologies

  4. Neutron fluctuations a treatise on the physics of branching processes

    CERN Document Server

    Pazsit, Imre; Pzsit, Imre

    2007-01-01

    The transport of neutrons in a multiplying system is an area of branching processes with a clear formalism. This book presents an account of the mathematical tools used in describing branching processes, which are then used to derive a large number of properties of the neutron distribution in multiplying systems with or without an external source. In the second part of the book, the theory is applied to the description of the neutron fluctuations in nuclear reactor cores as well as in small samples of fissile material. The question of how to extract information about the system under study is discussed. In particular the measurement of the reactivity of subcritical cores, driven with various Poisson and non-Poisson (pulsed) sources, and the identification of fissile material samples, is illustrated. The book gives pragmatic information for those planning and executing and evaluating experiments on such systems. - Gives a complete treatise of the mathematics of branching particle processes, and in particular n...

  5. Evaluation of radiotherapy after incomplete surgery in patients with carcinoma of the maxillary sinus

    International Nuclear Information System (INIS)

    Korzeniowski, S.; Reinfuss, M.; Skolyszewski, J.

    1985-01-01

    The retrospective analysis of 57 patients with cancer of the maxillary antrum irradiated after incomplete surgery was performed is described. The majority of patients had very advanced disease (54% T4 tumors). In 18 patients partial resection of maxillary antrum was performed: 39 patients underwent total maxillectomy. In 35 patients macroscopic residual tumor (MRT) was present after surgery. All patients were irradiated postoperatively with 60 Co teletherapy and received a dose of 60 Gy in 20-30 fractions over 4-6 weeks. Five year symptom-free survival in the whole group was 35%. An analysis of pattern of relapses indicates that histology should be regarded as an important factor of management. In keratinizing squamous cell cancer, local control remains the main problem. In patients with nonkeratinizing squamous cell cancer, both local and regional control is important and elective irradiation of neck nodes may be of value. In patients with undifferentiated cancer, distant metastases appear to have the greatest impact on survival

  6. Evaluation of radiotherapy after incomplete surgery in patients with carcinoma of the maxillary sinus

    Energy Technology Data Exchange (ETDEWEB)

    Korzeniowski, S.; Reinfuss, M.; Skolyszewski, J.

    1985-03-01

    The retrospective analysis of 57 patients with cancer of the maxillary antrum irradiated after incomplete surgery was performed is described. The majority of patients had very advanced disease (54% T4 tumors). In 18 patients partial resection of maxillary antrum was performed: 39 patients underwent total maxillectomy. In 35 patients macroscopic residual tumor (MRT) was present after surgery. All patients were irradiated postoperatively with /sup 60/Co teletherapy and received a dose of 60 Gy in 20-30 fractions over 4-6 weeks. Five year symptom-free survival in the whole group was 35%. An analysis of pattern of relapses indicates that histology should be regarded as an important factor of management. In keratinizing squamous cell cancer, local control remains the main problem. In patients with nonkeratinizing squamous cell cancer, both local and regional control is important and elective irradiation of neck nodes may be of value. In patients with undifferentiated cancer, distant metastases appear to have the greatest impact on survival.

  7. Autonomic nerve-sparing surgery with preoperative or intraoperative radiotherapy for advanced lower rectal cancer

    International Nuclear Information System (INIS)

    Saito, Norio; Ono, Masato; Sugifuji, Masanori; Kawashima, Kiyotaka; Arai, Tatsuo; Koda, Keishi; Takiguchi, Nobuhiro; Oda, Kenji; Nakajima, Nobuyuki

    2000-01-01

    Autonomic-nerve-sparing surgery was performed for advanced lower rectal cancer, and the results in patients who had undergone preoperative irradiation plus chemotherapy (RCT group) and intraoperative irradiation (IORT group) were compared. The autonomic nerves of 76 of the 84 patients in the RCT group were conserved. The radiation dose was 42.6 Gy, and surgery was performed 2 weeks after the irradiation. Their curability was A. Urinary function was maintained. The results for sexual function were better in the cases in which the autonomic nerves were completely conserved. The 5-year cumulative survival rate was 84.1%. The local recurrence rate was 7.9% and was no higher after treatment by the conventional method. The autonomic nerves of all 61 patients in the IORT group, were conserved. Patients were irradiated with 15 Gy (5 MeV) to the pelvic nerve plexuses and peripheral region with a cone 4 cm in diameter. Irradiation depth was estimated to be approximately 15 mm. The results for urinary function and sexual function were equivalent to those in the RCT group. The 5-year cumulative survival rate was 79%. The local recurrence rate was 9.8%. The autonomic nerve conservation rate was increased in both groups but the results in terms of QOL, such as sexual function, were inadequate. Further development and improvement of treatment methods for advanced lower rectal cancer are needed. (K.H.)

  8. Randomized trial addressing risk features and time factors of surgery plus radiotherapy in advanced head-and-neck cancer

    International Nuclear Information System (INIS)

    Ang, K. Kian; Trotti, Andy; Brown, Barry W.; Garden, Adam S.; Foote, Robert L.; Morrison, William H.; Geara, Fady B.; Klotch, Douglas W.; Goepfert, Helmuth; Peters, Lester J.

    2001-01-01

    Purpose: A multi-institutional, prospective, randomized trial was undertaken in patients with advanced head-and-neck squamous cell carcinoma to address (1) the validity of using pathologic risk features, established from a previous study, to determine the need for, and dose of, postoperative radiotherapy (PORT); (2) the impact of accelerating PORT using a concomitant boost schedule; and (3) the importance of the overall combined treatment duration on the treatment outcome. Methods and Materials: Of 288 consecutive patients with advanced disease registered preoperatively, 213 fulfilled the trial criteria and went on to receive therapy predicated on a set of pathologic risk features: no PORT for the low-risk group (n=31); 57.6 Gy during 6.5 weeks for the intermediate-risk group (n=31); and, by random assignment, 63 Gy during 5 weeks (n=76) or 7 weeks (n=75) for the high-risk group. Patients were irradiated with standard techniques appropriate to the site of disease and likely areas of spread. The study end points were locoregional control (LRC), survival, and morbidity. Results: Patients with low or intermediate risks had significantly higher LRC and survival rates than those with high-risk features (p=0.003 and p=0.0001, respectively), despite receiving no PORT or lower dose PORT, respectively. For high-risk patients, a trend toward higher LRC and survival rates was noted when PORT was delivered in 5 rather than 7 weeks. A prolonged interval between surgery and PORT in the 7-week schedule was associated with significantly lower LRC (p=0.03) and survival (p=0.01) rates. Consequently, the cumulative duration of combined therapy had a significant impact on the LRC (p=0.005) and survival (p=0.03) rates. A 2-week reduction in the PORT duration by using the concomitant boost technique did not increase the late treatment toxicity. Conclusions: This Phase III trial established the power of risk assessment using pathologic features in determining the need for, and dose of

  9. Preservation of cosmesis with low complication risk after conservative surgery and radiotherapy for ductal carcinoma in situ of the breast

    International Nuclear Information System (INIS)

    Mills, Janete M.; Schultz, Delray J.; Solin, Lawrence J.

    1997-01-01

    Purpose: Although the clinical outcome after treatment of ductal carcinoma in situ (DCIS) using breast-conservation surgery and radiation therapy has been well documented, little data has been reported on cosmetic outcome or treatment complications. Therefore, the present study was performed to evaluate cosmesis and complications after breast-conservation treatment for DCIS and to analyze various factors that might affect cosmesis and predispose to complications. Methods and Materials: The records of 90 patients who were alive without evidence of disease with a 3-year minimum follow-up were evaluated for cosmetic results and treatment complications following breast-conservation surgery and radiation therapy for DCIS. Complete gross excision of the primary tumor had been performed in all patients. Additionally, 24 patients had undergone an axillary lymph node dissection in the earlier years of the study. The majority of the patients had received 50-50.4 Gy to the whole breast followed by an electron boost for a total dose of 60-66 Gy. Results: The cosmetic results of 90 evaluable patients at 3 years were: excellent in 69 (77%), good in 19 (21%), and fair in 2 (2%). The cosmetic results of 64 evaluable patients at 5 years were: excellent in 46 (72%), good in 16 (25%), and fair in 2 (3%). Factors associated with worse cosmetic results were an increased volume of tissue excised (>70 cm 3 ) and a negative ipsilateral breast biopsy after radiotherapy. Complications in the 24 patients with an axillary dissection were: arm edema (n = 6), cellulitis of the arm (n = 5), and axillary vein thrombosis (n = 1). Complications in the 66 patients without an axillary dissection were: cellulitis of the arm (n = 1) and cellulitis of the breast (n = 1). Discussion: Breast-conservation surgery followed by radiation therapy achieved excellent or good cosmetic results in 98 and 97% of patients at 3 years and 5 years, respectively. Complications were associated primarily with axillary

  10. Cost-effectiveness of radiotherapy during surgery compared with external radiation therapy in the treatment of women with breast cancer

    Directory of Open Access Journals (Sweden)

    Hedie Mosalanezhad

    2016-04-01

    Full Text Available Introduction: Intraoperative radiation therapy device (IORT is one of the several options for partial breast irradiation. IORT is sent to the tumor bed during surgery and can be replaced with conventional standard therapy (EBRT. The aim of this study was to evaluate the safety and effectiveness of IORT machine compared with EBRT and to determine the dominant option in terms of the cost-effectiveness. Method: This study was conducted in two phases; the first phase was a comprehensive review of the electronic databases search that was extracted after extraction and selection of the articles used in this article on effectiveness outcomes. Data collection form was completed by professionals and experts to estimate the cost of treatment, intraoperative radiotherapy and radiotherapy cost when using external radiation therapy process; direct costs were considered from the perspective of service provider and they were calculated in the second phase to determine the option of cost-effective ICER. Excel software was used for data analysis and sensitivity analysis was performed to determine the strength of the results of cost-effectiveness. Results:18 studies were selected but only 8 of them were shown to have acceptable quality. The consequences like “rate of cancer recurrence”, “seroma”, “necrosis”, “toxic”, “skin disorders and delayed wound healing” and “spread the pain” were among the consequences used in the selected articles. The total costs for each patient during a course of treatment for EBRT and IORT were estimated 1398 and $5337.5, respectively. During the analysis, cost-effectiveness of the consequences of cancer recurrence, seroma, necrosis and skin disorders and delayed wound healing ICER was calculated. And IORT was found to be the dominant supplier in all cases. Also, in terms of implications of toxicity and prevalence of pain, IORT had a lower cost and better effectiveness and consequently the result was more cost

  11. Surgery vs. radiotherapy in patients with uveal melanoma. Analysis of the SEER database using propensity score matching and weighting

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Bum-Sup [Seoul National University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of); Chang, Ji Hyun [SMG-SNU Boramae Medical Center, Department of Radiation Oncology, Seoul (Korea, Republic of); Oh, Sohee [SMG-SNU Boramae Medical Center, Department of Biostatistics, Seoul (Korea, Republic of); Lim, Yu Jin [Kyunghee University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of); Kim, Il Han [Seoul National University College of Medicine, Department of Radiation Oncology, Seoul (Korea, Republic of)

    2017-11-15

    The treatment modalities for uveal melanoma (UM) include surgery and radiotherapy (RT). The utilization of RT as a strategy for organ preservation has been increasing, but the survival difference between the two aforementioned treatment modalities has not been reported. An observational and cohort study was performed using a propensity score with an already existing public database. Patients diagnosed with UM within the period from 2004-2013 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. One-to-one matching and inverse probability of treatment weighting (IPTW) using the propensity score were used to estimate and compare survival rates. Overall, 3291 patients were treated: 2503 received RT only (RT group) and 788 received surgical resection only (surgery group). The RT group had an improved crude 5-year overall survival (OS) rate compared with the surgery group (76% vs. 60%, P < 0.001), and an improved 5-year melanoma-specific survival (MSS) rate (89% vs. 73%, P < 0.001). Compared to the surgery group, the RT group was associated with improved OS (hazard ratio [HR] 0.52, 95% confidence interval [CI] 0.38-0.73, P < 0.001) and MSS (HR 0.48, 95% CI 0.35-0.65, P < 0.001) in the matched cohort. The survival benefit of the RT group maintained after adjustment with IPTW, both in OS and MSS. To our knowledge, the present study was the first to demonstrate the survival difference between the two treatment modalities for UM using both the propensity score matching and weighting methods with the SEER database. The current study suggests that RT may provide a survival advantage over surgery in the treatment of UM. (orig.) [German] Die Behandlungsmodalitaeten fuer das Uveamelanom (UM) sind die Chirurgie und Strahlentherapie (RT). Die Nutzung der RT als Strategie zum Organerhalt hat zugenommen, aber der Unterschied in der Ueberlebensrate zwischen den beiden zuvor genannten Behandlungsmodalitaeten wurde nicht berichtet. Beobachtungs- und

  12. A case of rectal cancer successfully treated with surgery and stereotactic radiotherapy for metachronous lung metastases

    International Nuclear Information System (INIS)

    Oshima, Yu; Hosoda, Yohei; Tachi, Hidekazu

    2016-01-01

    A 64-year-old woman underwent polypectomy for a rectal polyp (Isp). Pathological findings were invasion of the submucosa (3,500 μm diameter), and she underwent anterior resection for rectal cancer (RS, pT1b, pN0, cM0, Stage I ) without adjuvant chemotherapy. Lung masses were found in her right (8 mm) and left lung (7 mm). The tumors enlarged during the 4 month follow-up period. We decided to perform left partial pneumonectomy. The tumor was diagnosed as a lung metastasis from colon cancer by pathology. Because the right tumor was located towards the center, performing right pneumonectomy would have been quite invasive and we feared occult metastases. We decided to apply SRT (50 Gy) to the right tumor. The tumor shrunk and became a scar after treatment. There were no complications such as radiation pneumonitis. The patient was in good health without any recurrence for 12 months after SRT. Surgical resection is an optimal method to control lung metastasis from colon cancer if the lesion is operable. However, in the case of a tumor centrally located, surgical resection may cause deterioration of lung function. There are also cases with contraindications for surgery due to co-morbidities. In addition, there is no consensus on observation periods to exclude occult metastases. SRT can be an effective treatment for lung metastases from colon cancer when there are bilateral lung metastases and no metastases outside the lungs. (author)

  13. Is the time interval between surgery and radiotherapy important in operable nonsmall cell lung cancer? A retrospective analysis of 340 cases

    International Nuclear Information System (INIS)

    Wuerschmidt, Florian; Buenemann, Henry; Ehnert, Michael; Heilmann, Hans-Peter

    1997-01-01

    Purpose: To evaluate the influence of prognostic factors in postoperative radiotherapy of NSCLC with special emphasis on the time interval between surgery and start of radiotherapy. Methods and Materials: Between January 1976 and December 1993, 340 cases were treated and retrospectively analyzed meeting the following criteria: complete follow-up; complete staging information including pathological confirmation of resection status; maximum interval between surgery (SX) and radiotherapy (RT) of 12 weeks (median 36 days, range 18 to 84 days); minimum dose of 50 Gy (R0), and maximum dose of 70 Gy (R2). Two hundred thirty patients (68%) had N2 disease; 228 patients were completely resected (R0). One hundred six (31%) had adenocarcinoma, 172 (51%) squamous cell carcinoma. Results: In univariate analysis, Karnofsky performance status (90+ > 60-80%; p = 0.019 log rank), resection status stratified for nodal disease (R+ < R0; p = 0.046), and the time interval between SX and RT were of significant importance. Patients with a long interval (37 to 84 days) had higher 5-year survival rates (26%) and a median survival time (MST: 21.9 months, 95% C.I. 17.2 to 28.6 months) than patients with a short interval (18 to 36 days: 15%; 14.9 months, 13 to 19.9 months; p = 0.013). A further subgroup analysis revealed significant higher survival rates in patients with a long interval in N0/1 disease (p = 0.011) and incompletely resected NSCLC (p = 0.012). In multivariate analysis, the time interval had a p-value of 0.009 (nodal disease: p = 0.0083; KPI: p = 0.0037; sex: p = 0.035). Conclusion: Shortening the time interval between surgery and postoperative radiotherapy to less than 6 weeks even in R+ cases is not necessary. Survival of patients with a long interval between surgery and start of radiotherapy was better in this retrospective analysis as compared to patients with a short interval

  14. Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Min, Sun Young [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Department of Surgery, Kyung Hee University, Seoul (Korea, Republic of); Lee, Seung Ju [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Shin, Kyung Hwan, E-mail: radiat@ncc.re.kr [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Park, In Hae; Jung, So-Youn; Lee, Keun Seok; Ro, Jungsil; Lee, Seeyoun; Kim, Seok Won [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kim, Tae Hyun [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Kang, Han-Sung [Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of); Cho, Kwan Ho [Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang (Korea, Republic of)

    2011-12-01

    Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinical AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.

  15. Locoregional Recurrence of Breast Cancer in Patients Treated With Breast Conservation Surgery and Radiotherapy Following Neoadjuvant Chemotherapy

    International Nuclear Information System (INIS)

    Min, Sun Young; Lee, Seung Ju; Shin, Kyung Hwan; Park, In Hae; Jung, So-Youn; Lee, Keun Seok; Ro, Jungsil; Lee, Seeyoun; Kim, Seok Won; Kim, Tae Hyun; Kang, Han-Sung; Cho, Kwan Ho

    2011-01-01

    Purpose: Breast conservation surgery (BCS) and radiotherapy (RT) following neoadjuvant chemotherapy (NCT) have been linked with high locoregional recurrence (LRR) rates and ipsilateral breast tumor recurrence (IBTR) rates. The purpose of this study was to analyze clinical outcomes in patients who exhibited LRR and IBTR after being treated by BCS and RT following NCT. Methods and Materials: In total, 251 breast cancer patients treated with BCS and RT following NCT between 2001 and 2006 were included. All patients had been shown to be clinically node-positive. Clinical stage at diagnosis (2003 AJCC) was II in 68% of patients and III in 32% of patients. Of those, 50%, 35%, and 15% of patients received anthracycline-based, taxane-based, and combined anthracycline-taxane NCT, respectively. All patients received RT. Results: During follow-up (median, 55 months), 26 (10%) patients had LRR, 19 of these patients had IBTR. Five-year actuarial rates of IBTR-free and LRR-free survival were 91% and 89%, respectively. In multivariate analyses, lack of hormone suppression therapy was found to increase both LRR and IBTR rates. Hazard ratios were 7.99 (p < 0.0001) and 4.22 (p = 0.004), respectively. Additionally, pathology stage N2 to N3 increased LRR rate (hazard ratio, 4.22; p = 0.004), and clinical AJCC stage III IBTR rate (hazard ratio, 9.05; p = 0.034). Achievement of pathological complete response and presence of multifocal tumors did not affect LRR or IBTR. Conclusions: In patients with locally advanced disease, who were clinically node-positive at presentation, BCS after NCT resulted in acceptably low rates of IBTR and LRR. Mastectomy should be considered as an option in patients who present with clinical stage III tumors or who are not treated with adjuvant hormone suppression therapy, because they exhibit high IBTR rates after NCT and BCS.

  16. Influence of surgery-radiotherapy interval on recurrence in breast-conserving treatment of small breast cancer

    International Nuclear Information System (INIS)

    Fourquet, A.; Dreyfus, H.; Maher, M.; Gozy, M.; Campana, F.; Vilcoq, J. R.; Colombani, H.

    1995-01-01

    Purpose: To retrospectively evaluate the possible influence of surgery-radiotherapy interval (SRI) on breast recurrence in patients (pts.) with small breast cancers who had a breast-conserving treatment. Materials and Methods: Between January 1981 and December 1988, of 2012 pts. with stage I-II breast cancers treated with wide excision, axillary node dissection and breast irradiation, 1839 (91%) did not received adjuvant chemotherapy and were included in this study. Median age was 51 yrs. [23-88]. Mean tumor size was 2.1 cm [0.5-5]. Median tumor bed irradiation dose was 65 Gy [50-90]. The median SRI was 32 days [5-137]. Pts. were distributed among three SRI groups: 56 days (61 pts). Breast recurrence risk and survival were determined by Kaplan-Meier estimates. The following prognostic factors were evaluated for their possible influence on breast recurrence: age, tumor size, node involvement, estrogen receptor levels, Bloom and Richardson grading (SBR). Therapeutic factors were also analyzed: place of surgery (inside or outside the institution), breast and tumor bed radiation dose, and SRI as a time-dependent variable. A multivariate analysis of breast recurrence risk was performed to adjust for the various confounding factors. A prognostic index was established and the influence of SRI on recurrence was determined within the various prognostic groups. Results: Median follow-up for living pts. was 78 months [3-158]. Breast recurrence rate at 7 years was 11 % [10-13]. The 7-year survival rate was 89 % [88-91]. The 7-year breast recurrence risks in the three SRI groups were 12 %, 9 %, and 18%, respectively (p=0.045). The relative risk (RR) of breast failure was significantly lower in the 35-56 days SRI group compared with the 56 days) were also associated with a higher risk of recurrence, though not statistically significant because of the small numbers. The effect of SRI was time-dependent, i. e. influencing early recurrences and disappearing after 5 years. It was

  17. 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

  18. Parotid lymph-node metastases from cutaneous squamous-cell carcinomas: treatment outcome and prognostic factors following surgery and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Chua, M.T.; Veness, M.J.; Gebski, V.; Cakir, B.; Tiver, K.W.; Morgan, G.; Shakespeare, T.

    2002-01-01

    Australia has the highest incidence of cutaneous squamous cell carcinoma (SCC) in the world. The majority of lesions occur in the head and neck, and regional lymph-node metastases from cutaneous SCCs, though uncommon, reflect an aggressive manifestation. Surgery and adjuvant radiotherapy are currently considered best practice. Fifty-two eligible patients during 1980-1997 were identified in a retrospective review of patients treated within the department of Radiation Oncology, Westmead Hospital, Sydney. Relevant data were extracted from the files, referring clinicians and the New South Wales Cancer Council. The median age at diagnosis was 63 years and the majority were men (87%). Unfavourable pathological features were present in many of the patients. Only extranodal spread (P = 0.02) was identified as an independent predictor for locoregional recurrence on multivariate analysis. The cumulative locoregional recurrence rates were 28 and 45% at 2 and 5 years, respectively. The 5-year cause-specific survival rate in this study was 65%. We conclude that parotid lymph-node metastases from cutaneous SCCs of the head and neck are associated with a high rate of locoregional recurrence and cause-specific mortality despite surgery and adjuvant radiotherapy. The role of altered fractionation after surgery as a means to further enhance locoregional control warrants further investigation. Copyright (2002) Blackwell Science Pty Ltd

  19. Treatise on classical elasticity theory and related problems

    CERN Document Server

    Teodorescu, Petre P

    2013-01-01

    Deformable solids have a particularly complex character; mathematical modeling is not always simple and often leads to inextricable difficulties of computation. One of the simplest mathematical models and, at the same time, the most used model, is that of the elastic body – especially the linear one. But, notwithstanding its simplicity, even this model of a real body may lead to great difficulties of computation. The practical importance of a work about the theory of elasticity, which is also an introduction to the mechanics of deformable solids, consists of the use of scientific methods of computation in a domain in which simplified methods are still used. This treatise takes into account the consideration made above, with special attention to the theoretical study of the state of strain and stress of a deformable solid. The book draws on the known specialized literature, as well as the original results of the author and his 50+ years experience as Professor of Mechanics and Elasticity at the University o...

  20. Treatment and Prognosis of Isolated Local Relapse after Stereotactic Body Radiotherapy for Clinical Stage I Non-Small-Cell Lung Cancer: Importance of Salvage Surgery.

    Science.gov (United States)

    Hamaji, Masatsugu; Chen, Fengshi; Matsuo, Yukinori; Ueki, Nami; Hiraoka, Masahiro; Date, Hiroshi

    2015-11-01

    Many efforts have been made to detect local relapse (LR) in the follow-up after stereotactic body radiotherapy (SBRT) for non-small-cell lung cancer (NSCLC) although limited data are available on its treatment and prognosis. We aimed to characterize treatment options and clarify long-term outcomes of isolated LR after SBRT for patients with clinical stage I NSCLC. We reviewed our institutional database in search of patients with isolated LR after SBRT for clinical stage I NSCLC at our institution between 1999 and 2013. Patient characteristics were compared with Mann-Whitney U test, χ2 test, or Fisher's exact test as appropriate. Survival outcomes were estimated with Kaplan-Meier method. Potential prognostic factors were investigated using Cox proportional hazard model. Of 308 patients undergoing SBRT for clinical stage I NSCLC, 49 patients were identified to have isolated LR. Twelve patients underwent salvage surgery, none underwent radiotherapy, and eight patients received chemotherapy, whereas 29 patients received best supportive care. No patient characteristic except operability was significantly related with patient selection for LR treatments. Five-year overall survival (OS) rate of the whole cohort was 47.9% from SBRT and 25.7% from LR. Salvage surgery was associated with improved OS after LR (p = 0.014), and 5-year OS for patients undergoing salvage surgery was 79.5% from LR. It was confirmed that our patient selection for salvage surgery for isolated LR was associated with favorable survival outcomes. Operability based on multidisciplinary conferences, rather than measurable patient characteristics, is essential for appropriate patient selection for salvage surgery.

  1. Treatise on skull fractures by Berengario da Carpi (1460-1530).

    Science.gov (United States)

    Mazzola, Riccardo F; Mazzola, Isabella C

    2009-11-01

    Jacopo Berengario was born in Carpi, a medieval city close to Modena (northern Italy), circa 1460. He studied medicine at Bologna University and, in 1489, graduated in philosophy and medicine. He was appointed lecturer in anatomy and surgery at the same university, a position that he maintained for 24 years. Between 1514 and 1523, Berengario published some important anatomic and surgical works, which gave considerable fame to him.Commentaria... supra Anatomiam Mundini (Commentary... on the Anatomy of Mondino), published in 1521, constitutes the first example of an illustrated anatomic textbook ever printed. The anatomic illustrations were intended for explaining the text. Artistically speaking, the plates are typical examples of the Renaissance period and worthy of the greatest consideration.De Fractura Calvae sive Cranei (On Fracture of the Calvaria or Cranium), published in Bologna in 1518, is the first treatise devoted to head injuries ever printed. It is a landmark in the development of cranial surgery that went through numerous editions. The text was prepared in 2 months and dedicated to Lorenzo de' Medici, Duke of Urbino, who experienced a skull injury in the occipital region. Berengario wanted to demonstrate to other physicians his knowledge of anatomy and his expertise on the brain and head traumas. The book includes the illustration of an entire surgical kit or a corpus instrumentorum for performing cranial operations, which appeared for the first time in a printed book. However, Berengario's highly commendable aim was to indicate to the reader the step-by-step procedure of craniotomy for management of skull fractures along with the sequential use of the previously presented instruments.

  2. CROSS and beyond: a clinical perspective on the results of the randomized ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study.

    Science.gov (United States)

    van der Woude, Stephanie O; Hulshof, Maarten C C M; van Laarhoven, Hanneke W M

    2016-02-01

    Despite extensive research efforts oesophageal cancer remains a malignancy with a poor prognosis. Improvement of treatment is urgently needed. Although multimodality treatment for resectable oesophageal cancer has established it place in standard practice, there are still many differences worldwide in the preferred treatment. The Dutch ChemoRadiotherapy for Oesophageal cancer followed by Surgery Study (CROSS) trial has contributed significantly to the current use of neoadjuvant chemoradiation. This study compared neoadjuvant chemoradiotherapy (CRT) using a moderate radiation dose weekly combined with carboplatin and paclitaxel followed by surgery versus surgery alone. Median overall survival in the CRT group is 49.4 months compared to 24.0 months in the surgery alone group, resulting in an overall survival benefit of 13% in favor of the CRT group (HR, 0.81; 95% CI: 0.70-0.93; P=0.002). Recently the results after long-term follow-up (median 60 months) have been published and confirm the benefit of neoadjuvant CRT to surgery alone. Perioperative mortality rates are low and did not increase by adding CRT (4%) and the CROSS scheme has a favorable toxicity profile. Recurrence patterns in patients treated according to the CROSS protocol report significantly reduced loco regional recurrence in the CRT group (34% to 14%; P<0.001) and less peritoneal carcinomatosis (14% to 4%; P<0.001). With the contemporary focus of research on tumor tailored therapy, the effective and safe CROSS protocol serves as a backbone in many ongoing trials.

  3. Radiotherapy in Prostate Cancer Patients With Pelvic Lymphocele After Surgery: Clinical and Dosimetric Data of 30 Patients.

    Science.gov (United States)

    Jereczek-Fossa, Barbara Alicja; Colangione, Sarah Pia; Fodor, Cristiana; Russo, Stefania; Cambria, Raffaella; Zerini, Dario; Bonora, Maria; Cecconi, Agnese; Vischioni, Barbara; Vavassori, Andrea; Matei, Deliu Victor; Bottero, Danilo; Brescia, Antonio; Musi, Gennaro; Mazzoleni, Federica; Orsi, Franco; Bonomo, Guido; De Cobelli, Ottavio; Orecchia, Roberto

    2015-08-01

    The purpose of the study was to evaluate the feasibility of irradiation after prostatectomy in the presence of asymptomatic pelvic lymphocele. The inclusion criteria for this study were: (1) patients referred for postoperative (adjuvant or salvage) intensity modulated radiotherapy (IMRT; 66-69 Gy in 30 fractions); (2) detection of postoperative pelvic lymphocele at the simulation computed tomography [CT] scan; (3) no clinical symptoms; and (4) written informed consent. Radiotherapy toxicity and occurrence of symptoms or complications of lymphocele were analyzed. Dosimetric data (IMRT plans) and the modification of lymphocele volume during radiotherapy (cone beam CT [CBCT] scan) were evaluated. Between January 2011 and July 2013, in 30 of 308 patients (10%) treated with radiotherapy after prostatectomy, pelvic lymphocele was detected on the simulation CT. The median lymphocele volume was 47 cm(3) (range, 6-467.3 cm(3)). Lymphocele was not included in planning target volume (PTV) in 8 cases (27%). Maximum dose to lymphocele was 57 Gy (range, 5.7-73.3 Gy). Radiotherapy was well tolerated. In all but 2 patients, lymphoceles remained asymptomatic. Lymphocele drainage-because of symptom occurrence-had to be performed in 2 patients during IMRT and in one patient, 7 weeks after IMRT. CBCT at the end of IMRT showed reduction in lymphocele volume and position compared with the initial data (median reduction of 37%), more pronounced in lymphoceles included in PTV. Radiotherapy after prostatectomy in the presence of pelvic asymptomatic lymphocele is feasible with acceptable acute and late toxicity. The volume of lymphoceles decreased during radiotherapy and this phenomenon might require intermediate radiotherapy plan evaluation. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Breast cancer in patients carrying a germ-line CHEK2 mutation: Outcome after breast conserving surgery and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Meyer, Andreas; Doerk, Thilo; Sohn, Christof; Karstens, Johann H.; Bremer, Michael

    2007-01-01

    Background and purpose: Women carrying mutations in the CHEK2 gene are at an increased breast cancer risk. Data about outcome and prognosis for these patients after standard multimodality treatment are scarce at present. Materials and methods: One-hundred and fifty (150) patients with non-metastasized early-stage breast cancer (T1-2) receiving postoperative radiotherapy following breast-conservative surgery at our department were included in this analysis. Carriers were identified using mutation-specific restriction enzyme-based screening assays in previous investigations. Twenty-five breast cancer patients were heterozygous for one of three CHEK2 gene mutations (I157T, n = 13; 1100delC, n = 10; IVS2+1G > A, n = 2). The comparison group consisted of 125 early-stage breast cancer patients without a CHEK2 gene mutation (non-carriers). Median follow-up was 87 months for the total cohort of patients. Results: Local recurrences occurred in 13 patients (carriers, 3 (12%); non-carriers, 10 (8%)) and distant metastases occurred in 27 patients (carriers, 8 (32%); non-carriers, 19 (15%)). Twenty-five patients had deceased (carriers, 8 (32%); non-carriers, 17 (14%)) with all but 3 deaths related to breast cancer. Actuarial 7-year local relapse-free survival was 86% in carriers versus 90% in non-carriers (p = 0.48). Actuarial metastasis-free, disease-free and overall survival at 7 years were 64% vs. 84% (p = 0.045), 59% vs. 78% (p = 0.07) and 69% vs. 87% (p = 0.10), respectively. In a multivariate step-wise Cox regression analysis presence of a CHEK2 mutation remained a borderline significant discriminator for metastasis-free survival (p = 0.048; OR = 0.4; 95% CI 0.2-1.0) next to T-stage (p = 0.001; OR 0.3; 95% CI 0.1-0.6). Conclusions: Heterozygosity for a germline CHEK2 mutation appears to represent an adverse prognostic factor in patients with early-stage breast cancer. If confirmed in larger studies these data may serve as a basis for future surveillance and treatment

  5. Black pepper and health claims: a comprehensive treatise.

    Science.gov (United States)

    Butt, Masood Sadiq; Pasha, Imran; Sultan, Muhammad Tauseef; Randhawa, Muhammad Atif; Saeed, Farhan; Ahmed, Waqas

    2013-01-01

    For millennia, spices have been an integral part of human diets and commerce. Recently, the widespread recognition of diet-health linkages bolsters their dietary importance. The bioactive components present in them are of considerable significance owing to their therapeutic potential against various ailments. They provide physiological benefits or prevent chronic ailment in addition to the fundamental nutrition and often included in the category of functional foods. Black pepper (Piper Nigrum L.) is an important healthy food owing to its antioxidant, antimicrobial potential and gastro-protective modules. Black pepper, with piperine as an active ingredient, holds rich phytochemistry that also includes volatile oil, oleoresins, and alkaloids. More recently, cell-culture studies and animal modeling predicted the role of black pepper against number of maladies. The free-radical scavenging activity of black pepper and its active ingredients might be helpful in chemoprevention and controlling progression of tumor growth. Additionally, the key alkaloid components of Piper Nigrum, that is, piperine assist in cognitive brain functioning, boost nutrient's absorption and improve gastrointestinal functionality. In this comprehensive treatise, efforts are made to elucidate the antioxidant, antimicrobial, anti-inflammatory, gastro-protective, and antidepressant activities of black pepper. Moreover, the synergistic interaction of black pepper with different drugs and nutrients is the limelight of the manuscript. However, the aforementioned health-promoting benefits associated with black pepper are proven in animal modeling. Thus, there is a need to conduct controlled randomized trials in human subjects, cohort studies, and meta-analyses. Such future studies would be helpful in recommending its application in diet-based regimens to prevent various ailments.

  6. The Logic of Reflection: Samuel Taylor Coleridge's "treatise on Logic"

    Science.gov (United States)

    Land, Janet Sanders

    Though others discuss Coleridge's interest in science, light imagery, the phenomenon of reflection, and his references to Newton and Opticks,^1 this is the first study to examine Coleridge's art in terms of optics, its developing theories, and the nature-of-light debate. This study examines Coleridge's early predilection for visions, illusions, and the supernatural and demonstrates that he gradually shifts from the supernatural to the scientific aspects of "visions" and "illusions," concentrating on causes of illusions and the effects of their deceptive qualities rather than their mystical features. By the 1820's, his preoccupation with illusions had become an interest in optics, fueled, no doubt, by the increasing controversy of the nature-of-light debate and the number of advances in optics resulting from the efforts of its opponents to prove their theories. Tracing the development of the debate, its escalation in the early nineteenth century, and the formation of Coleridge's opinion concerning key issues of the debate, I outline the evolution of Coleridge's theory of reflection and examine the exposition of that theory in his treatise, Logic (1981). Finally, I analyze the relationship between the advances in optics and Coleridge's concepts of thought and knowledge and his notion of the mind as an instrument of knowledge. These ideas in turn, altered his opinions concerning the validity of knowledge resulting from philosophic debate, scientific experiment, and poetic exploration. ftn^1John Beer, "Coleridge and Wordsworth on Reflection," The Wordsworth Circle 20 (1989): 20-29; Coleridge the Visionary. London: Chatto and Windus, 1959; and Coleridge's Poetic Intelligence. London: Macmillan, 1977 and M. H. Abrams Natural Supernaturalism: Tradition and Revolution in Romantic Literature. New York: Norton, 1971; and "Coleridge's 'A Light in Sound': Science, Metascience, and Poetic Imagination." The Correspondent Breeze: Essays on English Romanticism. Eds. M. H. Abrams

  7. Radiobiology of human cancer radiotherapy

    International Nuclear Information System (INIS)

    Andrews, J.R.

    1978-01-01

    The author has systematically collected and collated the scientific literature correlating the basic and clinical sciences in this field in order to produce a definitive treatise. The book thoroughly reviews the biology and biochemistry relevant to radiobiology and describes the critical locus for the extinction of cell reproductive capacity. Extensive coverage is given to oxygen effect, hyperthermia, high linear energy transfer, cell populations, and similar topics. Separate sections cover time, dose, and fractionation; radiation hematology; cancer chemotherapy; and cancer immunology. The book also contains invaluable discussions of techniques for optimizing radiotherapy alone and in combination with other therapies

  8. Accelerated hypofractionated radiotherapy as adjuvant regimen after conserving surgery for early breast cancer: interim report of toxicity after a minimum follow up of 3 years

    Science.gov (United States)

    2010-01-01

    Background Accelerated hypofractionation is an attractive approach for adjuvant whole breast radiotherapy. In this study we evaluated the adverse effects at least 3 years post an accelerated hypofractionated whole breast radiotherapy schedule. Methods From October 2004 to March 2006, 39 consecutive patients aged over 18 years with pTis, pT1-2, pN0-1 breast adenocarcinoma who underwent conservative surgery were treated with an adjuvant accelerated hypofractionated radiotherapy schedule consisting of 34 Gy in 10 daily fractions over 2 weeks to the whole breast, followed after 1 week by an electron boost dose of 8 Gy in a single fraction to the tumour bed. Skin and lung radiation toxicity was evaluated daily during therapy, once a week for one month after radiotherapy completion, every 3 months for the first year and from then on every six months. In particular lung toxicity was investigated in terms of CT density evaluation, pulmonary functional tests, and clinical and radiological scoring. Paired t-test, Chi-square test and non-parametric Wilcoxon test were performed. Results After a median follow-up of 43 months (range 36-52 months), all the patients are alive and disease-free. None of the patients showed any clinical signs of lung toxicity, no CT-lung toxicity was denoted by radiologist on CT lung images acquired about 1 year post-radiotherapy, no variation of pulmonary density evaluated in terms of normalised Hounsfield numbers was evident. Barely palpable increased density of the treated breast was noted in 9 out of 39 patients (in 2 patients this toxicity was limited to the boost area) and teleangectasia (radiotherapy schedule investigated in this study (i.e 34 Gy in 3.4 Gy/fr plus boost dose of 8 Gy in single fraction) is a feasible and safe treatment and does not lead to adjunctive acute and late toxicities. A longer follow up is necessary to confirm these favourable results. PMID:20100335

  9. Morbidity of a combined modality therapy of I.A. Doxorubicin, neoadjuvant radiotherapy and surgery for locally advanced high grade Soft Tissue Sarcomas (STS) of the extremities

    International Nuclear Information System (INIS)

    Nijhuis, Paul; Pras, Betty; Sleijfer, Dirk Th.; Molenaar, Ineke M.; Schraffordt, Koops Heimen; Hoekstra, Harald J.

    1997-01-01

    Purpose/objective: In the early eighties a combined modality therapy of intra-arterial doxorubicin, neo-adjuvant radiotherapy and surgery was introduced as limb-saving treatment for 'unresectable' grade III high grade STS of the extremities. We studied short and long-term morbidity of this combined modality treatment. Materials and methods: Between 1982 and 1986 11 patients, 9 male and 2 female, median age 52 (range 24-70) years, with 'unresectable' grade III STS of the extremities were treated by preoperative i.a. infusion of doxorubicin for three consecutive days (daily dose 20 mg/m 2 ). Within 24 hours after infusion preoperative radiation of the compartment (10 x 350 cGy) was started. After chemo-radiotherapy the tumor was resected. Non-radical resections received additionally 20-30 Gy radiotherapy (9 patients). Results: No local recurrences (median follow-up 110 months); pulmonary metastases in five patients (45%). Local skin toxicity due to doxorubicin in three patients (27%). Preoperative 35 Gy radiotherapy was well tolerated. Limb-saving treatment was possible in ten patients (91%); in one patient an exarticulation of the hip had to be performed. Three of the five long-term survivors (follow-up > 10 years) developed a severe fibrosis of the affected limb (60%). Two severe long-term complications: a stress fracture of the affected femur (91 months after treatment), and a severe radiation-induced motor and sensory neuropathy of the sciatic nerve. Conclusion: The long-term results show a limb-saving rate of 91%, without increasing the risk of a local recurrence. Especially the long-term morbidity is extremely high (60%). This combination therapy should therefore no longer be advocated as a limb-saving treatment modality for these primarily 'unresectable' high grade STS of the extremities

  10. Treatment of the glottic squamous cell carcinoma in stages T1-T2, N0: surgery versus radiotherapy: retrospective study of 50 patients attended at the Hospital Mexico in the period 2005 to 2011

    International Nuclear Information System (INIS)

    Diaz Munoz, Angie

    2014-01-01

    Recurrence rates are compared in patients with glottic cancer in early stages, treated with surgery and/or radiotherapy. The study was composed by all patients diagnosed with glottic cancer in the Servicio de Otorrinolaringologia from Hospital Mexico, in early stages during the period 2005 to 2011. The local and locoregional recurrence rates are determined. Differences in recurrence rates are analyzed. Factors associated to higher recurrence rates are identified. Treatment with radiotherapy has had statistically a higher proportion of local recurrence than treatment with surgery [es

  11. The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy in ION SOLCA, Guayaquil Ecuador from November 1 to October 2002

    International Nuclear Information System (INIS)

    Gamboa, Eugenia; Falquez, Roberto

    2003-01-01

    To determine if the additional vaginal cuff irradiation is necessary or not in patients with cervix cancer, stages IB 1- IB 2, that has been treated previously with radical hysterectomies and pelvic radiotherapy, to get better local control and global survival versus presence of complications. We studied 54 patients from Radiation Oncology Department of ION SOLCA Guayaquil Ecuador, with cervix cancer stages IB1 - IB2, that have been treated with surgery plus pelvic radiotherapy plus or not brachytherapy. They have been divides into two arms, group one included surgery plus Rx T (radiotherapy) plus BxT (Brachytherapy), and group two included those patients with surgery plus external RxT alone. We studied, aged, histologic type, surgery type, doses and techniques of teletherapy and brachytherapy and we analyzed the presence of complications. Conclusions: The brachytherapy vaginal cuff boost in patients with cervix cancer IB1-IB2 that have been treated with surgery plus pelvic radiotherapy is not useful to get better local control and global survival in some patients carefully chosen without desfavorable factors, because this therapy represent and increase in the complication. (The author)

  12. Tamoxifen added to radiotherapy and surgery for the treatment of ductal carcinoma in situ of the breast: A meta-analysis of 2 randomized trials

    International Nuclear Information System (INIS)

    Petrelli, Fausto; Barni, Sandro

    2011-01-01

    Background: Surgical excision with adequate margins is the treatment of choice for ductal, in situ carcinoma of the breast (DCIS). The addition of radiotherapy (RT) halved local in situ and invasive recurrence. The purpose of our meta-analysis is to evaluate the reduction in recurrence (in situ or invasive) with the addition of tamoxifen (T), in particular in patients with DCIS treated with surgery + RT. Patients and methods: The eligible studies (NSABP-B24 and UK ANZ DCIS trials) included prospective, randomized, controlled trials in which the addition of T had been compared with surgery + RT without T in women with DCIS of the breast. Relative risks (RRs) with 95% confidence intervals (CIs) were calculated for both in situ and invasive recurrence (local and controlateral). Results: Tamoxifen does not reduce breast cancer-specific or overall mortality when added to loco-regional therapy for DCIS of the breast (surgery plus or minus RT). Tamoxifen reduces overall breast cancer recurrence by 29% in all patients and by 33% in those treated with both surgery and RT. Only ipsilateral invasive (RR 0.61 [95% CI 0.41, 0.92]; p = 0.02) and controlateral in situ relapses (RR 0.40 [95% CI 0.16, 0.96]; p = 0.04) are significantly lowered when T is added to RT. Tamoxifen seems to exert a local synergistic effect with RT. Both young and older women ( 50 years) achieve some benefit from the addition of T (RR 0.6 and 0.74, respectively). Conclusion: The addition of T to surgery and RT for DCIS of the breast reduces the risk of local invasive and controlateral in situ relapses, but not the survival. The benefit is independent of age. In conclusion, surgery associated with RT and T is the treatment of choice for patients with (estrogen-receptor positive) DCIS of the breast.

  13. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality

    DEFF Research Database (Denmark)

    McGale, P; Taylor, C; Correa, C

    2014-01-01

    BACKGROUND: Postmastectomy radiotherapy was shown in previous meta-analyses to reduce the risks of both recurrence and breast cancer mortality in all women with node-positive disease considered together. However, the benefit in women with only one to three positive lymph nodes is uncertain. We ai...

  14. Clinical outcomes of radiotherapy as initial local therapy for Graves’ ophthalmopathy and predictors of the need for post-radiotherapy decompressive surgery

    International Nuclear Information System (INIS)

    Prabhu, Roshan S; Liebman, Lang; Wojno, Ted; Hayek, Brent; Hall, William A; Crocker, Ian

    2012-01-01

    The optimal initial local treatment for patients with Graves’ ophthalmopathy (GO) is not fully characterized. The purpose of this retrospective study is to describe the clinical outcomes of RT as initial local therapy for GO and define predictors of the need for post-RT salvage bony decompressive surgery. 91 patients with active GO and without prior surgery were treated with RT as initial local therapy between 01/1999 and 12/2010, with a median follow-up period of 18.3 months (range 3.7 - 142 months). RT dose was 24 Gy in 12 fractions. 44 patients (48.4%) had prior use of steroids, with 31 (34.1%) being on steroids at the initiation of RT. The most common presenting symptoms were diplopia (79%), proptosis (71%) and soft tissue signs (62%). 84 patients (92.3%) experienced stabilization or improvement of GO symptoms. 58 patients (64%) experienced improvement in their symptoms. 19 patients (20.9%) underwent salvage post-RT bony decompressive surgery. Smoking status and total symptom score at 4 months were independent predictors of post-RT bony decompression with odds ratios of 3.23 (95% CI 1.03 – 10.2) and 1.59 (95% CI 1.06 – 2.4), respectively. Persistent objective vision loss at 4 months post-RT was the most important symptom type in predicting salvage decompression. Chronic dry eye occurred in 9 patients (9.9%) and cataracts developed in 4 patients (4.4%). RT is effective and well tolerated as initial local therapy for active GO, with only 21% of patients requiring decompressive surgery post RT. Most patients experience stabilization or improvement of GO symptoms, but moderate to significant response occurs in the minority of patients. Smoking status and total symptom severity at 4 months, primarily persistent objective vision loss, are the primary determinants of the need for post-RT salvage bony decompression. Patients who smoke or present with predominantly vision loss symptoms should be advised as to their lower likelihood of symptomatic response to RT

  15. Survey on nursing of breast cancer patients treated with radiotherapy following to breast-conserving surgery. Actual states and problems for nursing care by certified nurses in breast cancer nursing

    International Nuclear Information System (INIS)

    Kobayashi, Mariko; Higuchi, Yuki; Hirose, Kiyomi; Nakanishi, Yoko; Ichikawa, Kayo; Horikoshi, Masataka; Futawatari, Tamae

    2011-01-01

    The purpose of the present study is to elucidate the actual states and problems of nursing care provided by certified nurses in breast cancer patients treated with radiotherapy following to breast-conserving surgery. The survey was conducted by a postal anonymous questionnaire. Participants were drawn from the list of certified nurses on the website of Japanese Nursing Association. The questionnaires consisted of multiple choice questions regarding the contents of care performed before, during and after radiotherapy, and free questionnaire on the related problems. The rate of valid replies was 41.2% (40 out of 97 subjects). Before radiotherapy, the accomplishing rate exceeded 70% in about half of all nursing cares. The accomplishing rates were 30 to 50% in about 90% of all cares and 40 to 60% in all cares during and after radiotherapy, respectively. Problems were classified into three categories high-quality practice of radiotherapy nursing, establishment of continuing care system and improvement of cooperation. It is recommended to achieve high quality radiotherapy nursing by certified nurses, the establishment of continuing care system and the improvement of cooperation in order to improve nursing care during and after radiotherapy. (author)

  16. Features of nursing care provided for breast cancer patients treated with radiotherapy following breast-conserving surgery. Comparison of nursing practices between certified nurses in breast cancer nursing and non-specialist nurses working with breast cancer patients

    International Nuclear Information System (INIS)

    Kobayashi, Mariko; Takahira, Yumi; Ichikawa, Kayo; Horikoshi, Masataka; Futawatari, Tamae

    2012-01-01

    This study aimed to identifying features of nursing care provided for breast cancer patients during the course of radiotherapy following breast-conserving surgery and improve the quality of nursing care. Subjects were certified nurses in breast cancer nursing (CN) and non-specialist nurses working with breast cancer patients (NS). An anonymous survey questionnaire on nursing care and other practices provided before, during, and after radiotherapy was conducted by postal mail and the results were compared between CN and NS. Valid responses were obtained from 40 CN (41.2%) and 102 NS (56.7%). Significant differences between CN and NS were observed for 15 of 27 (55.6%) care items before radiotherapy, 18 of 18 (100%) items during radiotherapy, and 9 of 20 (45.0%) items after radiotherapy. Among the items with significant differences, significantly more NS than CN performed all nursing care items during the course of radiotherapy, except for one item provided before radiotherapy. These results demonstrate that it is necessary to facilitate enhanced collaboration and coordination between CN and NS providing nursing care for breast cancer patients in order to improve the quality of nursing care delivered to patients. (author)

  17. 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

  18. 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

  19. 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

  20. The rate and factors associated with non-adherence to surgery, chemotherapy, radiotherapy and hormonal therapy among breast cancer patients attending public hospitals in Malaysia

    Directory of Open Access Journals (Sweden)

    Nur Aishah Taib

    2017-12-01

    Full Text Available Background: The role of breast cancer treatments in reducing recurrence and death has been established. However, the treatments side effects greatly impact on quality of life and little is known about the non-adherence rates. The purpose of this study was to determine the non-adherence rates to surgery, chemotherapy, radiotherapy and hormonal therapy, and factors that affect it in public hospitals in Malaysia. Methods: A multicentre cross-sectional study was conducted in six public hospitals involving all newly diagnosed breast cancer patients in 2012. Data were collected through medical record reviews and interview by using structured questionnaire. Non-adherence was categorized as any breast cancer patients refusing or discontinuing any treatment due to non-medical reasons. Univariable logistic regression and multiple logistic regressions were used for analysis. Results: A total of 340 breast cancer patients were included in the study. The proportion for non-adherence to surgery, chemotherapy, radiotherapy and hormonal therapy were 14%, 30.1%, 33.3% and 36.3% respectively. Factors associated with non-adherence to surgery were localities involving Kuala Lumpur (2 (OR: 3.41, Johor (OR: 8.38 and Kelantan (OR: 6.32, and those required mastectomy (OR: 5.66. No factors were found to be associated with non-adherence to chemotherapy, radiotherapy and hormonal therapy. These three treatment modalities were then combined as oncology therapy and the only independent factor associated with non-adherence to oncology therapy was Perak locality (OR: 1.42. Conclusion: Non-adherence to breast cancer treatments was high among breast cancer patients at public hospitals in Malaysia. Factors influencing non-adherence were locations and mastectomy implicating of socio-culture, body image issues, psychological disturbance and treatment navigation. Community educational programs focusing on correcting misconceptions, treatment outcomes and treatments’ side effects

  1. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials

    DEFF Research Database (Denmark)

    Darby, S; McGale, P; Correa, C

    2011-01-01

    After breast-conserving surgery, radiotherapy reduces recurrence and breast cancer death, but it may do so more for some groups of women than for others. We describe the absolute magnitude of these reductions according to various prognostic and other patient characteristics, and relate the absolute...

  2. Is Hume Attempting to Introduce a New, Pragmatic Conception of a Contradiction in his Treatise?

    Directory of Open Access Journals (Sweden)

    Alan Kenneth Schwerin

    2016-09-01

    Full Text Available http://dx.doi.org/10.5007/1808-1711.2016v20n3p315 Hume’s Treatise, with its celebrated bundle theory of the self, is a significant contribution to the embryonic Newtonian experimental philosophy of the enlightenment. But the theory is inadequate as it stands, as the appendix to the Treatise makes clear. For this account of the self, apparently, rests on contradictory principles — propositions, fortunately, that can be reconciled, according to Hume. My paper is a critical exploration of Hume’s argument for this intriguing suggestion.

  3. 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.

  4. Quality of life as predictor of survival: A prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer

    International Nuclear Information System (INIS)

    Oskam, Inge M.; Verdonck-de Leeuw, Irma M.; Aaronson, Neil K.; Kuik, Dirk J.; Bree, Remco de; Doornaert, Patricia; Langendijk, Johannes A.; Leemans, Rene C.

    2010-01-01

    Background and purpose: The relation between health-related quality of life (HRQOL) and survival was investigated at baseline and 6 months in 80 patients with advanced oral or oropharyngeal cancer after microvascular reconstructive surgery and (almost all) adjuvant radiotherapy. Materials and methods: Multivariate Cox regression analyses of overall and disease-specific survival were performed including sociodemographic (age, gender, marital status, comorbidity), and clinical (tumor stage and site, radical surgical, metastasis, radiotherapy) parameters, and HRQOL (EORTC QLQ-C30 global quality of life scale). Results: Before treatment, younger age and having a partner were predictors of disease-specific survival; younger age predicted overall survival. At 6 months post-treatment, disease-specific and overall survival was predicted by (deterioration of) global quality of life solely. Global health-related quality of life after treatment was mainly influenced by emotional functioning. Conclusion: Deterioration of global quality of life after treatment is an independent predictor of survival in patients with advanced oral or oropharyngeal cancer.

  5. Prognostic significance of several histological features in intermediate and high-risk endometrial cancer patients treated with curative intent using surgery and adjuvant radiotherapy

    International Nuclear Information System (INIS)

    Narayan, K.; Bernshaw, D.; Quinn, M.; Allen, D.; Rejeki, V.; Herschtal, A.; Jobling, T.

    2009-01-01

    Full text: The purpose of the present study was to explore the prognostic significance of several histological features with respect to lymph node metastasis, failure-free survival (FeS), and overall survival (Os) in intermediate and high-risk endometrial cancer patients treated with curative intent. One hundred and eighty patients with endometrial cancer were treated with hysterectomy with or without lymphadenectomy and received external beam radiotherapy (EBRT). The mean follow-up period was 4.25 years (range 0.44-10.45 years). In multifactor analysis, fractional myometrial invasion (MI) (P = 0.047), histology (P < 0.001) and lymph-vascular space invasion (LVSI) (P = 0.025) were significant predictors for FFS when nodal status was not included. When lymph node status was known, histology (P - 0.007) and LVSI (P = 0.014) remained significant factors for FFS. For OS, histology (P < 0.001) and fractional MI (P = 0.004) were the significant factors. Lymph node status could be predicted by tumour grading (P = 0.016) and absolute MI (P 0.002). Histology type and the presence of LVSI were the most important prognostic factors in high-risk endometrial cancer patients treated by surgery and postoperative radiotherapy. Absolute MI and tumour grading were useful predictors of nodal spread.

  6. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    Energy Technology Data Exchange (ETDEWEB)

    Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Rooij, Peter van [Department of Biostatistics, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Verduijn, Gerda M. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Meeuwis, Cees A. [Department of Otorhinolaryngology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Levendag, Peter C. [Department of Radiation Oncology, Erasmus Medical Center-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

    2012-09-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4-172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade {>=}2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in

  7. Long-term Outcomes and Quality of Life of 186 Patients With Primary Parotid Carcinoma Treated With Surgery and Radiotherapy at the Daniel den Hoed Cancer Center

    International Nuclear Information System (INIS)

    Al-Mamgani, Abrahim; Rooij, Peter van; Verduijn, Gerda M.; Meeuwis, Cees A.; Levendag, Peter C.

    2012-01-01

    Purpose: To assess the outcomes, toxicity, and quality of life (QOL) of patients with primary parotid carcinoma treated with surgery and postoperative radiotherapy at the Daniel den Hoed Cancer Center. Methods and Materials: Between 1995 and 2010, 186 patients with parotid carcinoma were treated with parotidectomy with or without neck dissection, followed by radiotherapy. Elective nodal irradiation (ENI) was applied to high-risk, node-negative disease. End points were locoregional control (LRC), disease-free survival (DFS), cause-specific survival (CSS), and overall survival (OS), late toxicity, and QOL. Results: After a median follow-up of 58 months (range, 4–172 months), the 5-year Kaplan-Meier estimates for LRC, DFS, CSS, and OS were 89%, 83%, 80%, and 68%, respectively. Forty-five events were reported: 24 distant metastases (DM) and 21 locoregional failures (LRF). Event-free survival rates by histological types were 89%, 78%, 76%, 74%, and 70% for acinic cell, mucoepidermoid, adenoid cystic, adenocarcinoma, and squamous cell carcinoma, respectively. More LRF were reported in patients with squamous cell and high-grade mucoepidermoid carcinoma (21% and 19%, respectively) than in patients with other histological types (p = 0.04) and more DM in patients with adenoid cystic and adenocarcinoma (20% and 19%, respectively) than in patients with other types (p = 0.03). None of the high-risk node-negative patients who received ENI developed regional failure. On multivariate analysis, T stage, N stage, grade, and presence of perineural invasion and facial paralysis correlated significantly with DFS. The 5-year cumulative incidence of grade ≥2 late toxicity was 8%. QOL scores deteriorate during and shortly after treatment but returned in almost all scales to baseline scores within 6 months. Conclusions: Of the entire group, surgery and postoperative radiotherapy resulted in excellent outcomes with minimal side effects and preservation of good QOL scores. However, in

  8. Analytical techniques for thin films treatise on materials science and technology

    CERN Document Server

    Tu, K N

    1988-01-01

    Treatise on Materials Science and Technology, Volume 27: Analytical Techniques for Thin Films covers a set of analytical techniques developed for thin films and interfaces, all based on scattering and excitation phenomena and theories. The book discusses photon beam and X-ray techniques; electron beam techniques; and ion beam techniques. Materials scientists, materials engineers, chemical engineers, and physicists will find the book invaluable.

  9. Martyrological Torture and the Invention of Empathy : Gallonio’s Treatise

    NARCIS (Netherlands)

    Touber, Jetze

    2014-01-01

    The Treatise of the Instruments of Martyrdom (Italian version 1591, Latin version 1594), published by the Oratorian priest Antonio Gallonio (1556-1605), textually and graphically conveys the hundreds of ways in which persecutors tormented martyrs. It constitutes a clinical and, above all, technical

  10. FDG-PET-Detected Extracranial Metastasis in Patients with Non-Small Cell Lung Cancer Undergoing Staging for Surgery or Radical Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Macmanus, Michael P.; Hicks, Rodney; Fisher, Richard; Rischin, Danny; Michael, Michael; Wirth, Andrew; Ball, David L. [Peter MacCallum Cancer Inst., Melbourne (Australia). Dept. of Radiation Oncology

    2003-03-01

    The prognostic significance of extracranial distant metastasis detected by positron emission tomography (PET) was investigated in patients with non-small cell lung cancer (NSCLC). Forty-two patients staged with 18F-fluorodeoxyglucose-PET-detected distant metastasis before planned surgery (n=7) or radical radiotherapy (RT)/chemoradiotherapy (n=35) for NSCLC were identified from a prospective database. The influence of metastasis number and other prognostic factors was investigated using Cox's regression analysis. Treatment after PET included surgery (n=2), radical RT (n =5), palliative RT (n=25), chemotherapy (n=8) or supportive care (n=2). All but 4 patients had died by the last follow-up. Median survival was 9 months overall, 12 months for 27 patients with single PET-detected metastasis and 5 months for 15 patients with >1 metastasis (p=0.009). It was found that the Eastern Cooperative Oncology Group performance status (p=0.027) but not pre-PET stage, weight loss or metastasis site correlated with survival. PET-detected metastatic tumor burden appeared to influence survival and should be evaluated as a prognostic factor in NSCLC.

  11. Subsets of Women With Close or Positive Margins After Breast-Conserving Surgery With High Local Recurrence Risk Despite Breast Plus Boost Radiotherapy

    International Nuclear Information System (INIS)

    Lupe, Krystine; Truong, Pauline T.; Alexander, Cheryl; Lesperance, Mary; Speers, Caroline; Tyldesley, Scott

    2011-01-01

    Purpose: (1) To examine the effect of surgical margin status on local recurrence (LR) and survival following breast-conserving therapy; (2) To identify subsets with close or positive margins with high LR risk despite whole breast radiotherapy (RT) plus boost. Methods and Materials: Subjects were 2,264 women with pT1–3, any N, M0 invasive breast cancer, treated with breast-conserving surgery and whole breast ± boost RT. Five-year Kaplan-Meier (KM) LR, breast cancer–specific and overall survival (BCSS and OS) were compared between cohorts with negative (n = 1,980), close (n = 222), and positive (n = 62) margins. LR rates were analyzed according to clinicopathologic characteristics. Multivariable Cox regression modeling and matched analysis of close/positive margin cases and negative margin controls were performed. Results: Median follow-up was 5.2 years. Boost RT was used in 92% of patients with close or positive margins. Five-year KM LR rates in the negative, close and positive margin cohorts were 1.3%, 4.0%, and 5.2%, respectively (p = 0.001). BCSS and OS were similar in the three margin subgroups. In the close/positive margin cohort, LR rates were 10.2% with age 10% despite whole breast plus boost RT. These patients should be considered for more definitive surgery.

  12. Intraoperative radiotherapy in breast cancer: literature review

    International Nuclear Information System (INIS)

    Alfaro Hidalgo, Sabrina A.

    2013-01-01

    A literature review was performed on intraoperative radiotherapy of breast cancer. The strength and attractiveness is established of techniques of partial irradiation in the treatment of breast cancer. The benefit is originated to restrict the area immediate of radiotherapy to the tumor bed or quadrant index and identifying the benefit of being applied during the radiotherapy while surgical lumpectomy. The impact of local recurrence has been established using intraoperative radiotherapy. The advantages of intraoperative radiotherapy was compared in the management of the conservative surgery in early stages of breast cancer with external radiotherapy. Different methods of intraoperative radiotherapy have been compared and individual impact on local recurrence ranges. Intraoperative radiotherapy has had many advantages: radiobiological, technical, clinical, psychological and economical in the handling of conservative surgery in early stages of breast cancer, compared with external radiotherapy [es

  13. Prevention of malignant seeding at drain sites after invasive procedures (surgery and/or thoracoscopy) by hypofractionated radiotherapy in patients with pleural mesothelioma

    International Nuclear Information System (INIS)

    Di Salvo, Maurizio; Gambaro, Giuseppina; Pagella, Simonetta; Manfredda, Iren e; Casadio, Caterina; Krengli, Marco

    2008-01-01

    Introduction. Literature data show that mesothelioma cells can implant along the surgical pathway of invasive procedures such as thoracotomy and thoracoscopy. We investigated the use of hypofractionated radiotherapy for preventing such malignant seeding. Material and methods. Thirty-two consecutive patients diagnosed with pleural mesothelioma were included in the present retrospective study. All patients underwent surgery and/or thoracoscopy for diagnosis, staging or talc pleurodesis. They were treated with electron external beam radiation therapy (21 Gy in 3 fractions over 1 week), directed to the surgical pathway after the invasive procedure. After completion of radiation treatment, 20 of 32 patients (63%) underwent chemotherapy. Results. After a mean follow-up of 13.6 months (range 3-41) from the end of radiation therapy, no patient had tumour progression in the treated area. The treatment was well tolerated, as only erythema grade I (Radiation Therapy Oncology Group, RTOG, scale) was noted in 11 patients. Seventeen patients died of disease with local progression after a mean survival time of 12.6 months (range 3-27); thirteen patients are alive with disease after a mean follow-up of 13.9 months (range 4-41); two patients are alive without evidence of disease after a mean follow-up of 16.50 months (range 6-27). Discussion. The present study shows the efficacy and safety of local radiotherapy in preventing malignant seeding after thoracoscopy in patients with pleural mesothelioma although larger prospective trials are probably still needed to validate this treatment approach

  14. Prevention of malignant seeding at drain sites after invasive procedures (surgery and/or thoracoscopy) by hypofractionated radiotherapy in patients with pleural mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Di Salvo, Maurizio; Gambaro, Giuseppina; Pagella, Simonetta; Manfredda, Irene; Casadio, Caterina; Krengli, Marco (Radiotherapy, Univ. of Piemonte Orientale-Hospital Maggiore della Carit, Novara (Italy))

    2008-07-15

    Introduction. Literature data show that mesothelioma cells can implant along the surgical pathway of invasive procedures such as thoracotomy and thoracoscopy. We investigated the use of hypofractionated radiotherapy for preventing such malignant seeding. Material and methods. Thirty-two consecutive patients diagnosed with pleural mesothelioma were included in the present retrospective study. All patients underwent surgery and/or thoracoscopy for diagnosis, staging or talc pleurodesis. They were treated with electron external beam radiation therapy (21 Gy in 3 fractions over 1 week), directed to the surgical pathway after the invasive procedure. After completion of radiation treatment, 20 of 32 patients (63%) underwent chemotherapy. Results. After a mean follow-up of 13.6 months (range 3-41) from the end of radiation therapy, no patient had tumour progression in the treated area. The treatment was well tolerated, as only erythema grade I (Radiation Therapy Oncology Group, RTOG, scale) was noted in 11 patients. Seventeen patients died of disease with local progression after a mean survival time of 12.6 months (range 3-27); thirteen patients are alive with disease after a mean follow-up of 13.9 months (range 4-41); two patients are alive without evidence of disease after a mean follow-up of 16.50 months (range 6-27). Discussion. The present study shows the efficacy and safety of local radiotherapy in preventing malignant seeding after thoracoscopy in patients with pleural mesothelioma although larger prospective trials are probably still needed to validate this treatment approach.

  15. The UK HeartSpare Study (Stage IB): Randomised comparison of a voluntary breath-hold technique and prone radiotherapy after breast conserving surgery

    International Nuclear Information System (INIS)

    Bartlett, Frederick R.; Colgan, Ruth M.; Donovan, Ellen M.; McNair, Helen A.; Carr, Karen; Evans, Philip M.; Griffin, Clare; Locke, Imogen; Haviland, Joanne S.; Yarnold, John R.; Kirby, Anna M.

    2015-01-01

    Purpose: To compare mean heart and left anterior descending coronary artery (LAD) doses (NTD mean ) and positional reproducibility in larger-breasted women receiving left breast radiotherapy using supine voluntary deep-inspiratory breath-hold (VBH) and free-breathing prone techniques. Materials and methods: Following surgery for early breast cancer, patients with estimated breast volumes >750 cm 3 underwent planning-CT scans in supine VBH and free-breathing prone positions. Radiotherapy treatment plans were prepared, and mean heart and LAD doses were calculated. Patients were randomised to receive one technique for fractions 1–7, before switching techniques for fractions 8–15 (40 Gy/15 fractions total). Daily electronic portal imaging and alternate-day cone-beam CT (CBCT) imaging were performed. The primary endpoint was the difference in mean LAD NTD mean between techniques. Population systematic (Σ) and random errors (σ) were estimated. Within-patient comparisons between techniques used Wilcoxon signed-rank tests. Results: 34 patients were recruited, with complete dosimetric data available for 28. Mean heart and LAD NTD mean doses for VBH and prone treatments respectively were 0.4 and 0.7 (p < 0.001) and 2.9 and 7.8 (p < 0.001). Clip-based CBCT errors for VBH and prone respectively were ⩽3.0 mm and ⩽6.5 mm (Σ) and ⩽3.5 mm and ⩽5.4 mm (σ). Conclusions: In larger-breasted women, supine VBH provided superior cardiac sparing and reproducibility than a free-breathing prone position

  16. Effect of androgen suppression on hemoglobin in prostate cancer patients undergoing salvage radiotherapy plus 2-year buserelin acetate for rising PSA after surgery

    International Nuclear Information System (INIS)

    Chander, Sarat; Choo, Richard; Danjoux, Cyril; Morton, Gerard; Pearse, Andrew; Deboer, Gerrit; Szumacher, Ewa; Loblaw, Andrew; Cheung, Patrick; Woo, Tony

    2005-01-01

    Purpose: To examine the effect of 2-year androgen suppression (AS) on the pattern and extent of hemoglobin (Hb) change. Methods and Materials: The basis of this report was a Phase II study evaluating a combined treatment of salvage radiotherapy plus 2-year AS for a rising prostate-specific antigen level after surgery. Patients had laboratory tests performed, including Hb and serum testosterone, and answered a quality-of-life questionnaire (European Organization for Research and Treatment of Cancer Quality-of-life Questionnaire 30 item) at regular intervals during the AS and post-AS period. The pattern and extent of the change in Hb was analyzed in relation to the testosterone level. The clinical significance of the Hb change was evaluated with a correlation analysis between Hb and the three specific domains of the questionnaire (Global Health Status, Physical Functioning, and Fatigue). Results: Of a total of 74 accrued patients, 69 were identified as eligible for this report. The median patient age was 70 years. The median follow-up was 38.6 months. The mean Hb was 150.7 g/L at baseline and declined with radiotherapy by 5.9 g/L. The maximal Hb drop during AS was 16.0 g/L (p <0.0001), occurring at 16 months after the initiation of AS. Hb recovery in the post-AS period was slow. The decline and recovery of the mean Hb and hematocrit followed that of testosterone. The three quality-of-life domains did not show any significant correlation with the change in Hb. Conclusion: Two-year AS resulted in a statistically significant drop in the mean Hb, but had no clinically apparent adverse effect. The pattern of Hb change was similar to that of testosterone change

  17. The changes of histological malignancy in recurrent squamous cell carcinoma of oral cavity. Comparison between surgery and radiotherapy

    International Nuclear Information System (INIS)

    Nakazawa, Mitsuhiro; Iwai, Souichi; Tamura, Hiroshi; Moriga, Shigeru; Uekusa, Yasuhiro; Hasina, R.; Sakuda, Masayoshi; Matumura, Tatsushi

    1998-01-01

    We investigated the difference of histological malignancy between primary lesion and recurrent lesion using malignancy grading system by Lund (Jakobsson) for oral squamous cell carcinomas. Patients were divided into radiation group (20 patients) and surgery group (10 patients). The incidence of patients whose malignancy was increased was 40% in surgery group and 75% in radiation group. The mean points of total malignancy score was increased from 18.8 to 22.0 points (p<0.05) in radiation group while from 18.4 to 18.9 points (ns) in surgery group. In eight factors of grading system, the points of ''appearance'', ''nuclear differentiation'' and ''cellular response'' were significantly increased in radiation group (p<0.05), although there was no significant increase in surgery group. The characteristic changes in recurrent tumor compared with primary tumor were that all four factors for tumor-host relationship became worth in both groups, especially radiation group. It was suggested that resistance of host tissue against tumors was reduced in recurrent tumor and adjacent tissue after initial therapy. (author)

  18. Multiple Cutaneous Angiosarcomas after Breast Conserving Surgery and Bilateral Adjuvant Radiotherapy: An Unusual Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Icro Meattini

    2014-01-01

    Full Text Available Breast angiosarcomas (BAs are rare but serious events that may arise after radiation exposure. Disease outcome is poor, with high risk of local and distant failure. Recurrences are frequent also after resection with negative margins. The spectrum of vascular proliferations associated with radiotherapy in the setting of breast cancer has expanded, including radiation-associated atypical vascular lesions (AVLs of the breast skin as a rare, but well-recognized, entity. Although pursuing a benign behavior, AVLs have been regarded as possible precursors of postradiation BAs. We report an unusual case of a 71-year-old woman affected by well-differentiated bilateral cutaneous BA, diagnosed 1.9 years after adjuvant RT for synchronous bilateral breast cancer. Whole-life clinical followup is of crucial importance in breast cancer patients.

  19. Radiotherapy indications - rectum cancer

    International Nuclear Information System (INIS)

    2009-05-01

    This document is addressed to oncologists radiotherapists and to any health professional concerned by rectum cancer treatment. Rectum cancer therapy is based on various technical procedures including surgery, radiotherapy and systemic treatments defined for each patient according to his clinical situation. This document precises the specific situations where radiotherapy can be employed. However, the radiotherapy decision must be taken with respect to other therapeutic alternatives. Such a decision must be validated and must be the object of a discussion in the framework of a pluri-disciplinary consultation. (J.S.)

  20. Radiotherapy without boost in the tumor bed after conserving surgery in the treatment of early breast cancer

    International Nuclear Information System (INIS)

    Parvanova, V.; Pandova, V.

    1998-01-01

    The aim of this study is to analyse satisfactory local control and breast preservation with particular emphasis on the importance of the microscopic negative margin in patients who not receiving tumor bed boost therapy. Authors analysed 122 consecutive patients with breast cancer in pathological stages I and II, who were treated with quadrantectomy at full axillary dissection between 1992 and 1997. The median follow up was 34 months. The radiation treatment was started 60 - 80 day in 14 patients (11.5%) with high risk for metastases, because they underwent chemotherapy. The patients were treated with external beam radiation therapy on the entire breast to a mean total dose of 48.8 Gy. A boost to a tumor bed was not delivered. Only patients with follow-up period above 24 months were evaluated for the purpose of analysis of cosmetic results. Analyzed variables were: age, size, lymph node status, two-field versus three-field technique, operating scare. The major goal of breast conserving therapy is the preservation of cosmetically acceptable breast without local relapses in all patients of our study. A 43 years old patient with liver metastases and any regional and local relapses was dead 27 months after the radiotherapy. A single significant factor impairing excellent cosmetic outcome in our study is the surgical scar. The very high percent (51) of excellent cosmetic results and low percent of post radiotherapy injury is due to precise for breast conserving therapy, the prevailing number of young patients and precise CT and dosimetric planning on three level of treatment volume (author)

  1. Dosimetric study comparing volumetric arc modulation with RapidArc and fixed dynamic intensity-modulated radiation therapy for breast cancer radiotherapy after breast-conserving surgery

    International Nuclear Information System (INIS)

    Tie Jian; Sun Yan; Gong Jian; Han Shukui; Jiang Fan; Wu Hao

    2011-01-01

    Objective: To compare the dosimetric difference between volumetric are modulation with RapidArc and fixed field dynamic IMRT for breast cancer radiotherapy after breast-conserving surgery. Methods: Twenty patients with early left-sided breast cancer received radiotherapy after breast-conserving surgery. After target definition, treatment planning was performed by RapidArc and two fixed fields dynamic IMRT respectively on the same CT scan. The target dose distribution, homogeneity of the breast, and the irradiation dose and volume for the lungs, heart, and contralateral breast were read in the dose-volume histogram (DVH) and compared between RapidArc and IMRT. The treatment delivery time and monitor units were also compared. Results: In comparison with the IMRT planning,the homogeneity of clinical target volume (CTV), the volume proportion of 95% prescribed dose (V 95% ) was significantly higher by 0.65% in RapidArc (t=5.16, P=0.001), and the V 105% and V 110% were lower by 10.96% and 1.48 % respectively, however, without statistical significance (t=-2.05, P=0.055 and t=-1.33, P=0.197). The conformal index of planning target volume (PTV) by the RapidArc planning was (0.88±0.02), significantly higher than that by the IMRT planning [(0.74±0.03), t=18.54, P<0.001]. The homogeneity index (HI) of PTV by the RapidArc planning was 1.11±0.01, significantly lower than that by the IMRT planning (1.12±0.02, t=-2.44, P=0.02). There were no significant differences in the maximum dose (D max ) and V 20 for the ipsilateral lung between the RapidArc and IMRT planning, but the values of V 10 , V 5 , D min and D mean by RapidArc planning were all significantly higher than those by the IMRT planning (all P<0.01). The values of max dose and V 30 for the heart were similar by both techniques, but the values of V 10 and V 5 by the RapidArc planning were significantly higher (by 18% and 50%, respectively). The V 5 of the contralateral breast and lung by the RapidArc planning were

  2. Early-stage squamous cell carcinoma of the oropharynx: Radiotherapy vs. Trans-Oral Robotic Surgery (ORATOR) – study protocol for a randomized phase II trial

    International Nuclear Information System (INIS)

    Nichols, Anthony C; Kuruvilla, Sara; Chen, Jeff; Corsten, Martin; Odell, Michael; Eapen, Libni; Theurer, Julie; Doyle, Philip C; Wehrli, Bret; Kwan, Keith; Palma, David A; Yoo, John; Hammond, J Alex; Fung, Kevin; Winquist, Eric; Read, Nancy; Venkatesan, Varagur; MacNeil, S Danielle; Ernst, D Scott

    2013-01-01

    The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has markedly increased over the last three decades due to newly found associations with human papillomavirus (HPV) infection. Primary radiotherapy (RT) is the treatment of choice for OPSCC at most centers, and over the last decade, the addition of concurrent chemotherapy has led to a significant improvement in survival, but at the cost of increased acute and late toxicity. Transoral robotic surgery (TORS) has emerged as a promising alternative treatment, with preliminary case series demonstrating encouraging oncologic, functional, and quality of life (QOL) outcomes. However, comparisons of TORS and RT in a non-randomized fashion are susceptible to bias. The goal of this randomized phase II study is to compare QOL, functional outcomes, toxicity profiles, and survival following primary RT (± chemotherapy) vs. TORS (± adjuvant [chemo] RT) in patients with OPSCC. The target patient population comprises OPSCC patients who would be unlikely to require chemotherapy post-resection: Tumor stage T1-T2 with likely negative margins at surgery; Nodal stage N0-2, ≤3 cm in size, with no evidence of extranodal extension on imaging. Participants will be randomized in a 1:1 ratio between Arm 1 (RT ± chemotherapy) and Arm 2 (TORS ± adjuvant [chemo] RT). In Arm 1, patients with N0 disease will receive RT alone, whereas N1-2 patients will receive concurrent chemoradiation. In Arm 2, patients will undergo TORS along with selective neck dissections, which may be staged. Pathologic high-risk features will be used to determine the requirement for adjuvant radiotherapy +/- chemotherapy. The primary endpoint is QOL score using the M.D. Anderson Dysphagia Inventory (MDADI), with secondary endpoints including survival, toxicity, other QOL outcomes, and swallowing function. A sample of 68 patients is required. This study, if successful, will provide a much-needed randomized comparison of the conventional strategy of primary RT

  3. Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

    Directory of Open Access Journals (Sweden)

    Katz Alan

    2012-11-01

    Full Text Available Abstract Background As the long-term efficacy of stereotactic body radiation therapy (SBRT becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Methods Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients or SBRT (n = 216 American patients. QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24, and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. Results The largest differences in QOL occurred in the first 1–6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Conclusions Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment

  4. Comparison of quality of life after stereotactic body radiotherapy and surgery for early-stage prostate cancer

    International Nuclear Information System (INIS)

    Katz, Alan; Ferrer, Montserrat; Suárez, José Francisco

    2012-01-01

    As the long-term efficacy of stereotactic body radiation therapy (SBRT) becomes established and other prostate cancer treatment approaches are refined and improved, examination of quality of life (QOL) following prostate cancer treatment is critical in driving both patient and clinical treatment decisions. We present the first study to compare QOL after SBRT and radical prostatectomy, with QOL assessed at approximately the same times pre- and post-treatment and using the same validated QOL instrument. Patients with clinically localized prostate cancer were treated with either radical prostatectomy (n = 123 Spanish patients) or SBRT (n = 216 American patients). QOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC) grouped into urinary, sexual, and bowel domains. For comparison purposes, SBRT EPIC data at baseline, 3 weeks, 5, 11, 24, and 36 months were compared to surgery data at baseline, 1, 6, 12, 24, and 36 months. Differences in patient characteristics between the two groups were assessed using Chi-squared tests for categorical variables and t-tests for continuous variables. Generalized estimating equation (GEE) models were constructed for each EPIC scale to account for correlation among repeated measures and used to assess the effect of treatment on QOL. The largest differences in QOL occurred in the first 1–6 months after treatment, with larger declines following surgery in urinary and sexual QOL as compared to SBRT, and a larger decline in bowel QOL following SBRT as compared to surgery. Long-term urinary and sexual QOL declines remained clinically significantly lower for surgery patients but not for SBRT patients. Overall, these results may have implications for patient and physician clinical decision making which are often influenced by QOL. These differences in sexual, urinary and bowel QOL should be closely considered in selecting the right treatment, especially in evaluating the value of non-invasive treatments, such as SBRT

  5. Prognostic factors in adult soft tissue sarcoma treated with surgery combined with radiotherapy: a retrospective single-center study on 164 patients

    Directory of Open Access Journals (Sweden)

    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

  6. 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

  7. Conservative surgery and radiotherapy for early-stage breast cancer using a lung density correction: the University of Michigan experience

    International Nuclear Information System (INIS)

    Pierce, Lori J.; Strawderman, Myla H.; Douglas, Kathye R.; Lichter, Allen S.

    1997-01-01

    Purpose: Although an abundance of reports detail the successful use of definitive radiotherapy of the breast in the treatment in Stage I or II breast cancer, little data have been published concerning the use of lung density correction and its effect upon long-term outcome. As it has been the practice at the University of Michigan to routinely use lung density correction in the dose calculations to the breast, we retrospectively analyzed our results for local control, relapse-free, and overall survival. Methods and Materials: Clinical records were reviewed of 429 women with Stage I or II breast cancer treated with lumpectomy, axillary dissection, and breast irradiation with or without systemic chemo/hormonal therapy. Tangential radiotherapy fields delivering 45 to 50 Gy were used to treat the entire breast. A boost was delivered in 95% of cases for a total tumor bed dose of 60 to 66 Gy. All treatment plans were calculated using a lung density correction. Results: With a median follow up of 4.4 years, the 5-year actuarial rate of local control with local failure as the only site of first failure was 96% (95% CI 94-98%). Univariate analysis for local failure as only first failure found the following factors to statistically predict for increased risk of breast recurrence: young age (≤35 years old), premenopausal status, tumor size >2 cm, positive family history, and positive microscopic margins. Multivariate analysis revealed young age and margin status to be the only factors remaining significant for local failure. The 5-year actuarial relapse-free survival was 85% (95% CI 81-89%); overall survival at 5 years was 90% (95% CI 87-94%). Conclusions: Lung density correction results in rates of local control, disease-free, and overall survival at 5 years that compare favorably with series using noncorrected unit density calculations. While we will continue to update our results with increasing follow-up, our 5-year data indicate that the use of lung-density correction

  8. Beautiful Surfaces. Style and Substance in Florentius Schuyl's Illustrations for Descartes' Treatise on Man.

    Science.gov (United States)

    Chan, Eleanor

    2016-01-01

    The assumption that the Cartesian bête-machine is the invention of René Descartes (1596-1650) is rarely contested. Close examination of Descartes' texts proves that this is a concept founded not on the basis of his own writings, but a subsequent critical interpretation, which developed and began to dominate his work after his death. Descartes' Treatise on Man, published posthumously in two rival editions, Florentius Schuyl's Latin translation De Homine (1662), and Claude Clerselier's Traité de l'homme, has proved particularly problematic. The surviving manuscript copies of the Treatise on Man left no illustrations, leaving both editors the daunting task of producing a set of images to accompany and clarify the fragmented text. In this intriguing case, the images can be seen to have spoken louder than the text which they illustrated. This paper assesses Schuyl's choice to represent Descartes' Man in a highly stylized manner, without superimposing Clerselier's intentions onto De Homine.

  9. 125I implants as an adjuvant to surgery and external beam radiotherapy in the management of locally advanced head and neck cancer

    International Nuclear Information System (INIS)

    Martinez, A.; Goffinet, D.R.; Fee, W.; Goode, R.; Cox, R.S.

    1983-01-01

    125 I seeds either individually placed or inserted into absorbable Vicryl suture carriers were utilized in conjunction with surgery and external beam radiotherapy in an attempt to increase local control rates in patients with advanced oropharyngeal and laryngopharyngeal cancers (T3-T4, N2-N3), massive cervical lymphadenopathy (N3) and an unknown primary site and locally recurrent head and neck cancers. Forty-eight patients were treated with 55 implants. The carotid artery was implanted in 15 patients, while seven patients had seeds inserted into the base of the skull region, and another three patients had implants near cranial nerves. Eighteen of the 48 patients were treated for cure. The actuarial survival at five years in this subgroup was 50%. The overall local control in the head and neck area was 58%. In this group no patients to date have had a local failure in the implanted volume. Seventeen patients with comparable stage of disease treated prior to 1974 with curative intent without 125 I implants were analyzed retrospectively for comparison with the implanted patients. The actuarial survival of these patients was 18% and the overall head and neck control was 21%. These differences are statistically significant at a P value of 0.01 and 0.007, respectively. Seventeen patients received implants for local recurrence. The local control in the head and neck area was 50%; however, the 2.5 year actuarial survival was only 17%. The complication rate was 11% (six of 55 implants). The improved survival, the high local control, and the minimal complication rates in this series makes the intraoperative implantation of 125 I seeds and effective adjunctive treatment to surgery and external beam irradiation

  10. Copenhagen failure : a rhetorical treatise of how speeches unite and divide mankind

    OpenAIRE

    Kortetmäki, Teea

    2010-01-01

    The purpose of this treatise is to analyse five of the Copenhagen Climate Convention's main speeches to see how they supported or weakened the agreement possibilities in the convention. Particular focus will be on the elements that divide or unite negotiators and whether the summit's failing outcome is already built in the pre-planned speeches held at the main podium. Theoretically, the study builds on Kenneth Burke's identification thesis and Elizabeth L. Malone's climate change debate an...

  11. Technology Entrepreneurship : A Treatise on Entrepreneurs and Entrepreneurship for and in Technology Ventures. Band 2

    OpenAIRE

    Runge, Wolfgang

    2013-01-01

    The treatise is the first coherent and comprehensive presentation of the important sub-field of "technology entrepreneurship" emphasizing the science and engineering perspectives. It is a presentation of technology entrepreneurship as an inter-cultural approach referring to the US and Germany. It integrates micro- and macro aspects referring to numerous cases of firms' foundations. The book provides also a new semi-quantitative approach to growth of new technology ventures.

  12. Technology Entrepreneurship : A Treatise on Entrepreneurs and Entrepreneurship for and in Technology Ventures. Band 1

    OpenAIRE

    Runge, Wolfgang

    2013-01-01

    The treatise is the first coherent and comprehensive presentation of the important sub-field of "technology entrepreneurship" emphasizing the science and engineering perspectives. It is a presentation of technology entrepreneurship as an inter-cultural approach referring to the US and Germany. It integrates micro- and macro aspects referring to numerous cases of firms' foundations. The book provides also a new semi-quantitative approach to growth of new technology ventures.

  13. Keynes's theories of money and banking in the Treatise and The General Theory

    OpenAIRE

    John Smithin

    2013-01-01

    This paper identifies what seem to have been the five main issues in contention in monetary theory, both historically and in the current era, and discusses the view that J.M. Keynes took on each of them in the Treatise on Money and The General Theory. The key issues in monetary theory are the ontology of money, endogenous versus exogenous money, interest-rate determination, the choice of the monetary policy instrument, and the neutrality versus non-neutrality of money.

  14. Evaluation the consistency of location of moist desquamation and skin high dose area for breast cancer patients receiving adjuvant radiotherapy after breast conservative surgery

    International Nuclear Information System (INIS)

    Sun, Li-Min; Huang, Eng-Yen; Liang, Ji-An; Meng, Fan-Yun; Chang, Gia-Hsin; Tsao, Min-Jen

    2013-01-01

    To evaluate whether the location of moist desquamation matches high dose area for breast cancer patients receiving adjuvant radiotherapy (RT) after breast conservative surgery. One hundred and nine breast cancer patients were enrolled to this study. Their highest skin dose area (the hot spot) was estimated from the treatment planning. We divided the irradiated field into breast; sternal/parasternal; axillary; and inframammary fold areas. The location for moist desquamation was recorded to see if it matches the hot spot. We also analyzed other possible risk factors which may be related to the moist desquamation. Forty-eight patients with 65 locations developed moist desquamation during the RT course. Patients with larger breast sizes and easy to sweat are two independent risk factors for moist desquamation. The distribution of moist desquamation occurred most in the axillary area. All nine patients with the hot spots located at the axillary area developed moist desquamation at the axillary area, and six out of seven patients with the hot spots located at the inframammary fold developed moist desquamation there. The majority of patients with moist desquamation over the breast or sternal/parasternal areas had the hot spots located at these areas. For a patient with moist desquamation, if a hot spot is located at the axillary or inframammary fold areas, it is very likely to have moist desquamation occur there. On the other hand, if moist desquamation occurs over the breast or sternal/parasternal areas, we can highly expect these two areas are also the hot spot locations

  15. Radiotherapy boost dose-escalation for invasive breast cancer after breast-conserving surgery: 2093 Patients treated with a prospective margin-directed policy

    International Nuclear Information System (INIS)

    Livi, Lorenzo; Meattini, Icro; Franceschini, Davide; Saieva, Calogero; Meacci, Fiammetta; Marrazzo, Livia; Gerlain, Elena; Desideri, Isacco; Scotti, Vieri; Nori, Jacopo; Sanchez, Luis Jose; Orzalesi, Lorenzo; Bonomo, Pierluigi; Greto, Daniela; Bianchi, Simonetta; Biti, Giampaolo

    2013-01-01

    Purpose: To investigate the outcome of invasive early breast cancer patients that underwent breast-conserving surgery and adjuvant radiotherapy (RT), treated with a prospective margin-directed institutional policy for RT boost dose, based on final margins status (FMS). Methods and materials: A total of 2093 patients were treated between 2000 and 2008. 10 Gy boost was prescribed in case of FMS > 5 mm; 16 Gy boost with FMS between 2 and 5 mm; 20 Gy boost in case of FMS 5 mm. At multivariate analysis, higher nuclear grade (p = 0.045), triple negative subtype (p = 0.036) and higher T-stage (p = 0.02) resulted as the independent predictors of LR occurrence. Conclusions: Our experience showed that a margin-directed policy of RT boost dose-escalation seems to reduce the negative impact of FMS on LR, but it is not able to overcome the unfavorable effect of higher nuclear grade, higher T stage and triple negative subtype

  16. Glioblastoma: single institutional experience with 48 patients treated with surgery, radiotherapy and chemotherapy; Glioblastoma: experiencia uni-institucional com 48 pacientes tratados com cirurgia, radioterapia e quimioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Potamianos, Carina Fernandes; Souza, Paulo Gustavo Cavalcanti de; Dias, Rodrigo Souza; Giordani, Adelmo Jose; Segreto, Helena Regina Comodo; Segreto, Roberto Araujo [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo SP, (Brazil). Setor de Radioterapia], e-mail: segreto.dmed@epm.br; Malheiros, Suzana Maria Fleury [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sao Paulo, SP (Brazil). Dept. de Neurologia-Neurocirurgia

    2009-01-15

    Objective: to identify prognostic factors and evaluate the clinical outcome of patients with glioblastoma treated with surgery and radiotherapy combined or not with chemotherapy. Material and method: in this retrospective study, 48 patients with glioblastoma were treated between 1997 and 2007. All patients were classified according the recursive partitioning analysis (RPA) criteria. Results: the majority of patients were female, with 50 years of age or above. Performance status of 70 or greater were found in 70.8% of cases, and RPA classes V and VI prevailed. Seventy-two percent of patients were submitted to partial resection and 27.1% to total or subtotal resection. Chemotherapy was administered in 47.9% of patients and doses between 50 and 60 Gy were delivered in 72.9%. The median overall survival was 52 weeks. Conclusion: our data show an overall survival that approaches the related in others reports and were dependent of factors such as chemotherapy, dose of radiation and Karnofsky performance status. (author)

  17. Postmastectomy radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  18. Georg Bartisch: Ophthalmodouleia, der Augendienst, 1583. A treatise on service of the eyes and a review of the chapter on strabismus.

    Science.gov (United States)

    Lowe, R F

    1997-11-01

    In 1583, Georg Bartisch, oculist and cutter for bladder stones at the court of Duke August I of Saxony, published at his own expense a 273 page textbook of ophthalmology. It contained 91 wood cuts and, in the present volume, they are presented in brilliant colour as they were in the original books prepared for presentation. The book was one of the first medical treatises to be published in the German vernacular instead of traditional Latin. It has been translated into English and published in gothic type to simulate the original. Treatment of diseases of the eye by medicines or surgery are reported in great detail. It gives an account of ophthalmology at the time of the early Renaissance when enlightenment was beginning to overtake the darkness of the Middle Ages.

  19. Immunotherapy (excluding checkpoint inhibitors) for stage I to III non-small cell lung cancer treated with surgery or radiotherapy with curative intent.

    Science.gov (United States)

    Zhu, Jianwei; Li, Rui; Tiselius, Eva; Roudi, Raheleh; Teghararian, Olivia; Suo, Chen; Song, Huan

    2017-12-16

    Non-small cell lung cancer (NSCLC) is the most common lung cancer, accounting for approximately 80% to 85% of all cases. For patients with localised NSCLC (stages I to III), it has been speculated that immunotherapy may be helpful for reducing postoperative recurrence rates, or improving the clinical outcomes of current treatment for unresectable tumours. While several new agents have now entered phase III clinical trials, we felt a systematic review was needed to address the question of the effectiveness and safety of immunotherapy in patients with stages I to III NSCLC. To evaluate the effectiveness and safety of immunotherapy (excluding checkpoint inhibitors) in patients with localised NSCLC (stages I to III) who received surgery or radiotherapy with curative intent. We searched the following databases (from inception to 20 January 2017): CENTRAL, MEDLINE, Embase, and CINAHL, and five trial registers. We also manually checked abstracts or reports from relevant conference proceedings and the reference lists of included trials. We searched for randomised controlled trials (RCTs) in adults (≥ 18 years) with histologically-confirmed early-stage (stages I to III) NSCLC after surgical resection, and those with unresectable locally advanced stage III NSCLC who had received radiotherapy with curative intent. For patients who had received primary surgical treatment, postoperative radiotherapy or chemoradiotherapy was allowed if it was used for both experimental and control groups. Two review authors independently selected eligible trials, assessed risk of bias, and extracted data. We used survival analysis to pool time-to-event data, expressing the intervention effect as a hazard ratio (HR). We calculated risk ratios (RR) for dichotomous data, and mean differences for continuous data, with 95% confidence intervals (CI). Due to clinical heterogeneity (immunotherapeutic agents with different underlying mechanisms), we used random-effects models for our meta-analyses. We

  20. Late radiation side effects, cosmetic outcomes and pain in breast cancer patients after breast-conserving surgery and three-dimensional conformal radiotherapy. Risk-modifying factors

    International Nuclear Information System (INIS)

    Hille-Betz, Ursula; Soergel, Philipp; Kundu, Sudip; Klapdor, Ruediger; Hillemanns, Peter; Vaske, Bernhard; Bremer, Michael; Henkenberens, Christoph

    2016-01-01

    The purpose of this work was to identify parameters influencing the risk of late radiation side effects, fair or poor cosmetic outcomes (COs) and pain in breast cancer patients after breast-conserving therapy (BCT) and three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2013, 159 patients were treated at the Hannover Medical School. Physician-rated toxicity according to the LENT-SOMA criteria, CO and pain were assessed by multivariate analysis. LENT-SOMA grade 1-4 toxicity was observed as follows: fibrosis 10.7 %, telangiectasia 1.2 %, arm oedema 8.8 % and breast oedema 5.0 %. In addition, 15.1 % of patients reported moderate or severe breast pain, and 21.4 % complained about moderate or severe pain in the arm or shoulder. In multivariate analysis, axillary clearing (AC) was significantly associated with lymphoedema of the arm [odds ratio (OR) 4.37, p = 0.011, 95 % confidence interval (CI) 1.4-13.58]. Breast oedema was also highly associated with AC (OR 10.59, p = 0.004, 95 % CI 2.1-53.36), a ptosis grade 2/3 or pseudoptosis and a bra size ≥ cup C (OR 5.34, p = 0.029, 95 % CI 1.2-24.12). A ptosis grade 2/3 or pseudoptosis and a bra size ≥ cup C were the parameters significantly associated with an unfavourable CO (OR 3.19, p = 0.019, 95 % CI 1.2-8.4). Concerning chronic breast pain, we found a trend related to the prescribed radiation dose including boost (OR 1.077, p = 0.060, 95 % CI 0.997-1.164). Chronic shoulder or arm pain was statistically significantly associated with lymphoedema of the arm (OR 3.9, p = 0.027, 95 % CI 1.17-13.5). Chronic arm and breast oedema were significantly influenced by the extent of surgery (AC). Ptotic and large breasts were significantly associated with unfavourable COs and chronic breast oedema. Late toxicities exclusive breast pain were not associated with radiotherapy parameters. (orig.) [de

  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. Bowel disease after radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Schofield, P.F.; Holden, D.; Carr, N.D. (Christie Hospital and Holt Radium Inst., Manchester (UK))

    1983-06-01

    The clinical presentation, operative findings and outcome in 40 patients who required surgery for bowel disease after radiotherapy are presented. The type of presentation varied according to the time after radiotherapy. In the first month, many patients had a proctitis but none required surgery. Five patients were operated on within one month, 2 for radiation-induced acute ileitis and 3 for exacerbations of pre-existing disease (diverticular disease 2, ulcerative colitis 1). The commonest time of presentation was between 3 and 18 months after radiotherapy, when 20 patients needed surgery for bowel disease caused by radiation-induced local ischaemia. Twelve of these patients had chronic perforation, 6 had severe rectal bleeding and 2 had painful anorectal ulceration. Fifteen patients presented between 2 and 24 years after radiotherapy, usually with incomplete intestinal obstruction due to a fibrous stricture, but 2 patients had rectal carcinoma. Wide resection of the involved bowel was the principal method of treatment but any anastomosis was protected by a proximal defunctioning stoma. There was no operative mortality but 10 patients have died subsequently. The danger of dismissing these patients as having incurable malignancy is stressed because, although the condition is infrequent, it is usually amenable to adequate surgery.

  3. Timing of radiotherapy (RT) and chemotherapy (CT) following breast conserving surgery (BCS) for patients with node-positive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Wallgren, A; Bernier, J; Gelber, RD; Roncadin, M; Joseph, D; Castiglione, M

    1995-07-01

    Purpose: To evaluate the effects of delaying RT until after different durations of initial courses of CT for pts with node-positive breast cancer. Methods and Materials: From 7/86-4/93, the IBCSG enrolled 1475 eligible node-positive pre- and perimenopausal pts in Trial 6 and 1212 eligible node-positive postmenopausal pts in Trial 7. Pts in Trial 6 were randomized to receive one of four treatments: (1) CMF x 6 cycles (1 cycle=28 days; cyclophosphamide 100 mg/m{sup 2} orally days 1-14; methotrexate 40 mg/m{sup 2} iv. days 1 and 8; 5-fluorouracil 600 mg/m{sup 2} iv days 1 and 8); (2) CMF x 6 cycles followed by single cycles at months 9, 12 and 15; (3) CMF x 3 cycles; (4) CMF x 3 followed by single cycles at months 6, 9 and 12. Pts in Trial 7 were randomized to receive one of four treatments: (5) tamoxifen (TAM: 20 mg daily) plus CMF x 3 cycles, months 1,2,3; (6) TAM plus CMF x 3 plus single cycles of CMF at months 9, 12 and 15; (7) TAM alone for five yrs; (8) TAM plus single cycles of CMF at months 9, 12 and 15. The randomizations were stratified according to type of surgery; 434 pts in Trial 6 (29%) and 285 pts in Trial 7 (24%) had breast conserving surgery and are the subjects of this report. Pts were randomized to receive RT to the conserved breast AFTER completing the initial block of CT if assigned; i.e. month 7 for arms 1 and 2; month 4 for arms 3 and 4; month 4 for arms 5 and 6; month 1 for arms 7 and 8. 24% of pts in Trial 6 and 27% of pts in Trial 7 had four or more axillary lymph nodes involved. Possible prognostic factors including age, estrogen receptor status, nodal status and tumor size were balanced across randomized groups. Four-year actuarial total failure rates (failure at any site), risks of developing distant metastases (DM) (at any time during observation), and overall survival (OS) were estimated using the Kaplan-Meier method. To avoid potential bias due to competing causes of failure, only patients who could be followed for at least 4 years

  4. Breast-conserving surgery with or without radiotherapy in women with ductal carcinoma in situ: a meta-analysis of randomized trials

    Directory of Open Access Journals (Sweden)

    Leon Paola G

    2007-08-01

    Full Text Available Abstract Background To investigate whether Radiation therapy (RT should follow breast conserving surgery in women with ductal carcinoma in situ from breast cancer (DCIS with objective of decreased mortality, invasive or non invasive recurrence, distant metastases and contralateral breast cancer rates. We have done a meta-analysis of these results to give a more balanced view of the total evidence and to increase statistical precision. Methods A meta-analysis of randomized controlled trials (RCT was performed comparing RT treatment for DCIS of breast cancer to observation. The MEDLINE, EMBASE, CANCERLIT, Cochrane Library databases, Trial registers, bibliographic databases, and recent issues of relevant journals were searched. Relevant reports were reviewed by two reviewers independently and the references from these reports were searched for additional trials, using guidelines set by QUOROM statement criteria. Results The reviewers identified four large RCTs, yielding 3665 patients. Pooled results from this four randomized trials of adjuvant radiotherapy showed a significant reduction of invasive and DCIS ipsilateral breast cancer with odds ratio (OR of 0.40 (95% CI 0.33 – 0.60, p Conclusion The conclusion from our meta-analysis is that the addition of radiation therapy to lumpectomy results in an approximately 60% reduction in breast cancer recurrence, no benefit for survival or distant metastases compared to excision alone. Patients with high-grade DCIS lesions and positive margins benefited most from the addition of radiation therapy. It is not yet clear which patients can be successfully treated with lumpectomy alone; until further prospective studies answer this question, radiation should be recommended after lumpectomy for all patients without contraindications.

  5. Bone Fractures Following External Beam Radiotherapy and Limb-Preservation Surgery for Lower Extremity Soft Tissue Sarcoma: Relationship to Irradiated Bone Length, Volume, Tumor Location and Dose

    International Nuclear Information System (INIS)

    Dickie, Colleen I.; Parent, Amy L.; Griffin, Anthony M.; Fung, Sharon; Chung, Peter W.M.; Catton, Charles N.; Ferguson, Peter C.; Wunder, Jay S.; Bell, Robert S.; Sharpe, Michael B.; O'Sullivan, Brian

    2009-01-01

    Purpose: To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Methods and Materials: Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to ≥40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. Results: For fracture patients, mean dose to bone was 45 ± 8 Gy (mean dose at fracture site 59 ± 7 Gy), mean FS was 37 ± 8 cm, maximum dose was 64 ± 7 Gy, and V40 was 76 ± 17%, compared with 37 ± 11 Gy, 32 ± 9 cm, 59 ± 8 Gy, and 64 ± 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. Conclusions: The risk of radiation-induced fracture appears to be reduced if V40 <64%. Fracture incidence was lower when the mean dose to bone was <37 Gy or maximum dose anywhere along the length of bone was <59 Gy. There was a trend toward lower mean FS for nonfracture patients.

  6. Bone fractures following external beam radiotherapy and limb-preservation surgery for lower extremity soft tissue sarcoma: relationship to irradiated bone length, volume, tumor location and dose.

    Science.gov (United States)

    Dickie, Colleen I; Parent, Amy L; Griffin, Anthony M; Fung, Sharon; Chung, Peter W M; Catton, Charles N; Ferguson, Peter C; Wunder, Jay S; Bell, Robert S; Sharpe, Michael B; O'Sullivan, Brian

    2009-11-15

    To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to >or=40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. For fracture patients, mean dose to bone was 45 +/- 8 Gy (mean dose at fracture site 59 +/- 7 Gy), mean FS was 37 +/- 8 cm, maximum dose was 64 +/- 7 Gy, and V40 was 76 +/- 17%, compared with 37 +/- 11 Gy, 32 +/- 9 cm, 59 +/- 8 Gy, and 64 +/- 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. The risk of radiation-induced fracture appears to be reduced if V40 Fracture incidence was lower when the mean dose to bone was lower mean FS for nonfracture patients.

  7. 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

  8. Conservative surgery and radiotherapy for stage I/II breast cancer using lung density correction: 10-year and 15-year results

    International Nuclear Information System (INIS)

    Pierce, Lori J.; Griffith, Kent A.; Hayman, James A.; Douglas, Kathye R.; Lichter, Allen S.

    2005-01-01

    Purpose: Radiotherapy (RT) planning for breast cancer using lung density correction improves dose homogeneity. Its use obviates the need for a medial wedge, thus reducing scatter to the opposite breast. Although lung density correction is used at many centers in planning for early-stage breast cancer, long-term results of local control and survival have not been reported. Since 1984, we have used lung density correction for dose calculations at the University of Michigan. We now present our 10-year and 15-year results. Methods and Materials: The records of 867 patients with Stage I/II breast cancer treated with breast-conserving surgery and RT with or without systemic therapy were reviewed. Tangential fields delivering 45-50 Gy to the whole breast calculated using lung density correction were used. A boost was added in 96.8% of patients for a total median dose of 61.8 Gy. Results: With a median follow-up of 6.6 years (range, 0.2-18.9 years), 5-, 10-, and 15-year actuarial rates of in-breast tumor recurrence as only first failure were 2.2%, 3.6%, and 5.4%, respectively. With surgical salvage, the 15-year cumulative rate of local control was 99.7%. Factors that significantly predicted for increased rate of local recurrence in multivariate analysis were age ≤ 35 years, hazard ratio 4.8 (95% confidence interval [CI], 1.6-13.9) p = 0.004; negative progesterone receptor status, hazard ratio 6.8 (95% CI, 2.3-20.3) p = < 0.001; negative estrogen receptor status, hazard ratio 4.0 (95% CI, 1.5-11.1) p = 0.007; and lack of adjuvant tamoxifen therapy, hazard ratio 7.7 (95% CI, 1.7-33.3) p = 0.008. Relapse-free survival rates at 5, 10, and 15 years were 84.6%, 70.8%, and 55.9%, respectively; breast cancer-specific survival rates were 94.4%, 90.5%, and 86.9%, respectively; and corresponding estimates for overall survival were 89.7%, 75.7%, and 61.3%. Conclusions: Use of lung density correction was associated with high rates of local control, relapse-free survival, breast

  9. [Accelerated partial breast irradiation with image-guided intensity-modulated radiotherapy following breast-conserving surgery - preliminary results of a phase II clinical study].

    Science.gov (United States)

    Mészáros, Norbert; Major, Tibor; Stelczer, Gábor; Zaka, Zoltán; Mózsa, Emõke; Fodor, János; Polgár, Csaba

    2015-06-01

    The purpose of the study was to implement accelerated partial breast irradiation (APBI) by means of image-guided intensity-modulated radiotherapy (IG-IMRT) following breast-conserving surgery (BCS) for low-risk early invasive breast cancer. Between July 2011 and March 2014, 60 patients with low-risk early invasive (St I-II) breast cancer who underwent BCS were enrolled in our phase II prospective study. Postoperative APBI was given by means of step and shoot IG-IMRT using 4 to 5 fields to a total dose of 36.9 Gy (9×4.1 Gy) using a twice-a-day fractionation. Before each fraction, series of CT images were taken from the region of the target volume using a kV CT on-rail mounted in the treatment room. An image fusion software was used for automatic image registration of the planning and verification CT images. Patient set-up errors were detected in three directions (LAT, LONG, VERT), and inaccuracies were adjusted by automatic movements of the treatment table. Breast cancer related events, acute and late toxicities, and cosmetic results were registered and analysed. At a median follow-up of 24 months (range 12-44) neither locoregional nor distant failure was observed. Grade 1 (G1), G2 erythema, G1 oedema, and G1 and G2 pain occurred in 21 (35%), 2 (3.3%), 23 (38.3%), 6 (10%) and 2 (3.3%) patients, respectively. No G3-4 acute side effects were detected. Among late radiation side effects G1 pigmentation, G1 fibrosis, and G1 fat necrosis occurred in 5 (8.3%), 7 (11.7%), and 2 (3.3%) patients, respectively. No ≥G2 late toxicity was detected. Excellent and good cosmetic outcome was detected in 45 (75%) and 15 (25%) patients. IG-IMRT is a reproducible and feasible technique for the delivery of APBI following conservative surgery for the treatment of low-risk, early-stage invasive breast carcinoma. Preliminary results are promising, early radiation side effects are minimal, and cosmetic results are excellent.

  10. Prospective comparison of breast pain in patients participating in a randomized trial of breast-conserving surgery and tamoxifen with or without radiotherapy

    International Nuclear Information System (INIS)

    Rayan, Gamal; Dawson, Laura A.; Bezjak, Andrea; Lau, Anthea; Fyles, Anthony W.; Yi, Q.-L.; Merante, Pat; Vallis, Katherine A.

    2003-01-01

    Purpose: To determine whether breast pain affects quality of life (QOL) after breast-conserving surgery and tamoxifen (TAM) with or without adjuvant breast radiotherapy (RT). Methods and Materials: A randomized clinical trial was carried out at the Princess Margaret Hospital between 1992 and 2000 to evaluate the need for breast RT in addition to TAM in women ≥50 years treated with breast-conserving surgery for T1-T2N0 breast cancer. A companion study to assess breast pain was carried out during the last 2 years of the randomized clinical trial. The short-form McGill Pain Questionnaire (SF-MPQ), the European Organization for Research and Treatment of Cancer (EORTC) QOL (QLQ-C30) and EORTC breast cancer module (QLQ-BR23) questionnaires were completed by patients within 1 week of randomization in the randomized clinical trial (baseline) and at 3, 6, and 12 months. Results: Eighty-six patients participated in the breast pain study; 41 received RT plus TAM and 45 received TAM alone. The median age was 70 years (range 51-80). The baseline pain and QOL scores were similar for the two groups. No significant difference was found between the two groups for each scale of the QLQ-C30 and QLQ-BR23 questionnaires at 3, 6, or 12 months (p>0.100), except that at 12 months, the score for role function (QLQ-C30) was higher in the RT plus TAM group than in the RT-only group (p=0.02). At 3 months, the difference between the mean scores for the SF-MPQ was 0.553 (p=0.47). At 12 months, the pain scores had decreased in both groups; the difference was 0.199 (p=0.71). The number of breast operations or surgical complications did not correlate with breast pain in either group. Acute RT toxicity scores did not correlate with breast pain or QOL scores at 12 months. Conclusion: These results suggest that breast RT does not significantly contribute to breast pain or adversely impact the QOL up to 12 months after treatment in postmenopausal patients with node-negative breast cancer who take

  11. Patient reported outcomes following stereotactic ablative radiotherapy or surgery for stage IA non-small-cell lung cancer : Results from the ROSEL multicenter randomized trial

    NARCIS (Netherlands)

    Louie, Alexander V.; van Werkhoven, Erik; Chen, Hanbo; Smit, Egbert F.; Paul, Marinus A.; Widder, Joachim; Groen, Harry J. M.; van den Borne, Ben E. E. M.; De Jaeger, Katrien; Slotman, Ben J.; Senan, Suresh

    2015-01-01

    We report quality of life and indirect costs from patient reported outcomes from the ROSEL randomized control trial comparing stereotactic ablative radiotherapy (SABR, also known as stereotactic body radiotherapy or SBRT) versus surgical resection for medically operable stage IA non-small cell lung

  12. Value of intraoperative radiotherapy in locally advanced rectal cancer

    NARCIS (Netherlands)

    Ferenschild, Floris T. J.; Vermaas, Maarten; Nuyttens, Joost J. M. E.; Graveland, Wilfried J.; Marinelli, Andreas W. K. S.; van der Sijp, Joost R.; Wiggers, Theo; Verhoef, Cornelis; Eggermont, Alexander M. M.; de Wilt, Johannes H. W.

    PURPOSE: This study was designed to analyze the results of a multimodality treatment using preoperative radiotherapy, followed by surgery and intraoperative radiotherapy in patients with primary locally advanced rectal cancer. METHODS: Between 1987 and 2002, 123 patients with initial unresectable

  13. A comparison of multimodal therapy and surgery for esophageal adenocarcinoma.

    LENUS (Irish Health Repository)

    Walsh, T N

    1996-08-15

    Uncontrolled studies suggest that a combination of chemotherapy and radiotherapy improves the survival of patients with esophageal adenocarcinoma. We conducted a prospective, randomized trial comparing surgery alone with combined chemotherapy, radiotherapy, and surgery.

  14. The Gramática of Nebrija (1492: a didactic treatise and its typography

    Directory of Open Access Journals (Sweden)

    René Pellen

    2012-12-01

    Full Text Available This paper intends to show the potential interest for linguistic, cultural and socio-historical research of a detailed analysis of the structure and typography of the GC. The aim of this paper is to show the advantages of a system of reference first proposed in v. LXXXIX/2, 2009, of the RFE. Through close examination of its typography, the main characteristics of the text as a didactic treatise soon appear; it also becomes possible to observe certain features of Renaissance prose as it moves towards modern standards (chapter, paragraph, utterances, syntax.

  15. Preparation and properties of thin films treatise on materials science and technology

    CERN Document Server

    Tu, K N

    1982-01-01

    Treatise on Materials Science and Technology, Volume 24: Preparation and Properties of Thin Films covers the progress made in the preparation of thin films and the corresponding study of their properties. The book discusses the preparation and property correlations in thin film; the variation of microstructure of thin films; and the molecular beam epitaxy of superlattices in thin film. The text also describes the epitaxial growth of silicon structures (thermal-, laser-, and electron-beam-induced); the characterization of grain boundaries in bicrystalline thin films; and the mechanical properti

  16. Early Modern “Citation Index”? Medical Authorities in Academic Treatises on Plague (1480–1725

    Directory of Open Access Journals (Sweden)

    Karel Černý

    2012-01-01

    Full Text Available The paper deals with the problem of early modern scientific citations. It attempts to establish a measure of scientific popularity in a specific area of the academic medicine in a way which resembles a modern evaluation of scientific activity (citation index. For this purpose an analysis of a series of plague treatises written between 1480 and 1725 in Europe was conducted. Citations for various historical medical authorities (Hippocrates, Galen, etc. are given in Tables which reflect a long time development of popularity. The authorities from various groups (Ancient, Medieval, Arabic, Early Modern are linked together, and “generic authorities” are explained and discussed.

  17. Nasopharyngeal angiofibroma treated with radiotherapy

    Directory of Open Access Journals (Sweden)

    Janaki M

    2007-01-01

    Full Text Available Nasopharyngeal angiofibroma is a rare, highly vascular, benign, locally aggressive tumor, affecting boys of adolescent age. The aggressiveness and high vascularity makes surgery and even a biopsy difficult in majority of cases. Although surgery is the treatment of choice in early cases, considerable debate exists regarding the treatment of advanced disease with intracranial extension. Radiotherapy provides a good response and also avoids surgery-associated morbidity. We are herewith reporting a case of nasopharyngeal angiofibroma who showed complete hemostasis and improvement in vision to radiotherapy

  18. Late radiation side effects, cosmetic outcomes and pain in breast cancer patients after breast-conserving surgery and three-dimensional conformal radiotherapy. Risk-modifying factors

    Energy Technology Data Exchange (ETDEWEB)

    Hille-Betz, Ursula; Soergel, Philipp; Kundu, Sudip; Klapdor, Ruediger; Hillemanns, Peter [Hannover Medical School, Department of Obstetrics and Gynaecology, Hannover (Germany); Vaske, Bernhard [Hannover Medical School, Institute of Medical Biometry and Informatics, Hannover (Germany); Bremer, Michael; Henkenberens, Christoph [Hannover Medical School, Department of Radiation Oncology and Special Oncology, Hannover (Germany)

    2016-01-15

    The purpose of this work was to identify parameters influencing the risk of late radiation side effects, fair or poor cosmetic outcomes (COs) and pain in breast cancer patients after breast-conserving therapy (BCT) and three-dimensional conformal radiotherapy (3D-CRT). Between 2006 and 2013, 159 patients were treated at the Hannover Medical School. Physician-rated toxicity according to the LENT-SOMA criteria, CO and pain were assessed by multivariate analysis. LENT-SOMA grade 1-4 toxicity was observed as follows: fibrosis 10.7 %, telangiectasia 1.2 %, arm oedema 8.8 % and breast oedema 5.0 %. In addition, 15.1 % of patients reported moderate or severe breast pain, and 21.4 % complained about moderate or severe pain in the arm or shoulder. In multivariate analysis, axillary clearing (AC) was significantly associated with lymphoedema of the arm [odds ratio (OR) 4.37, p = 0.011, 95 % confidence interval (CI) 1.4-13.58]. Breast oedema was also highly associated with AC (OR 10.59, p = 0.004, 95 % CI 2.1-53.36), a ptosis grade 2/3 or pseudoptosis and a bra size ≥ cup C (OR 5.34, p = 0.029, 95 % CI 1.2-24.12). A ptosis grade 2/3 or pseudoptosis and a bra size ≥ cup C were the parameters significantly associated with an unfavourable CO (OR 3.19, p = 0.019, 95 % CI 1.2-8.4). Concerning chronic breast pain, we found a trend related to the prescribed radiation dose including boost (OR 1.077, p = 0.060, 95 % CI 0.997-1.164). Chronic shoulder or arm pain was statistically significantly associated with lymphoedema of the arm (OR 3.9, p = 0.027, 95 % CI 1.17-13.5). Chronic arm and breast oedema were significantly influenced by the extent of surgery (AC). Ptotic and large breasts were significantly associated with unfavourable COs and chronic breast oedema. Late toxicities exclusive breast pain were not associated with radiotherapy parameters. (orig.) [German] Ziel dieser Arbeit war es, Parameter zu identifizieren, die Spaetschaeden nach Radiotherapie, ein unguenstiges

  19. Correlation of clinical and pathologic features with outcome in patients with ductal carcinoma in situ of the breast treated with breast-conserving surgery and radiotherapy

    International Nuclear Information System (INIS)

    Rodrigues, Neesha; Carter, Darryl; Dillon, Deborah; Parisot, Nicole; Choi, Doo Ho; Haffty, Bruce G.

    2002-01-01

    Purpose: Although breast-conserving surgery followed by radiotherapy (RT) has become a standard treatment option for patients with ductal carcinoma in situ of the breast, risk factors for ipsilateral breast tumor recurrence (IBTR) in these patients remain an active area of investigation. The purpose of this study was to evaluate the impact of clinical and pathologic features on long-term outcome in a cohort of DCIS patients treated with breast-conserving surgery plus RT. Methods and Materials: Between 1973 and 1998, 230 patients with DCIS were treated with breast-conserving surgery plus RT at our institution. All patients were treated by local excision followed by RT to the breast to a total median tumor bed dose of 64 Gy. Adjuvant hormonal therapy was used in only 20 patients (9%). All available clinical, pathologic, and outcome data, including ipsilateral and contralateral events, were entered into a computerized database. The clinical and pathologic variables evaluated included detection method, mammographic appearance, age, family history, histologic subtype, presence of necrosis, nuclear grade, final margin status, and use of adjuvant hormonal therapy. Results: As of December 15, 2000, with a median follow-up of 8.2 years, 17 patients had developed a recurrence in the ipsilateral breast, resulting in a 5- and 10-year IBTR rate of 5% and 13%, respectively. Contralateral breast cancer developed in 8 patients, resulting in a 10-year contralateral recurrence rate of 5%. Patient age, family history, histologic subtype, margin status, and tumor grade were not significantly associated with recurrence on univariate analysis. A significantly higher rate of local relapse was observed in patients with the presence of necrosis. The 10-year relapse rate was 22% in 88 patients with necrosis compared with 7% in 142 patients without necrosis (p <0.01). In multivariate analysis, the presence of necrosis remained a significant predictor of local relapse. No breast relapses

  20. The Treatise on Names from the Nomocanon (Kormchaia of the Kirillo-Belozersk Redaction

    Directory of Open Access Journals (Sweden)

    Elena V. Belyakova

    2013-12-01

    Full Text Available This article for the first time publishes the Treatise on Names from the little known redaction of the nomocanon (Kormchaia. In the Treatise the unknown author protests against the widespread use of non-Christian names in his time, such as Tomilo, Shumilo, etc., and he says that it is unacceptable for a Christian to have any name other than the one he received at baptism. He allows adding to the name only some indications of a person’s trade, his fatherland or place of origin. In this article the author analyzes the manuscript tradition of the Kirillo-Belozersk redaction that occurred no later than the first quarter of the 17th century. The redaction is the shortened text of the Canon norms of the Daniil’s redaction. Thus its composition is expanded by sections addressing real-life problems, such as: icons painted by “infidels,” unrighteous wealth, and impious names. The paper also examines the issue of the attribution of the titles of this version, which historians formerly had ascribed to Maximus the Greek.

  1. Radiotherapy physics

    International Nuclear Information System (INIS)

    Chen, G.T.Y.; Collier, J.M.; Lyman, J.T.; Pitluck, S.

    1982-01-01

    The Radiotherapy Physics Group works on the physical and biophysical aspects of charged particle radiotherapy. Our activities include the development of isosurvival beams (beams of uniform biological effect), computerized treatment planning development for charged particle radiotherapy, design of compensation to shape dose distributions, and development of dosimetry techniques to verify planned irradiations in both phantoms and patients

  2. The study of target delineation and target movement of whole breast assisted by active breathing control in intensity modulated radiotherapy after breast conservative surgery

    International Nuclear Information System (INIS)

    Li Jianbing; Yu Jinming; Ma Zhifang; Lu Jie; Sun Tao; Guo Shoufang; Wang Jingguo

    2009-01-01

    Objective: To explore the influence of different delineators and different delineating time on target determination of the whole breast and to explore intrafraction and interfraction target displacements of the breast on moderate deep inspiration breathing hold (mDIBH) assisted by active breathing control (ABC) alter breast conservative surgery. Methods: Twenty patients received primary CT-simulation assisted by ABC to get five sets of CT image on the three breathing condition which included one set from free breath (FB), two sets from mDIBH and two sets from deep expiration breathing control (DEBH). After radiotherapy with ten to fifteen fractions, the repeat CT-simulation was carried out to get the same five sets of CT image as the primary CT- simulation. The whole breast target were delineated at different time by the same delineator and delineated respectively by five delineators on the first set of CT images got with mDIBH from the primary CT-simulation, and to compare the influence of delineator and delineating time on the whole breast target. The total silver clips in the cavity were marked respectively on the two sets of CT images got with mDIBH from the primary CT-simulation, and to compare the intrafraction displacement of geometric body structured by the total of silver clips. The two ribs near the isocentric plane of the breast target were delineated respectively on two sets of the mDIBH CT image from the primary CT-simulation and on one set of the mDIBH CT image from the repeat CT-simulation, and comparing the movement of the point of interest (POI) of the ribs delineated to get the value of intrafraction and interfraction thoracic expansion. Results: There was not statistically significant between the four volumes of whole breast targets delineated by the same delineator at different time, but with statistics significant between the volumes of whole breast target delineated by the different delineators ( F=19.681, P=0.000). There was not statistically

  3. Low p53 Binding Protein 1 (53BP1) Expression Is Associated With Increased Local Recurrence in Breast Cancer Patients Treated With Breast-Conserving Surgery and Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Neboori, Hanmanth J.R. [Department of Radiation Oncology, Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Haffty, Bruce G., E-mail: hafftybg@umdnj.edu [Department of Radiation Oncology, The Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Wu Hao [Department of Radiation Oncology, Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Yang Qifeng [Department of Breast Surgery, Qilu Hospital, Shandong University, Ji' nan (China); Aly, Amal [Division of Medical Oncology, The Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Goyal, Sharad; Schiff, Devora [Department of Radiation Oncology, Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Moran, Meena S. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT (United States); Golhar, Ryan [Department of Radiation Oncology, Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Chen Chunxia; Moore, Dirk [Department of Biostatistics, The Cancer Institute of New Jersey and University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ (United States); and others

    2012-08-01

    Purpose: To investigate whether the expression of p53 binding protein 1 (53BP1) has prognostic significance in a cohort of early-stage breast cancer patients treated with breast-conserving surgery and radiotherapy (BCS+RT). Methods and Materials: A tissue microarray of early-stage breast cancer treated with BCS+RT from a cohort of 514 women was assayed for 53BP1, estrogen receptor, progesterone receptor, and HER2 expression by immunohistochemistry. Through log-rank tests and univariate and multivariate models, the staining profile of each tumor was correlated with clinical endpoints, including ipsilateral breast recurrence-free survival (IBRFS), distant metastasis-free survival (DMFS), cause-specific survival (CSS), recurrence-free survival (RFS), and overall survival (OS). Results: Of the 477 (93%) evaluable tumors, 63 (13%) were scored as low. Low expression of 53BP1 was associated with worse outcomes for all endpoints studied, including 10-year IBRFS (76.8% vs. 90.5%; P=.01), OS (66.4% vs. 81.7%; P=.02), CSS (66.0% vs. 87.4%; P<.01), DMFS (55.9% vs. 87.0%; P<.01), and RFS (45.2% vs. 80.6%; P<.01). Multivariate analysis incorporating various clinico-pathologic markers and 53BP1 expression found that 53BP1 expression was again an independent predictor of all endpoints (IBRFS: P=.0254; OS: P=.0094; CSS: P=.0033; DMFS: P=.0006; RFS: P=.0002). Low 53BP1 expression was also found to correlate with triple-negative (TN) phenotype (P<.01). Furthermore, in subset analysis of all TN breast cancer, negative 53BP1 expression trended for lower IBRFS (72.3% vs. 93.9%; P=.0361) and was significant for worse DMFS (48.2% vs. 86.8%; P=.0035) and RFS (37.8% vs. 83.7%; P=.0014). Conclusion: Our data indicate that low 53BP1 expression is an independent prognostic indicator for local relapse among other endpoints in early-stage breast cancer and TN breast cancer patients treated with BCS+RT. These results should be verified in larger cohorts of patients to validate their clinical

  4. Low p53 Binding Protein 1 (53BP1) Expression Is Associated With Increased Local Recurrence in Breast Cancer Patients Treated With Breast-Conserving Surgery and Radiotherapy

    International Nuclear Information System (INIS)

    Neboori, Hanmanth J.R.; Haffty, Bruce G.; Wu Hao; Yang Qifeng; Aly, Amal; Goyal, Sharad; Schiff, Devora; Moran, Meena S.; Golhar, Ryan; Chen Chunxia; Moore, Dirk

    2012-01-01

    Purpose: To investigate whether the expression of p53 binding protein 1 (53BP1) has prognostic significance in a cohort of early-stage breast cancer patients treated with breast-conserving surgery and radiotherapy (BCS+RT). Methods and Materials: A tissue microarray of early-stage breast cancer treated with BCS+RT from a cohort of 514 women was assayed for 53BP1, estrogen receptor, progesterone receptor, and HER2 expression by immunohistochemistry. Through log–rank tests and univariate and multivariate models, the staining profile of each tumor was correlated with clinical endpoints, including ipsilateral breast recurrence–free survival (IBRFS), distant metastasis–free survival (DMFS), cause-specific survival (CSS), recurrence-free survival (RFS), and overall survival (OS). Results: Of the 477 (93%) evaluable tumors, 63 (13%) were scored as low. Low expression of 53BP1 was associated with worse outcomes for all endpoints studied, including 10-year IBRFS (76.8% vs. 90.5%; P=.01), OS (66.4% vs. 81.7%; P=.02), CSS (66.0% vs. 87.4%; P<.01), DMFS (55.9% vs. 87.0%; P<.01), and RFS (45.2% vs. 80.6%; P<.01). Multivariate analysis incorporating various clinico-pathologic markers and 53BP1 expression found that 53BP1 expression was again an independent predictor of all endpoints (IBRFS: P=.0254; OS: P=.0094; CSS: P=.0033; DMFS: P=.0006; RFS: P=.0002). Low 53BP1 expression was also found to correlate with triple-negative (TN) phenotype (P<.01). Furthermore, in subset analysis of all TN breast cancer, negative 53BP1 expression trended for lower IBRFS (72.3% vs. 93.9%; P=.0361) and was significant for worse DMFS (48.2% vs. 86.8%; P=.0035) and RFS (37.8% vs. 83.7%; P=.0014). Conclusion: Our data indicate that low 53BP1 expression is an independent prognostic indicator for local relapse among other endpoints in early-stage breast cancer and TN breast cancer patients treated with BCS+RT. These results should be verified in larger cohorts of patients to validate their

  5. Adjuvant and Definitive Radiotherapy for Adrenocortical Carcinoma

    International Nuclear Information System (INIS)

    Sabolch, Aaron; Feng, Mary; Griffith, Kent; Hammer, Gary; Doherty, Gerard; Ben-Josef, Edgar

    2011-01-01

    Purpose: To evaluate the impact of both adjuvant and definitive radiotherapy on local control of adrenocortical carcinoma. Methods and Materials: Outcomes were analyzed from 58 patients with 64 instances of treatment for adrenocortical carcinoma at the University of Michigan's Multidisciplinary Adrenal Cancer Clinic. Thirty-seven of these instances were for primary disease, whereas the remaining 27 were for recurrent disease. Thirty-eight of the treatment regimens involved surgery alone, 10 surgery plus adjuvant radiotherapy, and 16 definitive radiotherapy for unresectable disease. The effects of patient, tumor, and treatment factors were modeled simultaneously using multiple variable Cox proportional hazards regression for associations with local recurrence, distant recurrence, and overall survival. Results: Local failure occurred in 16 of the 38 instances that involved surgery alone, in 2 of the 10 that consisted of surgery plus adjuvant radiotherapy, and in 1 instance of definitive radiotherapy. Lack of radiotherapy use was associated with 4.7 times the risk of local failure compared with treatment regimens that involved radiotherapy (95% confidence interval, 1.2-19.0; p = 0.030). Conclusions: Radiotherapy seems to significantly lower the risk of local recurrence/progression in patients with adrenocortical carcinoma. Adjuvant radiotherapy should be strongly considered after surgical resection.

  6. Every second cancer patient receives radiotherapy

    International Nuclear Information System (INIS)

    Ojala, A.

    1996-01-01

    Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

  7. Radiotherapy of pineal tumors

    International Nuclear Information System (INIS)

    Danoff, B.; Sheline, G.E.

    1984-01-01

    Radiotherapy has universally been used in the treatment of pineal tumors and suprasellar germinomas. Recently however, major technical advances related to the use of the operating microscope and development of microsurgical techniques have prompted a renewed interest in the direct surgical approach for biopsy and/or excision. This interest has resulted in a controversy regarding the role of surgery prior to radiotherapy. Because of the heterogeneity of tumors occurring in the pineal region (i.e., germ cell tumors, pineal parenchymal tumors, glial tumors, and cysts) and their differing biological behavior, controversy also surrounds aspects of radiotherapy such as: the optimal radiation dose, the volume to be irradiated, and indications for prophylactic spinal irradiation. A review of the available data is presented in an attempt to answer these questions

  8. Cancer research and radiotherapy

    International Nuclear Information System (INIS)

    Matsuzawa, Taiju

    1978-01-01

    An actual condition of cancer, and the basis and a future view of radiotherapy were described by adding generally established biological and biochemical knowledge to the author's research. It was described that the relapse of cancer after irradiation was induced from outside of cancerous mass, and the nature of relapsed cancerous cells group was also stated. The histological structure of cancer from a view of cell movement and radioresistant cancerous cells group were described. The differentiation of cancerous cells were described, and a study of inhibition of cancer by redifferentiation was considered. It is important to grasp characteristics and a limit of radiotherapy for cancer, to systematize and materialize reasonable therapy which uses drug and immunotherapy together with surgery, and to use radiotherapy reasonably together with redifferentiation therapy of cancerous cells by extracting characteristics and a limit of radiationtherapy from an actual condition of cancer. (Serizawa, K.)

  9. Photobiomodulation therapy for the management of radiation-induced dermatitis. A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery

    Energy Technology Data Exchange (ETDEWEB)

    Strouthos, Iosif [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany); Medical Center - Albert Ludwigs University of Freiburg, Department of Radiotherapy and Oncology, Freiburg (Germany); Chatzikonstantinou, Georgios; Tselis, Nikolaos [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany); J.W. Goethe University, Department of Radiotherapy and Oncology, Frankfurt am Main (Germany); Bon, Dimitra [J.W. Goethe University, Institute of Biostatistics and Mathematical Modelling, Frankfurt am Main (Germany); Karagiannis, Efstratios [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany); Otto von Guericke University, Department of Radiation Oncology, Magdeburg (Germany); Zoga, Eleni; Ferentinos, Konstantinos; Maximenko, Julia; Nikolettou-Fischer, Vassiliki; Zamboglou, Nikolaos [Sana Klinikum Offenbach, Department of Radiation Oncology, Offenbach (Germany)

    2017-06-15

    Radiation therapy (RT) comprises a key component in the treatment of breast cancer. Radiation-induced skin toxicity is the major adverse event experienced by patients; however, radiodermatitis (RD) prevention and management remains trivial. It is proven that photobiomodulation (PBM) therapy using light-emitting diode (LED) increases wound healing and depicts an anti-inflammatory effect. This single-institute study evaluates the beneficial role of PBM-LED in preventing/reducing RD during breast cancer RT. Of 70 consecutively treated patients, 25 patients were treated with PBM-LED twice a week prior to adjuvant 3D conformal RT after breast-conserving surgery. RD was reported using Common Toxicity Criteria for Adverse Events Version 4.0 and pain intensity using a visual analog scale (VAS). For comparison, a control group (n = 45) received RT without PBM-LED. In addition, a ''matched'' group (n = 25) was generated from the control group based on propensity for potentially confounding variables. In the PBM group, 22 patients (88%) presented grade 1 and 3 (12%) grade 2 RD. In the control group, 25 patients (55.6%) developed grade 1 reactions, 18 patients (40%) grade 2, and 2 (4.4%) patients grade 3 RD. Concerning pain intensity, 15 patients (60%) of the PBM treatment arm reported no pain, 5 patients (20%) VAS 2, and 5 (20%) VAS 3. In the control group, 13 patients (28.9%) reported no pain, 2 (4.4%) VAS 1, 7 (15.6%) VAS 2, 9 patients (20%) reported VAS 3, 12 (26.7%) patients VAS 4, and 2 (4.4%) patients VAS 5. PBM-LED therapy applied prior to RT might be effective in decreasing the incidence and sequelae of radiation-induced skin toxicity in breast cancer patients treated with breast-conserving surgery. (orig.) [German] Radiotherapie (RT) ist integrativer Bestandteil der multimodalen Therapie beim Mammakarzinom. Strahlentherapieinduzierte Hauttoxizitaet ist dabei das haeufigste unerwuenschte Ereignis; dennoch sind Praevention und Management der

  10. Quality Assurance of 4D-CT Scan Techniques in Multicenter Phase III Trial of Surgery Versus Stereotactic Radiotherapy (Radiosurgery or Surgery for Operable Early Stage (Stage 1A) Non-Small-Cell Lung Cancer [ROSEL] Study)

    International Nuclear Information System (INIS)

    Hurkmans, Coen W.; Lieshout, Maarten van; Schuring, Danny; Heumen, Marielle J.T. van; Cuijpers, Johan P.; Lagerwaard, Frank J.; Widder, Joachim; Heide, Uulke A. van der; Senan, Suresh

    2011-01-01

    Purpose: To determine the accuracy of four-dimensional computed tomography (4D-CT) scanning techniques in institutions participating in a Phase III trial of surgery vs. stereotactic radiotherapy (SBRT) for lung cancer. Methods and Materials: All 9 centers performed a 4D-CT scan of a motion phantom (Quasar, Modus Medical Devices) in accordance with their in-house imaging protocol for SBRT. A cylindrical cedar wood insert with plastic spheres of 15 mm (o15) and 30 mm (o30) diameter was moved in a cosine-based pattern, with an extended period in the exhale position to mimic the actual breathing motion. A range of motion of R = 15 and R = 25 mm and breathing period of T = 3 and T = 6 s were used. Positional and volumetric imaging accuracy was analyzed using Pinnacle version 8.1x at various breathing phases, including the mid-ventilation phase and maximal intensity projections of the spheres. Results: Imaging using eight CT scanners (Philips, Siemens, GE) and one positron emission tomography-CT scanner (Institution 3, Siemens) was investigated. The imaging protocols varied widely among the institutions. No strong correlation was found between the specific scan protocol parameters and the observed results. Deviations in the maximal intensity projection volumes averaged 1.9% (starting phase of the breathing cycle [o]15, R = 15), 12.3% (o15, R = 25), and -0.9% (o30, R = 15). The end-expiration volume deviations (13.4%, o15 and 2.5%, o30), were, on average, smaller than the end-inspiration deviations (20.7%, o15 and 4.5%, o30), which, in turn, were smaller than the mid-ventilation deviations (32.6%, o15 and 8.0%, o30). A slightly larger variation in the mid-ventilation origin position was observed (mean, -0.2 mm; range, -3.6-4.2) than in the maximal intensity projection origin position (mean, -0.1 mm; range, -2.5-2.5). The range of motion was generally underestimated (mean, -1.5 mm; range, -5.5-1). Conclusions: Notable differences were seen in the 4D-CT imaging protocols

  11. Narrative and Cultural History in the Hippocratic Treatise On Ancient Medicine

    Directory of Open Access Journals (Sweden)

    Marco Romani Mistretta

    2016-12-01

    Full Text Available This paper focuses on the ‘history of medicine’ outlined by the author of the Hippocratic treatise On Ancient Medicine, in order to reflect on the relationship between medicine and narrative in Classical Greece. At the outset of the work, the author provides an account of the beginnings of his discipline, conceiving of medicine’s history as a continuum of research and findings that unravel the nature of the human body and the cause of diseases. As this paper shows, the physician-narrator assigns to his craft a crucial role in fostering the birth and progress of human civilization. The rhetorical goals of the historical account are, as I argue, attained through a subtle narrative strategy. In fact, the narrator locates the origins of medicine within a teleological framework, marked by strong emphasis on the heuristic method that characterizes the past, the present, and the future of medical knowledge at once.

  12. Clinical practice guidelines as learned treatises: understanding their use as evidence in the courtroom.

    Science.gov (United States)

    Recupero, Patricia R

    2008-01-01

    It is important for forensic experts to understand how clinical practice guidelines may enter the courtroom, what role they may play in a trial, and how they relate to expert testimony. Guidelines enter the record in several different ways and in several types of cases, typically with the assistance of an expert witness. A common vehicle for their introduction is the learned-treatise exception to the hearsay rule. Case law before and after Daubert v. Merrell Dow Pharmaceuticals, Inc. helps to elucidate the scrutiny that courts may direct toward medical texts proffered as evidence. This article discusses the implications of different rules and relevant case law for the forensic psychiatrist. The discussion notes important considerations for the expert witness, such as how guidelines may affect the expert's role, concerns about the reliability and relevance of scientific evidence, and questions about whether guidelines will be used for inculpatory or exculpatory purposes in medical malpractice trials.

  13. DE TESTIBUS TRACTATURI: A LATE TWELFTH-CENTURY ITALIAN CANONISTIC TREATISE ON LEGAL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Bruce C. Brasington

    2017-06-01

    Full Text Available De testibus tractaturi, an unedited late twelfth-century, southern Italian treatise, draws on both Gratian’s Decretum and decretals of Pope Alexander III to consider question concerning witnesses. It may also be influenced to some degree by the Summa of Simon of Bisignano. There is no evidence of any reliance on civilian authors. In considering the exceptio contra personam testis, it raises the question of whether testimony given by a witness who later died before trial remained valid. This subject is rarely treated in the early canonistic ordines iudiciorum. The author’s application of a letter of Alexander III to Bishop Roger of Worchester (JL 13162 to this question appears to be unusual, perhaps unique, and sheds light on how the early ius commune evaluated evidence.

  14. [Medical popularization and moral therapy in Plutarch's Treatise de tuenda sanitate praecepta (Ygieina paraggelmata)].

    Science.gov (United States)

    Jori, Alberto

    2007-01-01

    In his treatise De tuenda sanitate praecepta (Ygieina paraggelmata: Prescriptions for Health), the Greek philosopher Plutarch of Chaeronea (b. about 45 A.D., d. about 125 A.D.) pursues two aims, which have a deep pedagogical character and are closely connected. To begin with, he would like to provide both his colleagues, "the philosophers" (the equivalent of today's "intellectuals") and politicians with some sanitary/medical suggestions, so that they may adopt a healthy 'life-style', and consequently avoid disease to the best of their ability. Plutarch thus proposes that "philosophers" be made aware of the opportunity, or better yet, of the necessity of learning some medical notions: in their general education (paideia), his colleagues should allow medicine its adequate space, at least in regard to the practical side of the field which relates to a 'life-regimen'. At the same time, Plutarch wishes to impart a moral teaching: in order to remain in good health we must distance ourselves from irrational impulses and social conventions which induce us to practice detrimental behaviours. In this context, the author stresses the need to respect the principles of moderation--both medical and ethical: those of frugality, self-control, and naturalness. His advice is still valid and effective today. Within the background of Plutarch's treatise there is yet a third, implicit aim: to urge the physicians not to imprison themselves in their professional specialization, but rather to also acquire a philosophical education. Such education would indeed allow them to achieve a whole, "holistic" picture of man, who is at the same time soul and body. Many diseases could in fact be avoided if everyone would practice on himself a sort of "moral therapy", which would prevent the soul from falling prey to those deceptive desires from which "self-destructive" behaviours frequently derive.

  15. Critical Review of Rasaratna Samuccaya: A Comprehensive Treatise of Indian Alchemy

    Directory of Open Access Journals (Sweden)

    Dhirajsingh Rajput Sumersingh

    2016-01-01

    Full Text Available Rasaratna Samuccaya (RRS a 13th century C.E. alchemical treatise, authored by Vāgbhaṭa, is a useful compilation related to preparation and properties of drugs of mineral and metallic origin. This text throws light on the state of Indian expertise in the field of alchemy regarding the extraction, purification, conversion of metals/minerals into therapeutically suitable forms, various instruments developed for alchemical purposes and treatment of numerous diseases by using herbo-mineral preparations. The present work is an attempt to summarize the key features of RRS to highlight its utility and contribution in the development of Indian alchemy. To study and summarize the important, comprehensive and specific points mentioned in RRS and to elaborate the contribution of RRS in the field of Indian alchemy. A critical review of RRS from Suratnojjvalā Hindi commentary by Ambikadatta Shastri was done and the collected information was compared with other available literature of Rasaśāstra. Research of modern science was also utilized to explore some facts mentioned by Vāgbhaṭa. RRS is a precise treatise among available ancient literature. It comprises of all eight branches of Ayurveda, although it mainly deals with therapeutic aspects of Rasaśāstra and emphasizes the use of metals and minerals in treating nearly 68 types of ailments. It contains 30 chapters, 3871 verses and detailed description of 960 formulations. Classification of metals and minerals; description of some new instruments, formulations and averting use of metals and minerals in pregnancy are the key features of RRS.

  16. Mathematical instrumentation in fourteenth-century Egypt and Syria the illustrated treatise of Najm al-Din al-Misri

    CERN Document Server

    Charette, F

    2003-01-01

    An illustrated Arabic treatise, with an English translation and detailed commentary, on the construction of over 100 various astronomical instruments, many of which are otherwise unknown to specialists. It was composed by Najm al-Din al-Misri, a rather shadowy figure, in Cairo around 1330 CE.

  17. Whither radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W M

    1987-03-01

    The 1986 Glyn Evans Memorial Lecture, given at the Joint Provincial Meeting of the Royal College of Radiologists, Sheffield, September 1986, sketches an outline of the history of radiotherapy and discusses the future development of the art. Topics included are siting of centres, training needs, the relationship of radiotherapy to other medical specialities, and the advantages and disadvantages of radiotherapy practitioners forming a separate medical College. (U.K.)

  18. Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: a comparison of Australian series

    International Nuclear Information System (INIS)

    Wilcox, Shea W.; Last, Andrew J.; Aherne, Noel J.; McLachlan, Craig S.; McKay, Michael J.; Shakespeare, Thomas P.

    2015-01-01

    We compare the results of modern external-beam radiotherapy (EBRT), using combined androgen deprivation and dose-escalated intensity-modulated radiotherapy with MRI-CT fusion and daily image guidance with fiducial markers (DE-IG-IMRT), with recently published Australian series of brachytherapy and surgery. Five-year actuarial biochemical disease-free survival (bDFS), metastasis-free survival (MFS) and prostate cancer-specific survival (PCaSS) were calculated for 675 patients treated with DE-IG-IMRT and androgen deprivation therapy (ADT). Patients had intermediate-risk (IR) and high-risk (HR) disease. A search was conducted identifying Australian reports from 2005 onwards of IR and HR patients treated with surgery or brachytherapy, reporting actuarial outcomes at 3 years or later. With a median follow-up of 59 months, our 5-year bDFS was 93.3% overall: 95.5% for IR and 91.3% for HR disease. MFS was 96.9% overall (99.0% IR, 94.9% HR), and PCaSS was 98.8% overall (100% IR, 97.7% HR). Prevalence of Grade 2 genitourinary and gastrointestinal toxicity at 5 years was 1.3% and 1.6%, with 0.3% Grade 3 genitourinary toxicity and no Grade 3 gastrointestinal toxicity. Eight reports of brachytherapy and surgery were identified. The HDR brachytherapy series' median 5-year bDFS was 82.5%, MFS 90.0% and PCaSS 97.9%. One surgical series reported 5-year bDFS of 65.5% for HR patients. One LDR series reported 5-year bDFS of 85% for IR patients. Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option.

  19. Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: a comparison of Australian series.

    Science.gov (United States)

    Wilcox, Shea William; Aherne, Noel J; McLachlan, Craig Steven; McKay, Michael J; Last, Andrew J; Shakespeare, Thomas P

    2015-02-01

    We compare the results of modern external-beam radiotherapy (EBRT), using combined androgen deprivation and dose-escalated intensity-modulated radiotherapy with MRI-CT fusion and daily image guidance with fiducial markers (DE-IG-IMRT), with recently published Australian series of brachytherapy and surgery. Five-year actuarial biochemical disease-free survival (bDFS), metastasis-free survival (MFS) and prostate cancer-specific survival (PCaSS) were calculated for 675 patients treated with DE-IG-IMRT and androgen deprivation therapy (ADT). Patients had intermediate-risk (IR) and high-risk (HR) disease. A search was conducted identifying Australian reports from 2005 onwards of IR and HR patients treated with surgery or brachytherapy, reporting actuarial outcomes at 3 years or later. With a median follow-up of 59 months, our 5-year bDFS was 93.3% overall: 95.5% for IR and 91.3% for HR disease. MFS was 96.9% overall (99.0% IR, 94.9% HR), and PCaSS was 98.8% overall (100% IR, 97.7% HR). Prevalence of Grade 2 genitourinary and gastrointestinal toxicity at 5 years was 1.3% and 1.6%, with 0.3% Grade 3 genitourinary toxicity and no Grade 3 gastrointestinal toxicity. Eight reports of brachytherapy and surgery were identified. The HDR brachytherapy series' median 5-year bDFS was 82.5%, MFS 90.0% and PCaSS 97.9%. One surgical series reported 5-year bDFS of 65.5% for HR patients. One LDR series reported 5-year bDFS of 85% for IR patients. Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option. © 2015 The Royal Australian and New Zealand College of Radiologists.

  20. Matched-pair comparisons of stereotactic body radiotherapy (SBRT) versus surgery for the treatment of early stage non-small cell lung cancer: A systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Zhang, Binglan; Zhu, Fuping; Ma, Xuelei; Tian, Ye; Cao, Dan; Luo, Songe; Xuan, Yu; Liu, Lei; Wei, Yuquan

    2014-01-01

    Purpose: A population-based matched-pair comparison was performed to compare the efficacy of stereotactic body radiotherapy (SBRT) versus surgery for early-stage non-small cell lung cancer (NSCLC). Methods: All the eligible studies were searched by PubMed, Medline, Embase, and the Cochrane Library. The meta-analysis was performed to compare odds ratios (OR) for overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), local control (LC), and distant control (DC). Results: Six studies containing 864 matched patients were included in the meta-analysis. The surgery was associated with a better long-term OS in patients with early-stage NSCLC. The pooled OR and 95% confidence interval (CI) for 1-year, 3-year OS were 1.31 [0.90, 1.91] and 1.82 [1.38, 2.40], respectively. However, the difference in 1-year and 3-year CSS, DFS, LC and DC was not significant. Conclusions: This systematic review found a superior 3-year OS after surgery compared with SBRT, which supports the need to compare both treatments in large prospective, randomized, controlled clinical trials

  1. Curative and organ-preserving treatment with intra-arterial carboplatin induction followed by surgery and/or radiotherapy for advanced head and neck cancer: single-center five-year results

    Directory of Open Access Journals (Sweden)

    Tinelli Carmine

    2007-04-01

    Full Text Available Abstract Background This study evaluated the feasibility, toxicity, response rate and survival of neoadjuvant superselective intra-arterial infusion of high dose carboplatin in advanced head and neck cancer. Methods Forty-six patients with primary head and neck squamous cell carcinoma received 3 cycles of intra-arterial carboplatin (300 to 350 mg/m2 per cycle every 2 weeks, followed by radiotherapy or surgery plus radiotherapy. Results No complications or severe toxicity occurred. Sixteen patients (35% were complete responders, 20 (43% partial responders while 10 (22% did not respond to treatment. After completion of the multimodality treatment, 38/46 patients (83% were complete responders. After a 5-year follow-up period, 18/46 patients (39% are alive and disease-free, 3 (6,5% have died of a second primary tumor and 25 (54,5% have died of the disease. Conclusion Intra-arterial carboplatin induction chemotherapy is a safe, well-tolerated technique that discriminates between responders and non-responders and so may have prognostic significance in planning further integrated treatments aimed to organ preservation for advanced head and neck carcinomas.

  2. Ibn Tufail as a SciArtist in the Treatise of Hayy Ibn Yaqzan

    Directory of Open Access Journals (Sweden)

    Nadia Maftouni

    2017-12-01

    Full Text Available Ibn Tufail as a scientist as well as an artist exposes the issues of human anatomy, autopsy, and vivisection and, thereby, could be regarded as a SciArtist. SciArt might be defined as a reciprocal relation between art and science. Followings are the kinds of these interactions: artistically-inclined scientific activities,science-minded artistic activities, and intertwined scientific and artistic activities. In their fictional treatises, Avicenna, Ibn Tufail, and Suhrawardi are traditional avatars of SciArt. This paper frames an account of SciArt, suggesting in detail Ibn Tufail’s work as a prototypical example, while Avicenna and Suhrawardi go beyond the scope of this paper. An instant of intertwined scientific and artistic activities strongly captivates the attentions to Ibn Tufail, describing human anatomy, autopsy, and vivisection in his Treatiseof Hay Ibn Yaqzan. Recognized as the first philosophical story, Hay Ibn Yaqzan depicts the whole philosophy of Ibn Tufail by the story of an autodidactic feral child a gazelle raised whom in an island in the Indian Ocean.

  3. A Treatise for A New Age in Economic Theory: A Review of George Reisman's Capitalism

    Directory of Open Access Journals (Sweden)

    Wladimir Kraus

    2009-02-01

    Full Text Available George Reisman’s magnum opus Capitalism: A Treatise on Economics is a monumental attempt at theoretical integration of leading economic phenomena into one unified whole. Few such books have been published in the history of economics. Still fewer of them contain a comparable proportion of path-breaking innovations both in approach and substance that are integrated in a tightly-spun system of thought that Capitalism does. Yet despite its numerous path-breaking contributions to economic theory, the book has attracted virtually zero attention from the scientific community. History shows that for the most part this has been the fate of all great innovations in science. This review attempts (a to point out reasons why the book’s content is revolutionary, and (b to finally start a serious discussion of its substantive ideas. Specifically, the review focuses in some detail on some of Reisman’s most important innovations which all point the way to a wholly new direction in economic theory that promises to provide the hitherto unseen conformity with empirical reality, analytical rigor, and doctrinal integration.

  4. Headache as an occupational illness in the treatise "De morbis artificum diatriba" of Bernardino Ramazzini.

    Science.gov (United States)

    Zanchin, G; Rossi, P; Isler, H; Maggioni, F

    1996-04-01

    The treatise "De morbis artificum diatriba" (Modena, 1700) is considered to be the first text to specifically deal with occupational illnesses. It was also the last for over 150 years. Written by Bernardino Ramazzini (Carpi, 1633-Padua, 1714), a professor at the University of Padua from 1700 to 1714, the book highlights the importance given at the time to headache as an occupational symptom. Among the 69 professions described, accounting for the majority of the occupations of the period, 12 were found to lead to headache as an important symptom caused by work. Ramazzini appears to have paid more attention to this than we do today. Ramazzini's work opens up a wide view on social conditions in the 18th century, as his sensitivity for occupational hazards was exceptional. His remarks on headache are typical of his way of collecting first-hand experience of working conditions, and they underline the importance of occupational hazards in the assessment of headache, today just as in 1710.

  5. Sequencing of chemotherapy (CT) and radiotherapy (RT) following conservative surgery (CS) for patients with early-stage breast cancer: results of a randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Recht, A; Come, SE; Silver, B; Gelman, RS; Hayes, DF; Shulman, LN; Henderson, IC; Harris, JR

    1995-07-01

    Purpose: To determine the effects of different sequences of CT and RT following CS for pts with clinical Stage I or II breast carcinoma. Methods and Materials: From 6/84-12/92, 244 pts were randomized following CS to receive CT (4 cycles of CAMFP at 3-wk intervals) either before or after RT. Median pt age was 45 yrs (range, 20-68). 164 pts were pre-, 18 pts peri-, and 62 pts were postmenopausal. 209 pts were node-positive (61 had 4 or more positive nodes); after 6/88, 35 selected node-negative pts were also included. 45 Gy was prescribed to the entire breast, followed by a boost of 16 Gy; nodal RT was optional. The medians ( and ranges) of the surgery-radiotherapy interval (SRI) according to assigned arm were: RT-first, 36 days (14-234); CT-first, 126 days (98-185). Drug doses were based on ideal body weight. Doses (per square meter) and schedule were: methotrexate, 200 mg, d.1 and 15; leucovorin, 10 mg, q6H x 12, start d.2 and 16; 5-fluorouracil, 500 mg, d.1; cyclophosphamide, 500 mg, d.1; prednisone, 40 mg/day x 5d, start d.1; and doxorubicin, 45 mg, d.3. All except leucovorin and prednisone were given by IV bolus. Dose reductions were based on the granulocyte nadir from the previous cycle, with an attempt to reescalate doses in subsequent cycles. Tamoxifen 10 mg BID was prescribed to postmenopausal pts with ER+ tumors following both RT and CT. 4 pts were ineligible due to prior malignancies, 2 pts on the RT-first arm refused their assigned sequence and received CT first, 2 pts on the RT-first arm and 1 pt on the CT-first arm refused to start or complete CT, 1 pt on the CT-arm underwent elective mastectomy prior to starting RT, and 1 pt on each arm received nonprotocol CT. Possible prognostic factors including age, menopausal status, ERP status, nodal status, and lymphatic vessel invasion were distributed nearly uniformly between the 2 arms. There was an excess of pts with EIC-positive tumors on the RT-first arm (25%) compared to the CT-first arm (11%) (p-bar=0

  6. Sequencing of chemotherapy (CT) and radiotherapy (RT) following conservative surgery (CS) for patients with early-stage breast cancer: results of a randomized trial

    International Nuclear Information System (INIS)

    Recht, A; Come, SE; Silver, B; Gelman, RS; Hayes, DF; Shulman, LN; Henderson, IC; Harris, JR

    1995-01-01

    Purpose: To determine the effects of different sequences of CT and RT following CS for pts with clinical Stage I or II breast carcinoma. Methods and Materials: From 6/84-12/92, 244 pts were randomized following CS to receive CT (4 cycles of CAMFP at 3-wk intervals) either before or after RT. Median pt age was 45 yrs (range, 20-68). 164 pts were pre-, 18 pts peri-, and 62 pts were postmenopausal. 209 pts were node-positive (61 had 4 or more positive nodes); after 6/88, 35 selected node-negative pts were also included. 45 Gy was prescribed to the entire breast, followed by a boost of 16 Gy; nodal RT was optional. The medians ( and ranges) of the surgery-radiotherapy interval (SRI) according to assigned arm were: RT-first, 36 days (14-234); CT-first, 126 days (98-185). Drug doses were based on ideal body weight. Doses (per square meter) and schedule were: methotrexate, 200 mg, d.1 and 15; leucovorin, 10 mg, q6H x 12, start d.2 and 16; 5-fluorouracil, 500 mg, d.1; cyclophosphamide, 500 mg, d.1; prednisone, 40 mg/day x 5d, start d.1; and doxorubicin, 45 mg, d.3. All except leucovorin and prednisone were given by IV bolus. Dose reductions were based on the granulocyte nadir from the previous cycle, with an attempt to reescalate doses in subsequent cycles. Tamoxifen 10 mg BID was prescribed to postmenopausal pts with ER+ tumors following both RT and CT. 4 pts were ineligible due to prior malignancies, 2 pts on the RT-first arm refused their assigned sequence and received CT first, 2 pts on the RT-first arm and 1 pt on the CT-first arm refused to start or complete CT, 1 pt on the CT-arm underwent elective mastectomy prior to starting RT, and 1 pt on each arm received nonprotocol CT. Possible prognostic factors including age, menopausal status, ERP status, nodal status, and lymphatic vessel invasion were distributed nearly uniformly between the 2 arms. There was an excess of pts with EIC-positive tumors on the RT-first arm (25%) compared to the CT-first arm (11%) (p-bar=0

  7. Technology Entrepreneurship : A Treatise on Entrepreneurs and Entrepreneurship for and in Technology Ventures. Band 1 und Band 2

    OpenAIRE

    Runge, Wolfgang

    2013-01-01

    The treatise is the first coherent and comprehensive presentation of the important sub-field of "technology entrepreneurship" emphasizing the science and engineering perspectives. It is a presentation of technology entrepreneurship as an inter-cultural approach referring to the US and Germany. It integrates micro- and macro aspects referring to numerous cases of firms' foundations. The book provides also a new semi-quantitative approach to growth of new technology ventures.

  8. Radiotherapy and brachytherapy

    International Nuclear Information System (INIS)

    2007-02-01

    This presentation first defines the radiotherapy and brachytherapy techniques, indicates the used ionizing radiations (electromagnetic and particles), describes the mechanisms and processes of action of ionizing radiations: they can be physical by photon-matter interactions (Compton effect and photoelectric effect) or due to electron-matter interactions (excitation, ionization), physical-chemical by direct or indirect action (DNA damage), cellular (mitotic or apoptotic death), tissue (sane and tumorous tissues and differential effect). It discusses the biological efficiency of these treatments which depends on different parameters: intrinsic radio-sensitivity, time (session fractioning and organisation in time), oxygen, radiation quality, cellular cycle, dose rate, temperature. It presents the different types of radiotherapy: external radiotherapy (general sequence, delineation, dosimetry, protection of critical organs, treatment session, quality control, monitoring consultation) and briefly presents some specific techniques (total body irradiation, total cutaneous electron therapy, pre-operation radiotherapy, radio-surgery, hadron-therapy). It proposes an overview of the main indications for this treatment: brain tumours, upper aero digestive tract tumours, bronchial tumours, oesophagus, stomach and pancreas tumours, breast tumours, cervix cancer, rectum tumour, and so on, and indicates the possible associated treatments. The next part addresses brachytherapy. It presents the principles and comments the differences with radiotherapy. It indicates the used radio-elements (Caesium 137, Iridium 192, Iodine 125), describes the implementation techniques (plastic tubes, use of iodine 125, intracavitary and endo-luminal radiation therapy). It proposes an overview of the different treated tumours (skin, breast, prostates, bronchial, oesophagus, ENT) and indicates possible early and late secondary effects for different organs

  9. Curative radiotherapy of supraglottic cancer

    International Nuclear Information System (INIS)

    Kim, Yong Ho; Chai, Gyu Young

    1998-01-01

    The purpose of this study was to evaluate the efficacy of curative radiotherapy in the management of supraglottic cancer. Twenty-one patients with squamous cell carcinoma of the supraglottis were treated with radiotherapy at Gyeongsang National University Hospital between 1990 and 1994. Median follow-up period was 36 months and 95% were observed for at least 2 years. Actuarial survival rate at 5 years was 39.3% for 21 patients. The 5-year actuarial survival rate was 75.0% in Stage I, 42.9% in Stage II, 33.3% in Stage III, and 28.6% in Stage IV(p=0.54). The 5-year local control rate was 52.0% for 21 patients. The 5-year local control rate was 75.0% in Stage I, 57.1% in Stage II, 66.7% in Stage III, and 28.6% in Stage IV(p=0.33). Double primary cancer was developed in 3 patients and those were all esophageal cancers. In early stage(Stage I and II) supraglottic cancer, curative radiotherapy would be a treatment of choice and surgery would be better to be reserved for salvage of radiotherapy failure. In advanced stage(Stage III and IV), radiotherapy alone is inadequate for curative therapy and combination with surgery should be done in operable patients. This report emphasizes the importance of esophagoscopy and esophagogram at the follow-up of patients with supraglottic cancer

  10. [The anti-philosophical anthropology in the Hippocratic treatise De Vetere Medicina (On Ancient Medicine)].

    Science.gov (United States)

    Imai, Masahiro

    2007-01-01

    The Hippocratic treatise De Vetere Medicina (On Ancient Medicine) has been the focus of attention among classical scholars and historians of medicine. The author attacks in ch. 20 doctors and sophists who base their own medical theories and methods on philosophical anthropology taken from the contemporary natural philosophers. Many attempts have been made to elucidate, as opposed to their philosophical inquiry into human nature, the author's way of understanding it, which still remains unclear. I draw attention to the following points to make it clear that the conceptual framework of the author's medical anthropology is different from theirs. Their philosophical inquiry into human nature has its starting point in fundamental element(s), from which human beings were originally formed. The author focuses on human beings as existent in their present states, whose conditions and functions must be investigated through interrelations between them and their external factors, such as foods and drinks. A medical investigation into the interrelations will give us a scientific idea about human body, whose constituents are taken to be a large number of humors, reacting against some external factors and accordingly making us feel pain. This may presuppose that, in the author's medical anthropology, human body is conceptually demarcated as the physical or material aspect of human being, within which all physiological events depending on external factors and the humors take place. In their philosophical anthropology, however, human body doesn't seem to have been clearly conceptualized as such, because our experience of feeling pain should be judged to take place within the actions of the fundamental element(s), which must be supposed to constitute our cognitive self.

  11. Adjuvant radiotherapy for stage I endometrial cancer.

    Science.gov (United States)

    Kong, A; Johnson, N; Cornes, P; Simera, I; Collingwood, M; Williams, C; Kitchener, H

    2007-04-18

    The role of adjuvant radiotherapy (both pelvic external beam radiotherapy and vaginal intracavity brachytherapy) in stage I endometrial cancer following total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH and BSO) remains unclear. To assess the efficacy of adjuvant radiotherapy following surgery for stage I endometrial cancer. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CancerLit, Physician Data Query (PDQ) of National Cancer Institute. Handsearching was also carried out where appropriate. Randomised controlled trials (RCTs) which compared adjuvant radiotherapy versus no radiotherapy following surgery for patients with stage I endometrial cancer were included. Quality of the studies was assessed and data collected using a predefined data collection form. The primary endpoint was overall survival. Secondary endpoints were locoregional recurrence, distant recurrence and endometrial cancer death. Data on quality of life (QOL) and morbidity were also collected. A meta-analysis on included trials was performed using the Cochrane Collaboration Review Manager Software 4.2. The meta-analysis was performed on four trials (1770 patients). The addition of pelvic external beam radiotherapy to surgery reduced locoregional recurrence, a relative risk (RR) of 0.28 (95% confidence interval (CI) 0.17 to 0.44, p ASTEC; Lukka) are awaited. External beam radiotherapy carries a risk of toxicity and should be avoided in stage 1 endometrial cancer patients with no high risk factors.

  12. Stereotactic Body Radiotherapy Versus Surgery for Medically Operable Stage I Non–Small-Cell Lung Cancer: A Markov Model–Based Decision Analysis

    International Nuclear Information System (INIS)

    Louie, Alexander V.; Rodrigues, George; Hannouf, Malek; Zaric, Gregory S.; Palma, David A.; Cao, Jeffrey Q.; Yaremko, Brian P.; Malthaner, Richard; Mocanu, Joseph D.

    2011-01-01

    Purpose: To compare the quality-adjusted life expectancy and overall survival in patients with Stage I non–small-cell lung cancer (NSCLC) treated with either stereotactic body radiation therapy (SBRT) or surgery. Methods and Materials: We constructed a Markov model to describe health states after either SBRT or lobectomy for Stage I NSCLC for a 5-year time frame. We report various treatment strategy survival outcomes stratified by age, sex, and pack-year history of smoking, and compared these with an external outcome prediction tool (Adjuvant! Online). Results: Overall survival, cancer-specific survival, and other causes of death as predicted by our model correlated closely with those predicted by the external prediction tool. Overall survival at 5 years as predicted by baseline analysis of our model is in favor of surgery, with a benefit ranging from 2.2% to 3.0% for all cohorts. Mean quality-adjusted life expectancy ranged from 3.28 to 3.78 years after surgery and from 3.35 to 3.87 years for SBRT. The utility threshold for preferring SBRT over surgery was 0.90. Outcomes were sensitive to quality of life, the proportion of local and regional recurrences treated with standard vs. palliative treatments, and the surgery- and SBRT-related mortalities. Conclusions: The role of SBRT in the medically operable patient is yet to be defined. Our model indicates that SBRT may offer comparable overall survival and quality-adjusted life expectancy as compared with surgical resection. Well-powered prospective studies comparing surgery vs. SBRT in early-stage lung cancer are warranted to further investigate the relative survival, quality of life, and cost characteristics of both treatment paradigms.

  13. Risk-group definition by recursive partitioning analysis of patients with squamous cell head and neck carcinoma treated with surgery and postoperative radiotherapy

    NARCIS (Netherlands)

    Langendijk, JA; Slotman, BJ; van der Waal, [No Value; Doornaert, P; Berkof, J; Leemans, CR

    2005-01-01

    BACKGROUND. The objective of this study was to define different prognostic groups with regard to locoregional control (LRC) derived from recursive partitioning analysis (RPA). METHODS. Eight hundred one patients with squamous cell head and neck carcinoma underwent with primary surgery and received

  14. Radiotherapy; Strahlentherapie

    Energy Technology Data Exchange (ETDEWEB)

    Wannenmacher, M. [Heidelberg Univ., Mannheim (Germany). Abt. fuer Klinische Radiologie; Debus, J. [Univ. Heidelberg (Germany). Abt. Radioonkologie und Strahlentherapie; Wenz, F. (eds.) [Universitaetsklinikum Mannheim (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    2006-07-01

    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.

  15. Radiotherapy in Cancer Management

    International Nuclear Information System (INIS)

    Abdel-Wahab, M.

    2015-01-01

    Radiotherapy has been used for curative or palliative treatment of cancer, either alone or increasingly as part of a multimodality approach in conjunction with chemotherapy, immunotherapy or surgery. Radiation must be delivered in the safest and most effective way. The use of radiologic and nuclear medicine diagnostic techniques, e.g., the use of CT (Computerized Tomography) and PET/CT allow better detection and staging of diseases by displaying both morphological and functional abnormalities within the affected organs and are essential in the process of radiotherapy planning. Technical advances in radiotherapy have allowed better targeting of tumors, sparing of normal tissue and, in the case of radiosurgery, a decrease in the number of treatments. The IAEA Programme in Human Health aims to enhance the capabilities in Member States to address needs related to the treatment of diseases, including cancer, through the application of nuclear techniques. The Programme supports quality assurance in radiation medicine; DIRAC, the only radiation oncology-specific resource database world-wide; significant, innovative education and training programmes through telemedicine and e-learning accessible via the human health campus website. Technical expertise for country– and region–specific technical cooperation radiation-medicine projects is provided to establish or enhance radiation medicine worldwide. (author)

  16. Radiotherapy on hidradenocarcinoma.

    Science.gov (United States)

    Lalya, Issam; Hadadi, Khalid; Tazi, El Mehdi; Lalya, Ilham; Bazine, Amine; Andaloussy, Khalid; Elmarjany, Mohamed; Sifat, Hassan; Hassouni, Khalid; Kebdani, Tayeb; Mansouri, Hamid; Benjaafar, Noureddine; Elgueddari, Brahim Khalil

    2011-01-01

    Clear cell Hidradenocarcinoma is a rare carcinoma arising from sweat glands. It is an aggressive tumor that most metastasizes to regional lymph nodes and distant viscera; surgery with safe margins is the mainstay of treatment. We report a case of 68-year-old woman who presented with an invasive clear cell hidradenocarcinoma situated in the left parotid area which recurred 5 months after surgery, this recurrence was managed successfully by high-dose irradiation of the tumor bed (66 Gy) and regional lymphatic chains (50 Gy), after a follow-up of more than 15 months, the patient is in good local control without significant toxicity. POST OPERATIVE RADIOTHERAPY ALLOWS BETTER LOCAL CONTROL AND SHOULD BE MANDATORY WHEN HISTOLOGICAL FEATURES PREDICTIVE OF RECURRENCE ARE PRESENT: positive margins, histology poorly differentiated, perineural invasion, vascular and lymphatic invasion, lymph node involvement, and extracapsular spread.

  17. Radiotherapy apparatus

    International Nuclear Information System (INIS)

    Leung, P.M.; Webb, H.P.J.

    1985-01-01

    This invention relates to apparatus for applying intracavitary radiotherapy. In previously-known systems radioactive material is conveyed to a desired location within a patient by transporting a chain of balls pneumatically to and from an appropriately inserted applicator. According to this invention a ball chain for such a purpose comprises several radioactive balls separated by non-radioactive tracer balls of radiographically transparent material of lower density and surface hardness than the radioactive balls. The invention also extends to radiotherapy treatment apparatus comprising a storage, sorting and assembly system

  18. Chinese vegetative materia medica in a venereological treatise by Jean Astruc from 1740.

    Science.gov (United States)

    Drobnik, Jacek

    2016-07-01

    Historical medical sources can be still queried for forgotten cures and remedies. Traditional Chinese medicine has dealt with lues venerea (syphilis) since the Five Dynasties period (10th century). Chinese indigenous materia medica and remedies recorded, studied or imported by the Europeans can reveal known or quite unknown medicinal plants. The studied Jean Astruc's work is a published ethnopharmacological survey carried out in Beijing in the 1730s and it deserves a modern interpretation. This is the first proposal to identify historical Chinese medicinal plants listed in a scarcely known medical treatise De Morbis venereis… ('On venereal diseases…') by Jean Astruc from 1740. I searched for the current uses and position of the taxonomically identified herbal stock in both traditional Chinese and official medical knowledge, with special attention to syphilis. Chinese names of drugs and their botanical identities (originally expressed by means of pre-Linnaean polynomials, and now interpreted as accepted binomials) were independently cross-checked with younger till most recent taxonomical and ethnopharmacological sources. Plants and drugs identified this way were queried for their modern applications in traditional Chinese and official medicine with special attention to sexually transmitted diseases (STD) and other uses which are similar to the 18th-century understanding of venereology. For 24 items of medicinal stock, 34 medicinal plants have been identified or suspected: Acacia catechu, Achyranthes bidentata, Akebia quinata, Angelica dahurica, A. sinensis, Aquilaria sinensis, Aralia cordata, Aristolochia fangchi, Chaenomeles sinensis, Ch. speciosa, Clematis vitalba, Coix lacryma-jobi, Commiphora myrrha, Cydonia oblonga, Daemonorops draco, D. jenkinsiana, Dictamnus dasycarpus, Dryobalanops sumatrensis, Forsythia suspensa, Glycyrrhiza uralensis, Lonicera confusa, L. hypoglauca, L. japonica, Ligusticum striatum (=L. chuanxiong), Piper kadsura, Pterocarpus

  19. "Treatises on Earthquakes" in late Renaissance (16th-17th cent), at the roots of historical seismology

    Science.gov (United States)

    Albini, P.

    2009-04-01

    It was soon after the damaging November 1570 earthquake at Ferrara, Northern Italy, that the academic Stefano Breventano from Pavia, a small town in Northern Italy as well, started to compose his "Treatise on the earthquake". Completed by September 1576, this 250-page manuscript was to remain unpublished for centuries. The critical edition recently appeared (Albini, 2007) was a due tribute to the remarkable amount of information put together by Breventano, an otherwise "obscure" literate who, before getting involved with earthquakes, had published a history of the antiquities and remarkable events at his hometown Pavia (1570). Indeed, he was not the first Renaissance author to pursue the goal of checking into the historical sources of the previous centuries in search of earthquakes and other natural phenomena. What is outstanding in his "Treatise" is that he suceeded in retrieving information on more than two hundred earthquakes, along two thousand years, between 504 B.C. and 1575 A.D., covering the whole Euro-Mediterranean region, and the West Indies in early 16th century. Breventano's essay is here presented, together with a comparison between his style and amount of information with those included in the work by the contemporary British author Stephen Batman, "The Doome warning all men to the Judgement" (1581). A later treatise is presented also, the work by Marcello Bonito (1690) "Terra Tremante [Trembling Earth]", which could easily be defined as a worldwide list of earthquakes. In structure and content, Bonito's work goes along the same lines of Breventano, and could be considered a precursor of today descriptive catalogues, because of his outstandingly modern approach that paved the way to modern historical seismology.

  20. The radiotherapy affects the cognitive processes

    International Nuclear Information System (INIS)

    Anon.

    2009-01-01

    Researchers from the medical center of the free university of Amsterdam report that the radiotherapy can hinder the cognitive functions of patients affected by cerebral tumors treated after a surgery. Even low dose radiation could contribute in their opinion, to the progressive cognitive decline of patients suffering of low grade gliomas, the most commune cerebral tumor. To get these conclusions, 65 patients, whom half of them received a radiotherapy, had a neurological and psychological evaluation twelve years after their treatment. Results: 53% of patients treated by radiotherapy present disorders of attention, memory, execution and speed of information treatment against 27% of these ones that received an only surgery. The researchers conclude to the necessity to take into account this risk in the choice of treatment, or even to avoid radiotherapy in this precise case. (N.C.)

  1. [Study on processing adjuvant medicines in Lei Gong's treatise on preparation and broiling of materia medica (Leigong Paozhi Lun)].

    Science.gov (United States)

    Zhang, Wei; Zhang, Ruixian

    2010-09-01

    There were 268 kinds of medicines recorded in the book of Lei Gong's Treatise on preparation and broiling of materia medica (Leigong Paozhi Lun). Among these medicines, 178 medicines were prepared with adjuvant medicines, including general and special compatible adjuvant medicines. These adjuvant medicines used in this book can be explained by the theory of "seven-relation compatibility". The author tried to explain the usage and their compatibility of these adjuvant medicines and put forward that attention should be paid to the changes in functions of medicines and the influences of society should be paid attention.

  2. On textual and contextual position of the ophthalmological treatise of bodhisattva nāgārjuna.

    Science.gov (United States)

    Kim, Seongsu; Kang, Sungyong

    2013-04-01

    Medical knowledge in India began to be introduced to China in earliest from the Later Han Dynasty period to the times of Wei-Qin and South & North Dynasties. This is proved by many Buddhist medical books appeared in those days. Of the contents of Indian medicine, the theory of four major elements affected Chinese medicine more than did the theory of body fluids. Based on the theory of four major elements that was began to be introduced in Fú shuō fú yī jīng, an attempt to establish a new medical system was made in Zhŏu hòu băi yīfāng written by Táo Hóng-jĭng and Sūn Sī-miăo who tried to develop etiology further but could not achieve any great outcomes. Unlike the foregoing situation, Indian medicine aroused a large echo in China in the field of ophthalmology with ophthalmological knowledge mentioned in Suśrutasa hitā and 'Jīnzhēn-shù'(cataract couching) introduced as a surgical treatment of cataract. The Suśrutasa hitā which is one of the three major texts of Indian medicine contains additional information on surgical operations not introduced in the Carakasa hitā. The technique of cataract surgery was particularly popular in the Tang and Song dynasty periods in China under the name Lóng shù pú sà yăn lùn(The Ophthalmological Treatise of Bodhisattva Nāgārjuna) or Lóng shù lùn and was even designated as a subject to educate medical officers. While the original text of Lóng shù pú sà yăn lùn was not handed down, the first testimony that show the trace of the introduction of this text into China was the Tiān zhú jīng lùn yăn mentioned in Wài tái mì yào(Arcane Essential from the Imperial Library) written by Wang Tao. Long shàng dào ren who was mentioned as the compiler of the book is assumed to be Lóng shù. Although Tiān zhú jīng lùn yăn introduced anatomical knowledge about the eyeball that could have not been in the traditional Chinese medicine, this book has only limited quantity of information in this

  3. Radical radiotherapy for T3 laryngeal cancers

    International Nuclear Information System (INIS)

    Uno, T.; Itami, J.; Kotaka, K.; Toriyama, M.

    1996-01-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [de

  4. External radiotherapy of pituitary adenomas

    International Nuclear Information System (INIS)

    Zierhut, Dietmar; Flentje, Michael; Adolph, Juergen; Erdmann, Johannes; Raue, Friedhelm; Wannenmacher, Michael

    1995-01-01

    Purpose: To evaluate therapeutic outcome and side effects of radiotherapy in pituitary adenomas as sole or combined treatment. Methods and Materials: Retrospective analysis of 138 patients (74 male, 64 female) irradiated for pituitary adenoma from 1972 to 1991 was performed. Mean age was 49.7 years (15-80 years). Regular follow-up (in the mean 6.53 ± 3.99 years) included radiodiagnostical [computed tomography (CT), magnetic resonance imaging (MRI), x-ray], endocrinological, and ophthalmological examinations. Seventy patients suffered from nonfunctional pituitary adenoma, 50 patients suffered from growth-hormone producing adenomas, 11 had prolactinomas, and 7 patients had adrenocorticotropic hormone (ACTH) producing pituitary adenomas. In 99 patients surgery was followed by radiotherapy in case of suspected remaining tumor (invasive growth of the adenoma, assessment of the surgeon, pathologic CT after surgery, persisting hormonal overproduction). Twenty-three patients were treated for recurrence of disease after surgery and 16 patients received radiation as primary treatment. Total doses from 40-60 Gy (mean: 45.5 Gy) were given with single doses of 2 Gy 4 to five times a week. Results: Tumor control was achieved in 131 patients (94.9%). In seven patients, recurrence of disease was diagnosed in the mean 2.9 years (9-98 months) after radiotherapy and salvaged by surgery. A statistically significant dose-response relationship was found in favor of doses ≥ 45 Gy. Ninety percent of the patients with hormonally active pituitary adenomas had a benefit from radiotherapy in means of complete termination (38%) or at least reduction (52%) of hormonal overproduction. Partial or complete hypopituitarism after radiotherapy developed, depending on hormonal axis, in 12 (prolactin) to 27% (follicle-stimulating hormone FSH) of patients who had not already had hypopituitarism prior to radiation. Two out of 138 patients suffered reduction of visual acuity, which was, in part

  5. 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.

  6. Skin-Sparing Radiation Using Intensity-Modulated Radiotherapy After Conservative Surgery in Early-Stage Breast Cancer: A Planning Study

    International Nuclear Information System (INIS)

    Saibishkumar, Elantholi P.; MacKenzie, Marc A.; Severin, Diane; Mihai, Alina; Hanson, John M.Sc.; Daly, Helene; Fallone, Gino; Parliament, Matthew B.; Abdulkarim, Bassam S.

    2008-01-01

    Purpose: To evaluate the feasibility of skin-sparing by configuring it as an organ-at-risk (OAR) while delivering whole-breast intensity-modulated radiotherapy (IMRT) in early breast cancer. Methods and Materials: Archival computed tomography scan images of 14 left-sided early-breast tumor patients who had undergone lumpectomy were selected for this study. Skin was contoured as a 4- to 5-mm strip extending from the patient outline to anterior margin of the breast planning target volume (PTV). Two IMRT plans were generated by the helical tomotherapy approach to deliver 50 Gy in 25 fractions to the breast alone: one with skin dose constraints (skin-sparing plan) and the other without (non-skin-sparing plan). Comparison of the plans was done using a two-sided paired Student t test. Results: The mean skin dose and volume of skin receiving 50 Gy were significantly less with the skin-sparing plan compared with non-skin-sparing plan (42.3 Gy vs. 47.7 Gy and 12.2% vs. 57.8% respectively; p < 0.001). The reduction in skin dose was confirmed by TLD measurements in anthropomorphic phantom using the same plans. Dose-volume analyses for other OARs were similar in both plans. Conclusions: By configuring the skin as an OAR, it is possible to achieve skin dose reduction while delivering whole-breast IMRT without compromising dose profiles to PTV and OARs

  7. Radiotherapy for breast cancer and pacemaker

    International Nuclear Information System (INIS)

    Menard, J.; Campana, F.; Bollet, M.A.; Dendale, R.; Fournier-Bidoz, N.; Marchand, V.; Mazal, A.; Fourquet, A.; Kirova, Y.M.; Kirov, K.M.; Esteve, M.

    2011-01-01

    Purpose. - Patients with permanent cardiac pacemakers occasionally require radiotherapy. Therapeutic Irradiation may cause pacemakers to malfunction due to the effects of ionizing radiation or electromagnetic interference. We studied the breast cancer patients who needed breast and/or chest wall and lymph node irradiation to assess the feasibility and tolerance in this population of patients. Patients and methods. - From November 2008 to December 2009, more than 900 patients received radiotherapy for their breast cancer in our department using megavoltage linear accelerator (X 4-6 MV and electrons). Among them, seven patients were with permanent pacemaker. All patients have been treated to the breast and chest wall and/or lymph nodes. Total dose to breast and/or chest wall was 50 Gy/25 fractions and 46 Gy/23 fractions to lymph nodes. Patients who underwent conserving surgery followed by breast irradiation were boosted when indicated to tumour bed with 16 Gy/8 fractions. All patients were monitored everyday in presence of radiation oncologist to follow the function of their pacemaker. All pacemakers were controlled before and after radiotherapy by the patients' cardiologist. Results. - Seven patients were referred in our department for postoperative breast cancer radiotherapy. Among them, only one patient was declined for radiotherapy and underwent mastectomy without radiotherapy. In four cases the pacemaker was repositioned before the beginning of radiotherapy. Six patients, aged between 48 and 84 years underwent irradiation for their breast cancer. Four patients were treated with conserving surgery followed by breast radiotherapy and two with mastectomy followed by chest wall and internal mammary chain, supra- and infra-clavicular lymph node irradiation. The dose to the pacemaker generator was kept below 2 Gy. There was no pacemaker dysfunction observed during the radiotherapy. Conclusion. - The multidisciplinary work with position change of the pacemaker before

  8. Intraoperative radiotherapy for adenocarcinoma of the pancreas

    International Nuclear Information System (INIS)

    Yasue, Mitsunori; Yasui, Kenzo; Morimoto, Takeshi; Miyaishi, Seiichi; Morita, Kozo

    1986-01-01

    Thirty-six patients were given intraoperative radiotherapy for adenocarcinoma of the pancreas between April 1980 and March 1986. Twenty-six of those with well-advanced cancer underwent palliative intraoperative radiotherapy of their main primary lesions (1,500 to 3,000 rads). Fourteen of the 19 patients in this group who had intractable back pain before surgery achieved relief within one week after treatment. Of the remaining 10 patients who underwent pancreatectomy and received adjuvant intraoperative radiotherapy (2,000 to 3,000 rads), two remain clinically free of disease five years and six months and four years and six months after palliative distal pancreatectomy. (author)

  9. Radiological diagnostics and radiotherapy in Wilms' tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kutzner, J

    1981-01-01

    The possibilities of diagnosing Wilms' tumor correctly have been greatly extended by the introduction of computerised tomography and ultrasonic examination. In view of the fact that Wilms' tumor is subjected to combined treatment involving chemotherapy, surgery and radiotherapy, it appears justified to reduce the dose to 20-30 Gy, depending upon the age of the child and the extension of the tumor. It is believed that preoperative radiotherapy will yield better surgical possibilities in large tumours. Radiotherapy can be omitted in infants in the stages I and II as well as in children in stage I.

  10. Imaging and concomitant dose in radiotherapy

    International Nuclear Information System (INIS)

    Negi, P.S.

    2008-01-01

    Image guidance in radiotherapy now involves multiple imaging procedures for planning, simulation, set-up inter and intrafraction monitoring. Presently ALARA (i.e. as low as reasonable achievable) is the principle of management of dose to radiation workers and patients in any diagnostic imaging procedures including image guided surgery. The situation is different in repeated radiographic/fluoroscopic imaging performed for simulation, dose planning, patient positioning and set-up corrections during preparation/execution of Image guided radiotherapy (IGRT) as well as for Intensity Modulated Radiotherapy (IMRT). Reported imaging and concomitant doses will be highlighted and discussed for the management and optimization of imaging techniques in IMRT and IGRT

  11. Concurrent administration of adjuvant chemotherapy and radiotherapy after breast-conserving surgery enhances late toxicities: Long-term results of the ARCOSEIN multicenter randomized study

    International Nuclear Information System (INIS)

    Toledano, Alain; Garaud, Pascal; Serin, Daniel; Fourquet, Alain; Bosset, Jean-Francois; Breteau, Noel; Body, Gilles; Azria, David; Le Floch, Olivier; Calais, Gilles

    2006-01-01

    Purpose: In 1996, a multicenter randomized study was initiated that compared sequential vs. concurrent adjuvant chemotherapy (CT) with radiation therapy (RT) after breast-conserving surgery (ARCOSEIN study). After a median follow-up of 6.7 years (range, 4.3-9 years), we decided to prospectively evaluate the late effects of these 2 strategies. Methods and Materials: A total of 297 patients from the 5 larger participating institutions were asked to report for a follow-up examination. Seventy-two percent (214 patients) were eligible for evaluation of late toxicity. After breast-conserving surgery, patients were treated either with sequential treatment with CT first followed by RT (Arm A) or CT administered concurrently with RT (Arm B). In all patients, CT regimen consisted of mitoxantrone (12 mg/m 2 ), 5-FU (500 mg/m 2 ), and cyclophosphamide (500 mg/m 2 ), 6 cycles (Day 1 to Day 21). Conventional RT was delivered to the whole breast by administration of a 2 Gy per fraction protocol to a total dose of 50 Gy (± boost to the primary tumor bed). The assessment of toxicity was blinded to treatment and was graded by the radiation oncologist, according to the LENT/SOMA scale. Skin pigmentation was also evaluated according to a personal 5-points scoring system (excellent, good, moderate, poor, very poor). Results: Among the 214 evaluable patients, 107 were treated in each arm. The 2 populations were homogeneous for patient, tumor, and treatment characteristics. Subcutaneous fibrosis (SF), telangectasia (T), skin pigmentation (SP), and breast atrophy (BA) were significantly increased in Arm B. No statistical difference was observed between the 2 arms of the study concerning Grade 2 or higher pain, breast edema, or lymphedema. No deaths were caused by late toxicity. Conclusion: After breast-conserving surgery, the concurrent use of CT with RT is significantly associated with an increase incidence of Grade 2 or greater late side effects

  12. Low dose preoperative radiotherapy for carcinoma of the oesophagus

    International Nuclear Information System (INIS)

    Arnott, S.J.; Duncan, W.; Kerr, G.R.; Jack, W.J.L.; Mackillop, W.J.; Walbaum, P.R.; Cameron, E.

    1992-01-01

    Patients (176) with potentially operable squamous cell carcinoma or adenocarcinoma of middle or lower thirds of oesophagus were randomly assigned to preoperative radiotherapy or surgery alone. Patients assigned to the radiotherapy arm received 20 Gy in 10 treatments over 2 weeks, using parallel opposed 4 MV beams. The preoperative radiotherapy was not associated with any significant acute morbidity or any increase in operative complications. The median survival of the overall group of 176 patients was 8 moths, and the 5-year survival was 13%. There was no significant difference in the survival of the 90 patients who received preoperative radiotherapy and the 86 who were managed by surgery alone. Proportional hazards analysis identified lymph node involvement, high tumor grade and male sex as significant adverse prognostic features, but the treatment option assigned had no prognostic significance. It was concluded that low dose preoperative radiotherapy offered no advantage over surgery alone. (author). 9 refs.; 3 figs.; 6 tabs

  13. Combination of icotinib, surgery, and internal-radiotherapy of a patient with lung cancer severely metastasized to the vertebrae bones with EGFR mutation: a case report.

    Science.gov (United States)

    Qu, Li-Li; Qin, Hai-Feng; Gao, Hong-Jun; Liu, Xiao-Qing

    2015-01-01

    A 48-year-old Chinese female was referred to us regarding EGFR-mutated advanced non-small cell lung cancer, and metastasis to left scapula and vertebrae bones which caused pathological fracture at T8 and T10 thoracic vertebrae. An aggressive combined therapy with icotinib, vertebrae operation, and radioactive particle implantation and immunotherapy was proposed to prevent paraplegia, relieve pain, and control the overall and local tumor lesions. No postoperative symptoms were seen after surgery, and the pain was significantly relieved. Icotinib merited a 31-month partial response with grade 1 diarrhea as its drug-related adverse event. High dose of icotinib was administered after pelvis lesion progression for 3 months with good tolerance. Combination therapy of icotinib, surgery, and internal radiation for metastases of the vertebrae bones from non-small cell lung cancer seems to be a very promising technique both for sufficient pain relief and for local control of the tumor, vertebrae operation can be an encouraging option for patients with EFGR positive mutation and good prognosis indicator.

  14. Combination of icotinib, surgery, and internal-radiotherapy of a patient with lung cancer severely metastasized to the vertebrae bones with EGFR mutation: a case report

    Directory of Open Access Journals (Sweden)

    Qu LL

    2015-06-01

    Full Text Available Li-Li Qu, Hai-Feng Qin, Hong-Jun Gao, Xiao-Qing Liu Department of Lung Cancer, Affiliated Hospital of Academy of Military Medical Science, Beijing, People’s Republic of China Abstract: A 48-year-old Chinese female was referred to us regarding EGFR-mutated advanced non-small cell lung cancer, and metastasis to left scapula and vertebrae bones which caused pathological fracture at T8 and T10 thoracic vertebrae. An aggressive combined therapy with icotinib, vertebrae operation, and radioactive particle implantation and immunotherapy was proposed to prevent paraplegia, relieve pain, and control the overall and local tumor lesions. No postoperative symptoms were seen after surgery, and the pain was significantly relieved. Icotinib merited a 31-month partial response with grade 1 diarrhea as its drug-related adverse event. High dose of icotinib was administered after pelvis lesion progression for 3 months with good tolerance. Combination therapy of icotinib, surgery, and internal radiation for metastases of the vertebrae bones from non-small cell lung cancer seems to be a very promising technique both for sufficient pain relief and for local control of the tumor, vertebrae operation can be an encouraging option for patients with EFGR positive mutation and good prognosis indicator. Keywords: lung cancer, spinal metastasis, pathological fracture, spinal canal stenosis, icotinib

  15. Ultrasound elastography as an objective diagnostic measurement tool for lymphoedema of the treated breast in breast cancer patients following breast conserving surgery and radiotherapy

    International Nuclear Information System (INIS)

    Adriaenssens, Nele; Belsack, Dries; Buyl, Ronald; Ruggiero, Leonardo; Breucq, Catherine; De Mey, Johan; Lievens, Pierre; Lamote, Jan

    2012-01-01

    Lymphoedema of the operated and irradiated breast is a common complication following early breast cancer treatment. There is no consensus on objective diagnostic criteria and standard measurement tools. This study investigates the use of ultrasound elastography as an objective quantitative measurement tool for the diagnosis of parenchymal breast oedema. The elasticity ratio of the subcutis, measured with ultrasound elastography, was compared with high-frequency ultrasound parameters and subjective symptoms in twenty patients, bilaterally, prior to and following breast conserving surgery and breast irradiation. Elasticity ratio of the subcutis of the operated breast following radiation therapy increased in 88.9% of patients, was significantly higher than prior to surgery, unlike the non operated breast and significantly higher than the non operated breast, unlike preoperative results. These results were significantly correlated with visibility of the echogenic line, measured with high-frequency ultrasound. Big preoperative bra cup size was a significant risk factor for the development of breast oedema. Ultrasound elastography is an objective quantitative measurement tool for the diagnosis of parenchymal breast oedema, in combination with other objective diagnostic criteria. Further research with longer follow-up and more patients is necessary to confirm our findings

  16. SU-F-T-499: Anatomic Features for Selection of Electronic Tissue Compensation Radiotherapy in Early-Stage Breast Cancer Patients After Breast-Conserving Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Song, Y; Gan, L; Chen, X; Zhang, T; Ren, G [Chongqing Medical University, Chongqing, Chongqing (China); Zhang, M [Rutgers Cancer Institute of New Jersey, Rutgers The State University of New, New Brunswick, New Jersey (United States); Yue, N [Rutgers University, New Brunswick, NJ (United States)

    2016-06-15

    Purpose: To explore the correlations between anatomic features and dose-volumetric parameters in 3DCRT and eComp whole breast irradiation and identify the feasibility of anatomic parameters to predict the planning method selection. Methods: We compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and electronic tissue compensation (eComp) for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing dose to lung, heart, and skin. Statistical analyses were performed between critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS). Results: Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. To keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. Conclusion: The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost. This study was supported by National Natural Science Foundation of China (NO. 31420103915) and Chongqing Health and Family Planning Commission Project (2015MSXM012).

  17. Predictive parameters for selection of electronic tissue compensation radiotherapy in early-stage breast cancer patients after breast-conserving surgery.

    Science.gov (United States)

    Song, Yanbo; Zhang, Miao; Gan, Lu; Chen, Xiaopin; Zhang, Tao; Yue, Ning J; Goyal, Sharad; Haffty, Bruce; Ren, Guosheng

    2016-05-31

    Electronic tissue compensation (eComp) is an external beam planning technique allowing user to manually generate dynamic beam fluence to produce more uniform or modulated dose distribution. In this study, we compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and eComp for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing doses to lung, heart, and skin. Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. Statistical analyses were performed between critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS) to explore any correlations and planning method selection. It was found that to keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost.

  18. SU-F-T-499: Anatomic Features for Selection of Electronic Tissue Compensation Radiotherapy in Early-Stage Breast Cancer Patients After Breast-Conserving Surgery

    International Nuclear Information System (INIS)

    Song, Y; Gan, L; Chen, X; Zhang, T; Ren, G; Zhang, M; Yue, N

    2016-01-01

    Purpose: To explore the correlations between anatomic features and dose-volumetric parameters in 3DCRT and eComp whole breast irradiation and identify the feasibility of anatomic parameters to predict the planning method selection. Methods: We compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and electronic tissue compensation (eComp) for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing dose to lung, heart, and skin. Statistical analyses were performed between critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS). Results: Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. To keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. Conclusion: The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost. This study was supported by National Natural Science Foundation of China (NO. 31420103915) and Chongqing Health and Family Planning Commission Project (2015MSXM012).

  19. Cardiovascular complications following thoracic radiotherapy in patients with cancer

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Borchsenius, Julie I Helene; Offersen, Birgitte Vrou

    2016-01-01

    Cardiovascular complications following thoracic radiotherapy in patients with cancer are well described. Advancements in surgery, radiotherapy and systemic treatments have led to an increasing number of cancer survivors and thus an increasing number of patients with long-term side effects...... of their cancer treatments. This article describes the short- and long-term cardiovascular morbidity and mortality following thoracic radiotherapy and further, optimal cardiovascular assessments and diagnostic tools in asymptomatic and symptomatic patients....

  20. The role of radiotherapy in the sarcoma uterine treatment

    International Nuclear Information System (INIS)

    Sofroni, M.; Iahontova, T.; Rabel, I.; Samet, N.

    1997-01-01

    The analysis of a results of radiotherapy application on patients with sarcoma uterus were presented. The investigated patients was divided in to 6 age groups. The radiotherapy is proposed only in the cases of contraindication of surgery intervention or in the cases of the essential extinction of the tumor. The investigation shows that in the cases of the uterine sarcomas extinction forms radiotherapy is low efficient method

  1. Adenocarcinoma of the stomach following radical radiotherapy for testicular cancer

    International Nuclear Information System (INIS)

    Griffith, C.D.M.; Chadderton, R.; Bourke, J.B.

    1990-01-01

    Two male patients who underwent curative surgery and adjuvant radiotherapy (with further chemotherapy in one) for testicular cancer developed adenocarcinoma of the stomach 5 and 19 years after treatment. The stomach is included in the field of radiotherapy used to treat the para-aortic lymph nodes and this may lead to dysplastic changes in the stomach mucosa which can lead to frank malignancy. Early endoscopy should be offered to patients with dyspeptic symptoms after adjuvant radiotherapy for testicular cancer. (author)

  2. Interstitial radiotherapy

    International Nuclear Information System (INIS)

    Scardino, P.T.; Bretas, F.

    1987-01-01

    The authors now have 20 years of experience with modern techniques of brachytherapy. The large number of patients treated in medical centers around the world and the widespread use of this type of radiotherapy have provided us with substantial information about the indications and contraindications, advantages and disadvantages, pitfalls and complications, as well as the results of these techniques. Although the focus of this review is the experience at Baylor using the combined technique of gold seed implantation plus external beam irradiation, the alternative forms of brachytherapy will be described and compared. The authors' intention is to provide the busy clinician with a succinct and informative review indicating the status of modern interstitial radiotherapy and describing day-to-day approach and results

  3. RADIATION AND SURGERY

    African Journals Online (AJOL)

    Dr. S.A. Adewuyi

    Radiation therapy and surgery in cancer management. 1S.A.Adewuyi,. 2 ... cancer, since axillary node status may determine whether or not a ... The principles are 'En-bloc' dissection which ... prevention of symptoms of cancer, including pain alleviation, and .... Pre-Operative And Post-Operative Radiotherapy: These terms ...

  4. Palliative Radiotherapy

    International Nuclear Information System (INIS)

    Salinas, J.

    2003-01-01

    Palliative care does not attempt to prolong survival but to the achieve the highest quality of life both for the patient and their family covering their physical, psychological, social and spiritual needs. Radiotherapy (RT), one of the most important therapeutic modalities, has a great significance in palliative medicine for cancer since it attempts to reduce as much as possible the acute reaction associated with the treatment for the patient. (Author)

  5. Photobiomodulation therapy for the management of radiation-induced dermatitis. A single-institution experience of adjuvant radiotherapy in breast cancer patients after breast conserving surgery

    International Nuclear Information System (INIS)

    Strouthos, Iosif; Chatzikonstantinou, Georgios; Tselis, Nikolaos; Bon, Dimitra; Karagiannis, Efstratios; Zoga, Eleni; Ferentinos, Konstantinos; Maximenko, Julia; Nikolettou-Fischer, Vassiliki; Zamboglou, Nikolaos

    2017-01-01

    Radiation therapy (RT) comprises a key component in the treatment of breast cancer. Radiation-induced skin toxicity is the major adverse event experienced by patients; however, radiodermatitis (RD) prevention and management remains trivial. It is proven that photobiomodulation (PBM) therapy using light-emitting diode (LED) increases wound healing and depicts an anti-inflammatory effect. This single-institute study evaluates the beneficial role of PBM-LED in preventing/reducing RD during breast cancer RT. Of 70 consecutively treated patients, 25 patients were treated with PBM-LED twice a week prior to adjuvant 3D conformal RT after breast-conserving surgery. RD was reported using Common Toxicity Criteria for Adverse Events Version 4.0 and pain intensity using a visual analog scale (VAS). For comparison, a control group (n = 45) received RT without PBM-LED. In addition, a ''matched'' group (n = 25) was generated from the control group based on propensity for potentially confounding variables. In the PBM group, 22 patients (88%) presented grade 1 and 3 (12%) grade 2 RD. In the control group, 25 patients (55.6%) developed grade 1 reactions, 18 patients (40%) grade 2, and 2 (4.4%) patients grade 3 RD. Concerning pain intensity, 15 patients (60%) of the PBM treatment arm reported no pain, 5 patients (20%) VAS 2, and 5 (20%) VAS 3. In the control group, 13 patients (28.9%) reported no pain, 2 (4.4%) VAS 1, 7 (15.6%) VAS 2, 9 patients (20%) reported VAS 3, 12 (26.7%) patients VAS 4, and 2 (4.4%) patients VAS 5. PBM-LED therapy applied prior to RT might be effective in decreasing the incidence and sequelae of radiation-induced skin toxicity in breast cancer patients treated with breast-conserving surgery. (orig.) [de

  6. Clinical and technical guide on prostate cancer proposal treated with radiotherapy

    International Nuclear Information System (INIS)

    Loria Ruiz, Rolando Alberto

    2013-01-01

    New treatment schemes with radiotherapy in prostate cancer are reviewed. The different modalities for the treatment of prostate cancer are described, such as surgery, chemotherapy and radiotherapy. Hypofractionated treatments and intensity-modulated radiotherapy are studied. The benefit of implementing these schemes in the Caja Costarricense del Seguro Social is analyzed [es

  7. Changing prostate-specific antigen outcome after surgery or radiotherapy for localized prostate cancer during the prostate-specific antigen era

    International Nuclear Information System (INIS)

    D'Amico, Anthony V.; Chen, M.-H.; Oh-Ung, Jean; Renshaw, Andrew A.; Cote, Kerri; Loffredo, Marian; Richie, Jerome P.

    2002-01-01

    Purpose: To evaluate the change in prostate-specific antigen (PSA) outcome after radical prostatectomy (RP) or external beam radiotherapy (EBRT), controlling for follow-up during the PSA era. Methods and Materials: The study cohort consisted of 1440 patients with clinically localized prostate cancer managed with RP (n=1059) or EBRT (n=381) between 1989 and 2000. A single genitourinary pathologist reviewed all pathology specimens. For patients with a 2-year minimal follow-up, the 2-year actual PSA outcome stratified by risk group (low vs. high) was calculated for three periods (January 1, 1989 to December 31, 1992; January 1, 1993 to December 31, 1996; and January 1, 1997 to December 31, 2000) and compared for each treatment modality. PSA failure was defined using the American Society for Therapeutic Radiology and Oncology consensus definition for all patients, and comparisons were made using a chi-square metric. Results: During the study period, the proportion of patients treated with RP and EBRT with low-risk disease increased significantly (p <0.0001) from 60% to 89% and from 26% to 76%, respectively. In addition, the 2-year actual PSA outcome also improved from 60% to 82% (RP: p<0.0001) and from 67% to 91% (RT: p=0.0008). The 2-year actual PSA outcome was not significantly different in the low-risk patients but improved during the three periods in the high-risk patients treated with RP (from 20% to 39% to 75%, p=0.0004) or EBRT (from 50% to 59% to 83%, p=0.01). This improvement in PSA outcome could be explained by a shift toward a more favorable PSA level (RP: p=0.0002; RT: p=0.006) and clinical T stage (RP: p=0.0008, RT: p<0.0001) distribution for patients with biopsy Gleason score ≥7 disease. Conclusion: Improved PSA outcome during the PSA era after RP or EBRT has resulted from a shift in presentation toward low-risk disease and earlier detection of high-grade disease

  8. Factors of influence on acute skin toxicity of breast cancer patients treated with standard three-dimensional conformal radiotherapy (3D-CRT) after breast conserving surgery (BCS)

    International Nuclear Information System (INIS)

    Kraus-Tiefenbacher, Uta; Sfintizky, Andreas; Welzel, Grit; Simeonova, Anna; Sperk, Elena; Siebenlist, Kerstin; Mai, Sabine; Wenz, Frederik

    2012-01-01

    Standard 3D-CRT after BCS may cause skin toxicity with a wide range of intensity including acute effects like erythema or late effects. In order to reduce these side effects it is mandatory to identify potential factors of influence in breast cancer patients undergoing standard three-dimensional conformal radiation therapy (3D-CRT) of the breast and modern systemic therapy. Between 2006 and 2010 a total of 211 breast cancer patients (median age 52,4 years, range 24–77) after BCS consecutively treated in our institution with 3D-CRT (50 Gy whole breast photon radiotherapy followed by 16 Gy electron boost to the tumorbed) were evaluated with special focus on documented skin toxicity at the end of the 50 Gy-course. Standardized photodocumentation of the treated breast was done in each patient lying on the linac table with arms elevated. Skin toxicity was documented according to the common toxicity criteria (CTC)-score. Potential influencing factors were classified in three groups: patient-specific (smoking, age, breast size, body mass index = BMI, allergies), tumor-specific (tumorsize) and treatment-specific factors (antihormonal therapy with tamoxifen or aromatase inhibitors, chemotherapy). Uni- and multivariate statistical analyses were done using IBM SPSS version 19. After 50 Gy 3D-CRT to the whole breast 28.9% of all 211 patients had no erythema, 62.2% showed erythema grade 1 (G1) and 8.5% erythema grade 2. None of the patients had grade 3/4 (G3/4) erythema. In univariate analyses a significant influence or trend on the development of acute skin toxicities (erythema G0 versus G1 versus G2) was observed for larger breast volumes (p=0,004), smoking during radiation therapy (p=0,064) and absence of allergies (p=0,014) as well as larger tumorsize (p=0,009) and antihormonal therapy (p=0.005). Neither patient age, BMI nor choice of chemotherapy showed any significant effect on higher grade toxicity. In the multivariate analysis, factors associated with higher grade

  9. The result of radiotherapy for pituitary adenoma

    International Nuclear Information System (INIS)

    Lee, H. J.; Yang, K. M.; Suh, S. H.

    1997-01-01

    To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median: 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy(median: 5040cGy) were delivered over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. For radiation therapy alone, the 5 YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy , the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achieved normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes. (author)

  10. The result of radiotherapy for pituitary adenoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, H. J.; Yang, K. M.; Suh, S. H. [Inje Univ., Seoul (Korea, Republic of). Coll. of Medicine; Cho, H. L.; Shon, S. C. [Pusan Paik Hospital, Pusan (Korea, Republic of)

    1997-12-01

    To evaluate the prognostic factors for disease-free survival and long-term results of radiotherapy for pituitary adenoma. The study involved a retrospective review of outcome in a series of 27 patients with pituitary adenoma, between 1984 and 1995 at Paik hospital. The study included 20 patients treated with surgery and postoperative radiotherapy and 7 with radiotherapy alone. The patients were followed for 12-146 months (median: 97 months). Seventeen were men and 10 were women. The numbers of functioning and non-functioning pituitary adenoma were 22 and 5 respectively and those of microadenoma and macroadenoma were 4 and 23 respectively. The radiation doses of 5040-5580cGy(median: 5040cGy) were delivered over 5-7 weeks, using 4MV LINAC. The prognostic factors were analyzed by log-rank test. For radiation therapy alone, the 5 YSR was 100% and progression free survival rate was 85.8%. The tumor was controlled in 6/7 (85.8%). For surgery and postoperative radiotherapy , the 5YSR, progression free survival rate and local control rate were 95%, 84.8%, and 89.5% respectively. The parameters of tumor size, hormone secretion, radiation dose, radiotherapy field size were evaluated in a uni- and multivariate analysis and all the factors were not statistically significant (P>0.05). Eleven of 12 (92%) with visual field defect experienced normalization or improvement, and 5 for 7 evaluable patients with hyperprolactinoma achieved normalization in 4 and decrement in 5 patients. Only 2 patients developed mild degree of panhypopituitarism. The radiotherapy appears to be effective in controlling clinical symptoms and signs resulting from pituitary adenoma. Local control rate with radiotherapy alone or with surgery and postoperative radiotherapy was comparable. There was a trend toward high recurrence rate in patients with nonfunctioning or prolactin secreting tumor and larger radiation field sizes. (author).

  11. Conformation radiotherapy and conformal radiotherapy

    International Nuclear Information System (INIS)

    Morita, Kozo

    1999-01-01

    In order to coincide the high dose region to the target volume, the 'Conformation Radiotherapy Technique' using the multileaf collimator and the device for 'hollow-out technique' was developed by Prof. S. Takahashi in 1960. This technique can be classified a type of 2D-dynamic conformal RT techniques. By the clinical application of this technique, the late complications of the lens, the intestine and the urinary bladder after radiotherapy for the maxillary cancer and the cervical cancer decreased. Since 1980's the exact position and shape of the tumor and the surrounding normal tissues can be easily obtained by the tremendous development of the CT/MRI imaging technique. As a result, various kinds of new conformal techniques such as the 3D-CRT, the dose intensity modulation, the tomotherapy have been developed since the beginning of 1990'. Several 'dose escalation study with 2D-/3D conformal RT' is now under way to improve the treatment results. (author)

  12. The radiotherapy affects the cognitive processes; La radiotherapie affecte la cognition

    Energy Technology Data Exchange (ETDEWEB)

    Anon

    2009-10-15

    Researchers from the medical center of the free university of Amsterdam report that the radiotherapy can hinder the cognitive functions of patients affected by cerebral tumors treated after a surgery. Even low dose radiation could contribute in their opinion, to the progressive cognitive decline of patients suffering of low grade gliomas, the most commune cerebral tumor. To get these conclusions, 65 patients, whom half of them received a radiotherapy, had a neurological and psychological evaluation twelve years after their treatment. Results: 53% of patients treated by radiotherapy present disorders of attention, memory, execution and speed of information treatment against 27% of these ones that received an only surgery. The researchers conclude to the necessity to take into account this risk in the choice of treatment, or even to avoid radiotherapy in this precise case. (N.C.)

  13. Stereotactic body radiotherapy in lung cancer: an update

    Energy Technology Data Exchange (ETDEWEB)

    Abreu, Carlos Eduardo Cintra Vita; Ferreira, Paula Pratti Rodrigues; Moraes, Fabio Ynoe de; Neves Junior, Wellington Furtado Pimenta; Carvalho, Heloisa de Andrade, E-mail: heloisa.carvalho@hc.fm.usp.br [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Gadia, Rafael [Hospital Sirio-Libanes, Brasilia, DF (Brazil). Departamento de Radioterapia; Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil). Departamento de Radiologia e Oncologia. Servico de Radioterapia

    2015-07-15

    For early-stage lung cancer, the treatment of choice is surgery. In patients who are not surgical candidates or are unwilling to undergo surgery, radiotherapy is the principal treatment option. Here, we review stereotactic body radiotherapy, a technique that has produced quite promising results in such patients and should be the treatment of choice, if available. We also present the major indications, technical aspects, results, and special situations related to the technique. (author)

  14. Radiotherapy for eyelid cancer

    International Nuclear Information System (INIS)

    Saika, Kazumi

    2001-01-01

    Some studies on radiotherapy for eyelid cancer have been reported, but the optimal radiation doses for different histological types and tumor sizes have not been detailed. So I studied the optimal radiation doses in radiotherapy for eyelid cancer. The patients were fourteen and histological diagnoses were made on the basis of biopsies or surgery before radiotherapy. Surgical cut margins were positive in 10 cases. In 5 of these cases, tumors were visible. There were 9 sebaceous adenocarcinomas (SAC), 4 squamous cell carcinomas (SCC), and 1 basal cell carcinoma (BCC). In 13 of 14 cases, radiation was applied to eyelids in which tumor-surgical cut margin distances were 3 mm or less. The eyeballs were covered with lead or tungsten shields, and the eyelids were irradiated with a total dose of 50 to 66.6 Gy. In 5 cases, radiation was applied prophylactically for ipsilateral pre-auricle lymph node areas. 11 of 13 cases were locally controlled. I gave greater radiation doses for SAC than for SCC or BCC. I also gave greater doses for in visible tumors than for invisible ones. In the acute phase dermatitis, inflammation of the cornea, conjunctivitis, etc. occurred but they were mild. Later reactions were decreased cilia, dry eye, inflammation of cornea, conjunctivitis, discomfort of the scar, etc. Cataracts were also seen, but they were of senile origen. Because 81.8% of the tumors were controlled, this radiation method was useful with salvage therapies to select an optimal radiation dose according to the differences among histological types and tumor sizes. 60% of visible tumors were also controlled so I think that radical therapy using radiation alone is possible. (author)

  15. Can advanced new radiation therapy technologies improve outcome of high grade glioma (HGG) patients? analysis of 3D-conformal radiotherapy (3DCRT) versus volumetric-modulated arc therapy (VMAT) in patients treated with surgery, concomitant and adjuvant chemo-radiotherapy

    International Nuclear Information System (INIS)

    Navarria, Pierina; Pessina, Federico; Cozzi, Luca; Ascolese, Anna Maria; Lobefalo, Francesca; Stravato, Antonella; D’Agostino, Giuseppe; Franzese, Ciro; Caroli, Manuela; Bello, Lorenzo; Scorsetti, Marta

    2016-01-01

    To assess the impact of volumetric-modulated arc therapy (VMAT) compared with 3D-conformal radiotherapy (3DCRT) in patients with newly diagnosed high grade glioma in terms of toxicity, progression free survival (PFS) and overall survival (OS). From March 2004 to October 2014, 341 patients underwent surgery followed by concomitant and adjuvant chemo-radiotherapy. From 2003 to 2010, 167 patients were treated using 3DCRT; starting from 2011, 174 patients underwent VMAT. The quantitative evaluation of the treatment plans was performed by means of standard dose volume histogram analysis. Response was recorded using the Response Assessment in Neuro-Oncology (RANO) criteria and toxicities graded according to Common Terminology Criteria for Adverse Event version 4.0. Both techniques achieved an adequate dose conformity to the target. The median follow up time was 1.3 years; at the last observation 76 patients (23.4 %) were alive and 249 (76.6 %) dead (16 patients were lot to follow-up). For patients who underwent 3DCRT, the median PFS was 0.99 ± 0.07 years (CI95: 0.9–1.1 years); the 1 and 3 years PFS were, 49.6 ± 4 and 19.1 ± 3.1 %. This shall be compared, respectively, to 1.29 ± 0.13 years (CI95: 1.01–1.5 years), 60.8 ± 3.8, and 29.7 ± 4.6 % for patients who underwent VMAT (p = 0.02). The median OS for 3DCRT patients was 1.21 ± 0.09 years (CI95:1.03–1.3 years); 1 and 5 year OS was, 63.3 ± 3.8 and 21.5 ± 3.3 %. The corresponding results for 3DRCT patients were 1.56 ± 0.09 years (CI95:1.37–1.74 years), 73.4 ± 3.5, 30 ± 4.6 % respectively (p < 0.01). In both groups, prognostic factors conditioning PFS and OS were age, gender, KPS, histology and extent of resection (EOR). VMAT resulted superior to 3DCRT in terms of dosimetric findings and clinical results

  16. 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)

  17. Radiotherapy for bladder cancer and kidney cancer

    International Nuclear Information System (INIS)

    Ishikawa, Hitoshi; Tanaka, Keiichi; Iizumi, Takashi; Shimizu, Shosei; Okumura, Toshiyuki; Sakurai, Hideyuki; Kimura, Tomokazu; Nishiyama, Hiroyuki

    2017-01-01

    This paper explained the current state of radiotherapy for bladder cancer and kidney cancer, and discussed the role of radiotherapy in curative treatment and the future development. In the diagnosis and treatment of bladder cancer, it is important to judge the existence of pathological muscular layer invasion based on transurethral resection of bladder tumor (TUR-BT). In surgical results in Japan, the U.S., and Switzerland, 5-year survival rate is about 60 to 70%. Standard treatment for bladder cancer with muscle layer invasion had been surgery, and radiotherapy had been applied to the cases without resistance to surgery. Three combined therapy with TUR-BT and simultaneous chemoradiotherapy is the current standard bladder conserving therapy. The 5-year survival rate is approximately 60%, which is superior to the treatment with irradiation alone. Radiotherapy for kidney cancer is most often used as perioperative treatment for locally advanced cancer or as symptomatic treatment for metastatic lesions. However, due to recent improvement in radiotherapy technology, correspondence to respiratory movement and high dose administration associated with improvement in dose concentration have been realized, and stereotactic irradiation using a high single dose for inoperable disease cases or surgery refusal disease cases has come to be clinically applied. (A.O.)

  18. Radiotherapy for breast cancer and pacemaker; Radiotherapie pour un cancer du sein et stimulateur cardiaque

    Energy Technology Data Exchange (ETDEWEB)

    Menard, J.; Campana, F.; Bollet, M.A.; Dendale, R.; Fournier-Bidoz, N.; Marchand, V.; Mazal, A.; Fourquet, A.; Kirova, Y.M. [Oncologie-radiotherapie, institut Curie, 26, rue d' Ulm, 75005 Paris (France); Kirov, K.M.; Esteve, M. [Departement d' anesthesie-reanimation-douleur, institut Curie, 75005 Paris (France)

    2011-06-15

    Purpose. - Patients with permanent cardiac pacemakers occasionally require radiotherapy. Therapeutic Irradiation may cause pacemakers to malfunction due to the effects of ionizing radiation or electromagnetic interference. We studied the breast cancer patients who needed breast and/or chest wall and lymph node irradiation to assess the feasibility and tolerance in this population of patients. Patients and methods. - From November 2008 to December 2009, more than 900 patients received radiotherapy for their breast cancer in our department using megavoltage linear accelerator (X 4-6 MV and electrons). Among them, seven patients were with permanent pacemaker. All patients have been treated to the breast and chest wall and/or lymph nodes. Total dose to breast and/or chest wall was 50 Gy/25 fractions and 46 Gy/23 fractions to lymph nodes. Patients who underwent conserving surgery followed by breast irradiation were boosted when indicated to tumour bed with 16 Gy/8 fractions. All patients were monitored everyday in presence of radiation oncologist to follow the function of their pacemaker. All pacemakers were controlled before and after radiotherapy by the patients' cardiologist. Results. - Seven patients were referred in our department for postoperative breast cancer radiotherapy. Among them, only one patient was declined for radiotherapy and underwent mastectomy without radiotherapy. In four cases the pacemaker was repositioned before the beginning of radiotherapy. Six patients, aged between 48 and 84 years underwent irradiation for their breast cancer. Four patients were treated with conserving surgery followed by breast radiotherapy and two with mastectomy followed by chest wall and internal mammary chain, supra- and infra-clavicular lymph node irradiation. The dose to the pacemaker generator was kept below 2 Gy. There was no pacemaker dysfunction observed during the radiotherapy. Conclusion. - The multidisciplinary work with position change of the pacemaker

  19. Adjuvant Chemotherapy Seemed Not to Have Survival Benefit in Rectal Cancer Patients with ypTis-2N0 After Preoperative Radiotherapy and Surgery from a Population-Based Propensity Score Analysis.

    Science.gov (United States)

    Hu, Xiang; Li, Ya-Qi; Li, Qing-Guo; Ma, Yan-Lei; Peng, Jun-Jie; Cai, San-Jun

    2018-04-19

    Adjuvant chemotherapy is currently offered routinely, as standard, after radical resection for patients with rectal cancer receiving neo-adjuvant chemoradiation. However, the efficacy of adjuvant chemotherapy in patients with ypTis-2N0M0 has not been documented to the same extent, and the survival benefit remained controversial. The purpose of this work was to determine the role of chemotherapy in patients with ypTis-2N0M0 classification. Data were obtained from the Surveillance, Epidemiology, and End Results database ( n  = 4,217). A propensity score model was utilized to balance baseline covariates. Of the 4,217 included patients, 335 with ypTis-2N0M0 did not receive adjuvant chemotherapy. There were comparable cancer-specific survivals (CSS) between those undergoing adjuvant chemotherapy or not (log-rank test = 0.136, p  = .712) in the overall sample. After propensity score matching, the cancer-specific survival did not differ between the chemotherapy and observation groups (log-rank test = 0.089, p  = .765). Additionally, the Cox model did not demonstrate adjuvant chemotherapy as the prognostic factor, with hazard ratio = 0.95 (95% confidence interval 0.69-1.32) for CSS. Furthermore, the 10-year cumulative CSS was 78.7% and 79.4% between the chemotherapy and observation groups, indicating no significance, and no impact of adjuvant chemotherapy on survival was observed in different subgroups stratified by T stage, histological grade, histology, lymph nodes, and tumor size. Patients with ypTis-2N0 rectal cancer did not benefit from adjuvant chemotherapy after preoperative radiology and radical surgery in this cohort study. These results provided new insight into the routine use of adjuvant chemotherapy for patients with rectal cancer with completed neo-adjuvant radiotherapy and curative surgery. Inconsistent recommendations for patients with rectal cancer receiving neo-adjuvant chemoradiation are offered by clinical guidelines. Adjuvant

  20. Comparative effectiveness of radical prostatectomy and radiotherapy in prostate cancer: Observational study of mortality outcomes

    NARCIS (Netherlands)

    P. Sooriakumaran (Prasanna); T. Nyberg (Tommy); O. Akre (Olof); L. Haendler (Leif); I. Heus (Inge); M. Olsson (Marita); S. Carlsson (Sigrid); M.J. Roobol-Bouts (Monique); G. Steineck (Gunnar); P. Wiklund (Peter)

    2014-01-01

    textabstractObjective: To compare the survival outcomes of patients treated with surgery or radiotherapy for prostate cancer. Design: Observational study. Setting: Sweden, 1996-2010. Participants: 34 515 men primarily treated for prostate cancer with surgery (n=21 533) or radiotherapy (n=12 982).

  1. Phase II study of a trimodal preoperative treatment followed by radical surgery or radiotherapy in non-resectable cervical cancer ≥ Figo IIB

    International Nuclear Information System (INIS)

    Cho, C.; Gellermann, J.; Jungnickel, K.; Kuemmel, S.; Hildebrandt, B.; Wust, P

    2005-01-01

    Full text: Regional hyperthermia is combined with radiochemotherapy to achieve resectability in non-resectable cervical carcinoma. In a phase II study at the Charite Medical School approved by the institutionals ethical committee non-resectable cervical carcinoma of at least FIGO IIB were treated with radiochemotherapy combined with regional hyperthermia. The treatment concept comprises cisplatinum therapy of 40 mg/sqm body surface once weekly during regional hyperthermia supplementing radiation therapy of 5 x 1.8 Gy to a total dose of 45 - 50.4 Gy. A gynecological status and imaging is performed for evaluation of resectability of the tumor. If a tumor resection was not feasable radiation was completed to 59.4 - 63 Gy supplemented by 4 - 5 afterloading sessions. Regional hyperthermia was conducted with SIGMA 60 or SIGMA Eye applicator of the system BSD-2000, on average steady state temperatures between 40-41 o C were achieved over the therapeutic time. From 2000 to 2003 we recruited 30 patients. Acute toxicity was in the usual range (10-15 % grade ≥ 3). Two thirds were FIGO stage III/IV with tumor diameters > 6 cm. After treatment 20/30 (67 %) of the former inoperable cases were evaluated as resectable, 3 of these patients refused surgery. Of the remaining 17 cases 14 patients were R0-resected, 2 patients were R1-resected, and 1 patient had a positive paraaortal lymphnode. In 13/30 patients nonsurgical treatment was continued. Response was achieved in 23/30 patients (77 %), i.e. 14 resectable cases with downstaging and 9 partial remissions (PR) after hyperthermic radiochemotherapy with 45 - 50.4 Gy. Response correlated well with thermal parameters, in particular the mean temperature in the vaginal reference point. For the whole group a three year overall survival of 60 % was achieved together with a moderate late toxicity ≥ 3 in 4/30 patients (13 %). R0-resected patients have an excellent prognosis with a 3-year survival of 95 % and a late toxicity ≥ 3 below

  2. Radiotherapy in breast cancer and its prognosis

    International Nuclear Information System (INIS)

    Mitter, Mihir

    1980-01-01

    Various aspects of breast cancer are discussed. These include clinical staging, histological grading, site of growth, frequency and lactation, immunological response and prognosis, and survival of untreated cases. Importance of early detection is emphasised and prognosis after radiotherapy alone or in combination with surgery is briefly discussed. (M.G.B.)

  3. Adjuvant radiotherapy and 5-fluorouracil after curative resection of cancer of the pancreas and periampullary region: phase III trial of the EORTC gastrointestinal tract cancer cooperative group

    NARCIS (Netherlands)

    Klinkenbijl, J. H.; Jeekel, J.; Sahmoud, T.; van Pel, R.; Couvreur, M. L.; Veenhof, C. H.; Arnaud, J. P.; Gonzalez, D. G.; de Wit, L. T.; Hennipman, A.; Wils, J.

    1999-01-01

    The survival benefit of adjuvant radiotherapy and 5-fluorouracil versus observation alone after surgery was investigated in patients with pancreatic head and periampullary cancers. A previous study of adjuvant radiotherapy and chemotherapy in these cancers by the Gastrointestinal Tract Cancer

  4. 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

  5. Determinants of variability in waiting times for radiotherapy in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Bouche, Gauthier; Ingrand, Isabelle; Mathoulin-Pelissier, Simone; Ingrand, Pierre; Breton-Callu, Christel; Migeot, Virginie

    2010-01-01

    Purpose: To examine psycho-social and geographic determinants of delay in starting radiotherapy in early invasive breast cancer patients. Material and methods: Waiting time was defined as the time elapsed until the beginning of radiotherapy, starting from the date of surgery (in absence of chemotherapy) or from the end of chemotherapy. Results: Eight hundred and ninety six women aged 24-89 took part in the study. Mean waiting times were 52 days (sd = 19) between surgery and radiotherapy and 31 days (sd = 14) between chemotherapy and radiotherapy. Differences between radiotherapy centres (p < 0.0001) accounted for 30% and 12%, respectively, of total variance in waiting times. Using a multivariate mixed analysis that took into account intra-centre correlation, the time between surgery and radiotherapy was shorter for young patients (p = 0.020), those who had sought information about their illness (p = 0.024) and those who had undergone surgery and radiotherapy in the same centre (p = 0.021). On the other hand, no patient characteristic was associated with the time between chemotherapy and radiotherapy. Conclusion: Centre is the major factor that explained longer waiting times in radiotherapy, emphasising the structural hypothesis. It is important to pursue initiatives to improve the organization within radiotherapy centres and then to verify that these initiatives have succeeded in shortening waiting times.

  6. Intraoperative radiotherapy for cancer of the pancreas

    International Nuclear Information System (INIS)

    Manabe, Tadao; Nagai, Toshihiro; Tobe, Takayoshi; Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

    1985-01-01

    Seven patients treated by intraoperative radiotherapy for cancer of the pancreas were evaluated. Three patients undergoing pancreaticoduodenectomy for cancer of the head of the pancreas received a dose of 2,500--3,000 rad (6--10 MeV Betatron) intraoperatively with or without external beam irradiation at a dose of 2,520 rad (10 MeV lineac X-ray). One patient developed radiation pancreatitis and died 0.8 month after surgery. Autopsy revealed the degeneration of cancer cells in the involved superior mesenteric artery. One died of hepatic metastasis 8.5 months after surgery, however, recurrence was not found in the irradiation field. The other patient who had external beam irradiation combined with intraoperative radiotherapy is alive 7.5 months after surgery. Four patients with unresectable cancer of the body of the pancreas received a dose of 2,500--3,000 rad (13--18 MeV Betatron) intraoperatively with or without external beam irradiation at a dose of 1,500--5,520 rad (10 MeV lineac X-ray). One patient died of peritonitis carcinomatosa 3.0 months after surgery. One patient died of DIC 0.6 month after surgery. Two patients are alive 1.0 and 6.5 months after surgery. In these patients with intraoperative radiotherapy for unresectable cancer of the pancreas, remarkable effects on relief of pain and shrinkage of tumor were obtained. Further pursuit of intraoperative and external beam radiotherapies in combination with pancreatectomy should be indicated in an attempt to prolong survival of patient with cancer of the pancreas. (author)

  7. Radiotherapy of early stage glottic cancer

    International Nuclear Information System (INIS)

    Kim, Y. H.; Chai, G. M.

    1997-01-01

    To evaluate the role of curative radiotherapy and salvage surgery in patients with T1, T2 glottic cancer. Between June 1989 and December 1994, 23 patients with early glottic cancer, 18 with T1N0M0 and 5 with T2N0M0, were treated with radiotherapy at Gyeongsang University Hospital. All patients were male. Median follow-up period was 46 months, and 100% were observed for at least 3 years. Actuarial survival rates at 5 years were 84.3% for 23 patients. The 5-year actuarial survival rates were 94.4% for T1 and 53.3% for T2 (P=0.05). The 5-year local control rates was 70.0% for T1 and 60.0% for T2 (P=0.44). Of 8 patients with treatment failure, 6 patients (75.0%) were salvaged with surgery. After surgical salvage, the 5-year local control rates were 87.2% for T1 and 80.0% for T2 (p=0.55). In early stage (Stage I and II) glottic cancer, curative radiotherapy can be a treatment of choice and surgery reserved for salvage of radiotherapy failure. (author)

  8. Advances in radiotherapy

    International Nuclear Information System (INIS)

    Mackie, T.R.

    2005-01-01

    computer optimization to determine optimal beam delivery intensity maps in order to maximize the target coverage and spare critical tissues as much as possible. The intensity modulated beams are delivered by conventional multileaf collimators or binary collimators modulating fan beams delivered rotationally. IMRT can enable higher doses to be delivered to the tumor and/or reduce the complications of sensitive tissues. Variability in the setup of the patient and movement of organs has likely limited the success of radiation therapy in the past but has become critical with the newfound ability of IMRT to put high dose gradients between the tumor and critical tissues. These issues are now being addressed with imaging systems present in the treatment room. Image-guided radiation therapy (IGRT) includes methods, such as transabdominal ultrasound and in-room CT scanners to image the patient just before treatment to improve setup accuracy and methods such as electronic x-ray imaging systems viewing implanted markers during treatment to minimize the effect of organ motion. 18 Excluding proton radiotherapy, equipment costs of modern radiotherapy are only marginally greater than for conventional radiotherapy. In the developed world the cost of radiotherapy equipment is about 15-20% of the total to deliver the treatment. Moreover, the cost of radiation therapy delivery represents only about 10-15% of the budget of a comprehensive cancer center and so it is a bargain as compared to other therapy forms such as surgery and chemotherapy. (author)

  9. Radiotherapy for carcinoma of the larynx

    International Nuclear Information System (INIS)

    Terhaard, C.H.J.

    1991-01-01

    Data of patients treated for laryngeal cancer with radiotherapy are analyzed by uni- and multivariate methods. Patients are subdivided into the various T-categories, obtaining more homogeneous groups of laryngeal cancer. Prognostic factors are defined for survival, local and regional control after radiotherapy, and for ultimate locoregional control after salvage surgery (partial or total laryngectomy and/or neck dissection). An attempt is made to set up a refined treatment recommendation, based on these prognostic factors, and to define an optimal fractionation schedule for advanced laryngeal cancer. Future prospects to improve the therapeutic ratio on advanced laryngeal cancer are discussed. (H.W.). 360 refs.; 28 figs.; 35 tabs

  10. Second cancer after radiotherapy of the uterine cervical cancer

    International Nuclear Information System (INIS)

    Koizumi, Tadashi; Soejima, Toshinori; Hirota, Saeko; Obayashi, Kayoko; Ishida, Teruko; Takada, Yoshiki; Yoshida, Shoji; Kimura, Shuji

    1993-01-01

    To study the relative risk of second cancer after radiotherapy, we reviewed 2465 cases of uterine cervical cancer who were treated in our institute from 1962 to 1986 and were followed up for more than 5 years. Among them, 1502 cases were treated by radiotherapy with or without surgery (radiotherapy group), and the remainder were treated by surgery only (surgery only group). We defined second cancer as malignancy that occurred in another organ after an interval of 5 years or more from the end of treatment of the first cancer. The relative risk of second cancer was computed by the person-year method advocated by Schoenberg. Second cancer was observed among 8 cases of the surgery group, whereas 43 cases were observed among the radiotherapy group. The cases were: rectal cancer, 6 cases; bladder cancer, 4 cases. The observed and expected ratio (O/E ratio) was 4.02 in rectal cancer and 7.98 in bladder cancer. This incidence of the both cancers was significantly high in the radiotherapy group. Three of the 6 cases with rectal cancer underwent operation in our institute. The incubation periods between the first and second cancers were from 9 to 21 years. Each case exhibited symptoms of chronic radiation proctitis after radiotherapy for uterine cervical cancer. It is thought necessary to follow up such cases carefully to detect radiation induced cancer. (author)

  11. National arrangements for radiotherapy

    International Nuclear Information System (INIS)

    2007-01-01

    After a presentation of several letters exchanged between the French health ministry and public agencies in charge of public health or nuclear safety after a radiotherapy accident in Epinal, this report comments the evolution of needs in cancerology care and the place given to radiotherapy. It outlines the technological and organisational evolution of radiotherapy and presents the distribution of radiotherapy equipment, of radio-therapists and other radiotherapy professionals in France. Within the context of radiotherapy accidents which occurred in 2007, it presents the regulatory arrangements which aimed at improving the safety, short term and middle term arrangements which are needed to support and structure radiotherapy practice quality. It stresses the fact that the system will deeply evolve by implementing a radiotherapy vigilance arrangement and a permanent follow-on and adaptation plan based on surveys and the creation of a national committee

  12. Radiotherapy of malignant lymphomas

    Energy Technology Data Exchange (ETDEWEB)

    Kujawska, J [Instytut Onkologii, Krakow (Poland)

    1979-01-01

    The paper discusses current views on the role of radiotherapy in the treatment of patients with malignant lymphomas. Principles of radiotherapy employed in the Institute of Oncology in Cracow in case of patients with malignant lymphomas are also presented.

  13. Esophageal carcinoma: surgery, radiotherapy, and chemotherapy

    NARCIS (Netherlands)

    van Lanschot, J. Jan B.; Aleman, Berthe M. P.; Richel, Dick J.

    2002-01-01

    Several new developments in the potentially curative therapy of esophageal cancer have drawn attention over the past year. There is a potential benefit of centralization of esophagectomies in dedicated centers. Early mucosal lesions are increasingly treated by local ablative therapy. Tumors invading

  14. Treatise on acoustics the first comprehensive English translation of E.F.F. Chladni's traité d’acoustique

    CERN Document Server

    Chladni, E F F

    2015-01-01

    This is the first comprehensive translation of the expanded French version of E.F.F. Chladni’s Traité d’Acoustique, using Chladni's 1802 Die Akustik for reference and clarification.  Chladni’s experiments and observations with sound and vibrations profoundly influenced the development of the field of Acoustics.  The famous Chladni diagrams along with other observations are contained in Die Akustik, published in German in 1802 and Traité d’Acoustique, a greatly expanded version, published in French in 1809.  The present translation was undertaken by Robert T. Beyer, PhD (1920-2008), noted acoustician, Professor of Physics at Brown University, and Gold Medal recipient of the Acoustical Society of America. Along with many other projects completed over the course of his career, Dr. Beyer translated Von Neumann’s seminal work, Mathematical Foundations of Quantum Mechanics from the original German, spent 30 years translating Russian physics treatises and journals, served as editor of the English t...

  15. Magic squares in the tenth century twoAarabic treatises by Anṭākī and Būzjānī

    CERN Document Server

    Sesiano, Jacques

    2017-01-01

    This volume contains the texts and translations of two Arabic treatises on magic squares, which are undoubtedly the most important testimonies on the early history of that science. It is divided into the three parts: the first and most extensive is on tenth-century construction methods, the second is the translations of the texts, and the third contains the original Arabic texts, which date back to the tenth century. .

  16. A Treatise on the Systematization of School Health Guidance (3) : The Formation of the Comcept of Guidance under the Theory of School Health in the Meiji Era

    OpenAIRE

    瀧澤, 利行

    1990-01-01

    In early Meiji era, the foundations of theories on school health in Japan were formed by translation and interpretation of theories on school health in mordern Europe. Simultaneously, school health practices were consisted of three backgrounds, community prevention of infectious diseases, the maintenance of school facilities, and school child protections. The points of this treatise are summurised as follows. 1) the assesment the dates of realization of each backgrounds above mentioned. 2) th...

  17. 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

  18. Stereotactic radiotherapy in oligometastatic cancer.

    Science.gov (United States)

    Kennedy, Thomas A C; Corkum, Mark T; Louie, Alexander V

    2017-09-01

    Oligometastatic cancer describes a disease state somewhere between localized and metastatic cancer. Proposed definitions of oligometastatic disease have typically used a cut-off of five or fewer sites of disease. Treatment of oligometastatic disease should have the goal of long-term local control, and in selected cases, disease remission. While several retrospective cohorts argue for surgical excision of limited metastases (metastasectomy) as the preferred treatment option for several clinical indications, limited randomized data exists for treating oligometastases. Alternatively, stereotactic ablative radiotherapy (SABR) is a radiotherapy technique that combines high radiation doses per fraction with precision targeting with the goal of achieving long-term local control of treated sites. Published cohort studies of SABR have demonstrated excellent local control rates of 70-90% in oligometastatic disease, with long-term survival in some series approaching 20-40%. A recent randomized phase 2 clinical trial by Gomez et al. demonstrated significantly improved progression free survival with aggressive consolidative therapy (surgery, radiotherapy ± chemotherapy or SABR) in oli-gometastatic non-small cell lung cancer (NSCLC). As additional randomized controlled trials are ongoing to determine the efficacy of SABR in oligometastatic disease, SABR is increasingly being used within routine clinical practice. This review article aims to sum-marize the history and current paradigm of the oligometastatic state, review recently pub-lished literature of SABR in oligometastatic cancer and discuss ongoing trials and future directions in this context.

  19. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    International Nuclear Information System (INIS)

    McCord, Mark W.; Buatti, John M.; Fennell, Eileen M.; Mendenhall, William M.; Marcus, Robert B.; Rhoton, Albert L.; Grant, Maria B.; Friedman, William A.

    1997-01-01

    Purpose: To review outcome and treatment sequelae in patients treated with external beam radiotherapy for pituitary adenomas. Methods and Materials: One hundred forty-one patients with pituitary adenomas received radiotherapy at the University of Florida and had 2-year minimum potential follow-up. One hundred twenty-one had newly diagnosed adenomas, and 20 had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (n = 98) or radiotherapy alone (n = 23). Patients with recurrent tumors received salvage treatment with surgery and radiotherapy (n = 10) or radiotherapy alone (n = 10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on tumor control was analyzed. Tumor control is defined by the absence of radiographic progression and stable or decreased hormone level (in hormonally active tumors) after treatment. Effect of therapy on vision, hormonal function, neurocognitive function, life satisfaction, and affective symptoms were examined. A Likert categorical scale survey was used for assessment of neurocognitive, life satisfaction, and affective symptom status. Survey results from the radiotherapy patients were compared with a control group treated with transsphenoidal surgery alone. Multivariate analysis used the forward step-wise sequence of chi squares for the log rank test. Results: At 10 years, tumor control for the surgery and radiotherapy group (S + RT) was 95% and not statistically different (p = 0.58) than for patients treated with radiotherapy alone (RT) (90%). Patients with prolactin- and ACTH-secreting tumors had significantly worse tumor control, as did patients treated for recurrent tumors. Multivariate analysis for tumor control revealed that only young age was predictive of worse outcome (p = 0.0354). Visual function was either unaffected or improved in most patients, although four patients developed visual

  20. Secondary effects of radiotherapy on the orofacial sphere

    International Nuclear Information System (INIS)

    Guillaume, Nicolas

    2012-01-01

    The objective of this research is to determine the role of the dental surgeon in the taking into care of patients treated by head and neck radiotherapy. It also aims at giving information to the patient on secondary effects which radiotherapy may induce, and at determining which therapeutic behaviour to adopt to prevent or at least mitigate the appearance of complications. The author first presents some generalities on radiotherapy: presentation of upper aero-digestive tract cancers (surgery, radiotherapy, and chemotherapy), description of the different radiotherapy techniques (external radiotherapy, brachytherapy), discussion of factors influencing local secondary effects of radiotherapy. The second part addresses the specific case of early orofacial secondary effects, discusses their origin, clinic signs and prevention means: cutaneous effect, mucositis, xerostomia, candidiasis, taste disorders, relationship between early local reactions and anti-tumour treatment efficiency. The third part addresses late orofacial secondary effects: cervix sclerosis, limitation of mouth opening, dental effects, periodontal diseases, osteoradionecrosis. The last part discusses the evolution of radiotherapy: intensity modulated conformational radiotherapy, targeted therapeutics [fr

  1. Fractionated stereotactic radiotherapy for craniopharyngiomas

    International Nuclear Information System (INIS)

    Schulz-Ertner, Daniela; Frank, Claudia; Herfarth, Klaus K.; Rhein, Bernhard; Wannenmacher, Michael; Debus, Juergen

    2002-01-01

    Purpose: To investigate outcome and toxicity after fractionated stereotactic radiation therapy (FSRT) in patients with craniopharyngiomas. Methods and Materials: Twenty-six patients with craniopharyngiomas were treated with FSRT between May 1989 and February 2001. Median age was 33.5 years (range: 5-57 years). Nine patients received FSRT after surgery as primary treatment, and 17 patients were irradiated for recurrent tumor or progressive growth after initial surgery. Median target dose was 52.2 Gy (range: 50.0-57.6 Gy) with conventional fractionation. Follow-up included MRI and neurologic, ophthalmologic, and endocrinologic examinations. Results: The median follow-up was 43 months (range: 7-143 months). The actuarial local control rate and actuarial overall survival rates were 100% and 100%, respectively, at 5 years and 100% and 83%, respectively, at 10 years. Four patients showed complete response, 14 patients showed partial response, and 8 patients remained stable. In 5 patients, vision improved after radiation therapy. Acute toxicity was mild. One patient required cyst drainage 3 months after radiotherapy. Late toxicity after radiotherapy included impairment of hormone function in 3 out of 18 patients at risk. We did not observe any vision impairment, radionecrosis, or secondary malignancies. Conclusions: FSRT is effective and safe in the treatment of cystic craniopharyngiomas. Toxicity is extremely low using this conformal technique

  2. The role of radiotherapy in the management of desmoid tumors

    International Nuclear Information System (INIS)

    Kirschner, M.J.; Sauer, R.

    1993-01-01

    698 published cases are reviewed and analysed with respect to the previous surgery and the therapeutic impact of postoperative radiotherapy. After an R1 surgical resection radiotherapy significantly decreases the risk for loco-regional relapse in about 40%. Radiotherapy is also recommended after an R0 surgical resection with safety margins less than 2 cm. A total radiotherapy dose of 50 Gy seems to be sufficient, whereas radiotherapy doses beyond 60 Gy provide no additional control. Following an R2 resection up to 28% of these tumors may not progress or even show a complete remission. A wait-and-see policy is justified for R1-2-resected lesions in the abdominal wall, especially if severe treatment sequelae have to be expected. The role of chemotherapy still remains questionable. (orig./MM) [de

  3. A prospective randomised multi-centre study of the impact of Ga-68 PSMA-PET/CT imaging for staging high risk prostate cancer prior to curative-intent surgery or radiotherapy (proPSMA study): clinical trial protocol.

    Science.gov (United States)

    Hofman, Michael S; Murphy, Declan G; Williams, Scott G; Nzenza, Tatenda; Herschtal, Alan; De Abreu Lourenco, Richard; Bailey, Dale L; Budd, Ray; Hicks, Rodney J; Francis, Roslyn J; Lawrentschuk, Nathan

    2018-05-03

    Accurate staging of patients with prostate cancer is important for therapeutic decision making. Relapse following surgery or radiotherapy of curative intent is not uncommon and, in part, represents a failure of staging with current diagnostic imaging techniques to detect disease spread. Prostate-specific-membrane-antigen (PSMA) positron emission tomography / computed tomography (PET/CT) is a new whole body scanning technique that enables visualisation of prostate cancer with high contrast. The hypotheses of this study are that (a) PSMA-PET/CT has improved diagnostic performance compared to conventional imaging, (b) PSMA-PET/CT should be used as a first-line diagnostic test for staging, (c) the improved diagnostic performance of PSMA-PET/CT will result in significant management impact and (d) there are economic benefits if PSMA-PET/CT is incorporated into the management algorithm. This is a prospective, multi-centre study in which patients with untreated high-risk prostate cancer will be randomised to Gallium-68-PSMA11-PET/CT or conventional imaging, consisting of computer tomography of the abdomen/pelvis and bone scintigraphy with SPECT/CT. Inclusion criteria are newly diagnosed prostate cancer patients with select high-risk prostate cancer defined as International Society of Urological Pathology (ISUP) grade group ≥ 3 (primary Gleason grade 4, or any Gleason grade 5), PSA ≥ 20ng/mL or clinical stage ≥ T3. Patients with negative, equivocal or oligometastatic disease on first line-imaging will cross-over to receive the other imaging arm. The primary objective is to compare the accuracy of PSMA-PET/CT to conventional imaging for detecting nodal or distant metastatic disease. Histopathologic, imaging and clinical follow-up at six months will define the primary endpoint according to a pre-defined scoring system. Secondary objectives include comparing management impact, the number of equivocal studies, the incremental value of second-line imaging in patients who

  4. A Controlled Study on Vaginal Blood Flow During Sexual Arousal Among Early-Stage Cervical Cancer Survivors Treated With Conventional Radical or Nerve-Sparing Surgery With or Without Radiotherapy

    NARCIS (Netherlands)

    Bakker, Rinske Maria; Pieterse, Quirine D.; van Lonkhuijzen, Luc R. C. W.; Trimbos, Baptist J. B. M. Z.; Creutzberg, Carien L.; Kenter, Gemma G.; de Kroon, Cor D.; ter Kuile, Moniek M.

    2017-01-01

    Objective: Sexual problems among cervical cancer survivors may in part be caused by reduced vaginal blood flow due to damaged hypogastric nerves during radical hysterectomy with pelvic lymphadenectomy and/or by radiation-induced vaginal changes after pelvic radiotherapy. A nerve-sparing modification

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

    International Nuclear Information System (INIS)

    Ohkawa, Reiko; Takamizawa, Hiroyoshi; Arai, Tatsuo; Morita, Shinroku.

    1981-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1981-03-01

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

  7. Neoadjuvant radiotherapy for primary advanced or locally recurrent breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Hiroaki; Nio, Yoshinori; Inoue, Yasushi; Teramoto, Mutsumi; Nagami, Haruhiko; Yano, Seiji; Sumi, Shoichiro; Tamura, Katsuhiro; Kushima, Takeyuki [Shimane Medical Univ., Izumo (Japan)

    1998-03-01

    Neoadjuvant radiotherapy for breast cancer has rarely been reported. In the present study, we investigated the objective response and histopathological effects of neoadjuvant radiotherapy in patients with primary advanced or locally recurrent breast cancer. Between 1992 and 1997, a total of 11 patients with primary or recurrent breast cancer (5 primary advanced and 6 locally recurrent breast cancers) were treated with neoadjuvant radiotherapy before surgery. Six patients received radiotherapy alone and 5 received radiotherapy in combination with chemotherapy, and the objective response was assessed according to the criteria of the Japanese Society of Cancer Therapy. After neoadjuvant radiotherapy or radiochemotherapy, all patients underwent surgery or biopsy, and histopathological effects were assessed according to the criteria of the Japanese Research Society for Gastric Cancer Study. The overall objective response was 27% (3PR/11; 2PR in 5 primary cancers and 1PR in 6 recurrent cancers), and histopathological effects included 5 grade-3 or -2 responses (45%; 2 grade-3 and 1 grade-2 in primary cancers and 2 grade-2 in recurrent cancers). There were no correlations between total radiation dose and objective response or histopathological effects. The objective response rates were 40% (2/5) in the radiochemotherapy group and 17% (1/6) in the radiotherapy alone group, histopathological effects higher than grade-2 were seen in 60% (3/5) in the radiochemotherapy group and 33% (2/6) in the radiotherapy alone group, and a grade-3 response was seen only in the radiochemotherapy group. Neoadjuvant radiotherapy for breast cancer resulted in a high response rate and was more effective against primary cancer than recurrent cancer. Furthermore, chemotherapy may be beneficial in improving the efficacy of radiotherapy. (author)

  8. Neoadjuvant radiotherapy for primary advanced or locally recurrent breast cancer

    International Nuclear Information System (INIS)

    Watanabe, Hiroaki; Nio, Yoshinori; Inoue, Yasushi; Teramoto, Mutsumi; Nagami, Haruhiko; Yano, Seiji; Sumi, Shoichiro; Tamura, Katsuhiro; Kushima, Takeyuki

    1998-01-01

    Neoadjuvant radiotherapy for breast cancer has rarely been reported. In the present study, we investigated the objective response and histopathological effects of neoadjuvant radiotherapy in patients with primary advanced or locally recurrent breast cancer. Between 1992 and 1997, a total of 11 patients with primary or recurrent breast cancer (5 primary advanced and 6 locally recurrent breast cancers) were treated with neoadjuvant radiotherapy before surgery. Six patients received radiotherapy alone and 5 received radiotherapy in combination with chemotherapy, and the objective response was assessed according to the criteria of the Japanese Society of Cancer Therapy. After neoadjuvant radiotherapy or radiochemotherapy, all patients underwent surgery or biopsy, and histopathological effects were assessed according to the criteria of the Japanese Research Society for Gastric Cancer Study. The overall objective response was 27% (3PR/11; 2PR in 5 primary cancers and 1PR in 6 recurrent cancers), and histopathological effects included 5 grade-3 or -2 responses (45%; 2 grade-3 and 1 grade-2 in primary cancers and 2 grade-2 in recurrent cancers). There were no correlations between total radiation dose and objective response or histopathological effects. The objective response rates were 40% (2/5) in the radiochemotherapy group and 17% (1/6) in the radiotherapy alone group, histopathological effects higher than grade-2 were seen in 60% (3/5) in the radiochemotherapy group and 33% (2/6) in the radiotherapy alone group, and a grade-3 response was seen only in the radiochemotherapy group. Neoadjuvant radiotherapy for breast cancer resulted in a high response rate and was more effective against primary cancer than recurrent cancer. Furthermore, chemotherapy may be beneficial in improving the efficacy of radiotherapy. (author)

  9. Preoperative radiotherapy of maxillary sinus cancer

    International Nuclear Information System (INIS)

    Kim, Jae Chul; Park, In Kyu

    1998-01-01

    This study was to evaluate the effectiveness of preoperative radiotherapy in maxillary sinus cancer. A retrospective analysis was done for 42 patients with maxillary sinus cancer who were treated with radiation with or without surgery from April 1986 to September 1996. There were 27 male and 15 female patients. Patients' age ranged from 24 to 75 years (median 56 years). Stage distribution showed 2 in T2, 19 in T3, and 21 in T4 lesions. The histologic type was squamous cell carcinoma in 38, undifferentiated carcinoma in 1, transitional cell carcinoma in 1, and adenoid cystic carcinoma in 2 patients, All patients were treated with radiation initially with a dosage range of 50.4-70.2 Gy (median 70.2 Gy) before further evaluation of remnant disease. Eleven patients were given induction chemotherapy (2 cycles of 5-fluorouracil and cisplatin) concurrently with radiotherapy. Six to eight weeks after radiotherapy with or without chemotherapy, computerized tomography (CT) of paranasal sinus was taken to evaluate remnant disease. If the CT finding showed remnant disease, a Caldwell-Luc procedure was done to get the specimen of suspicious lesions. A radical maxillectomy was done if the specimen was proven to contain malignancy. In contrast periodic follow-up examination was done without any radical surgery if the tissue showed only granulation tissue. Follow-up period ranged from 3 to 92 months with a median 16 months. Nine (21.4%) patients showed complete response (CR) and 33 patients (78.6%) showed persistent disease (PER) to initial radiotherapy. Among the 9 CR patients, 7 patients had no evidence of disease (NED), 1 patient had local failure, and 1 patient had regional failure. Among 33 PER patients, salvage total maxillectomy was done in 10 patients, and the surgery was not feasible or refused in 23 patients. Following the salvage radical surgery, 2 patients were NED and 8 patients were PER status. Overall and disease- free survival rate at 5 years was 23.1% and 16

  10. Preoperative radiotherapy of maxillary sinus cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Chul; Park, In Kyu [College of Medicine, Kyungpook National Univ., Taegu (Korea, Republic of)

    1998-09-01

    This study was to evaluate the effectiveness of preoperative radiotherapy in maxillary sinus cancer. A retrospective analysis was done for 42 patients with maxillary sinus cancer who were treated with radiation with or without surgery from April 1986 to September 1996. There were 27 male and 15 female patients. Patients' age ranged from 24 to 75 years (median 56 years). Stage distribution showed 2 in T2, 19 in T3, and 21 in T4 lesions. The histologic type was squamous cell carcinoma in 38, undifferentiated carcinoma in 1, transitional cell carcinoma in 1, and adenoid cystic carcinoma in 2 patients, All patients were treated with radiation initially with a dosage range of 50.4-70.2 Gy (median 70.2 Gy) before further evaluation of remnant disease. Eleven patients were given induction chemotherapy (2 cycles of 5-fluorouracil and cisplatin) concurrently with radiotherapy. Six to eight weeks after radiotherapy with or without chemotherapy, computerized tomography (CT) of paranasal sinus was taken to evaluate remnant disease. If the CT finding showed remnant disease, a Caldwell-Luc procedure was done to get the specimen of suspicious lesions. A radical maxillectomy was done if the specimen was proven to contain malignancy. In contrast periodic follow-up examination was done without any radical surgery if the tissue showed only granulation tissue. Follow-up period ranged from 3 to 92 months with a median 16 months. Nine (21.4%) patients showed complete response (CR) and 33 patients (78.6%) showed persistent disease (PER) to initial radiotherapy. Among the 9 CR patients, 7 patients had no evidence of disease (NED), 1 patient had local failure, and 1 patient had regional failure. Among 33 PER patients, salvage total maxillectomy was done in 10 patients, and the surgery was not feasible or refused in 23 patients. Following the salvage radical surgery, 2 patients were NED and 8 patients were PER status. Overall and disease- free survival rate at 5 years was 23.1% and 16

  11. Radiotherapy in early stage dupuytren's contracture

    International Nuclear Information System (INIS)

    Adamietz, B.; Sauer, R.; Gruenert, J.

    2001-01-01

    Purpose: In early stage Dupuytren's contracture radiotherapy was applied to prevent disease progression. Long-term results and late toxicity of this treatment were evaluated in a retrospective analysis. Patients and Methods: Between 1982 and 1994, 99 patients (176 hands) received orthovoltage radiotherapy, which consisted of two courses with 5 x 3 Gy (total dose: 30 Gy, daily fractionated; 120 kV, 4 mm Al), separated by a 6 to 8-week pause. The Dupuytren's contracture was staged according to the classification of Tubiana et al. The long-term outcome was analyzed at last follow-up between July and November 1999. The median follow-up was 10 years (range 7-18 years). Late toxicity was assessed using the LENT-SOMA criteria. Results: In Stage N 84% and Stage N/I 67% of cases remained stable. 65% of the cases in Stage I and 83% in Stage II showed progressive nodules and cords. In case of progression we saw no complications after a second radiotherapy or salvage operation. Conclusion: Radiotherapy effectively prevents disease progression for early stage Dupuytren's contracture (Stage N, N/I). Moreover, in case of disease progression despite radiotherapy salvage surgery is still feasible. (orig.) [de

  12. The metabolic radiotherapy. La radiotherapie metabolique

    Energy Technology Data Exchange (ETDEWEB)

    Begon, F.; Gaci, M. (Centre Hospitalier Universitaire, 86 - Poitiers (France))

    In this article, the authors recall the principles of the metabolic radiotherapy and present these main applications in the treatment of thyroid cancers, hyperthyroidism, polycythemia, arthritis, bone metastases, adrenergic neoplasms. They also present the radioimmunotherapy.

  13. The place of radiotherapy in muco-epidermoid carcinomas of salivary glands in child

    International Nuclear Information System (INIS)

    Thariat, J.; Temam, S.; Orbach, D.; Nicollas, R.; Penicaud, M.; Toussaint, B.; Makeieff, M.; Laprie, A.; Castillo, L.; Vedrin, P.

    2011-01-01

    As muco-epidermoid carcinomas are the most frequent tumours of salivary glands for child, the authors report the study of the role of radiotherapy. This study is based on a survey performed in 34 paediatric departments. The authors analyse the age and gender, the use of irradiation, the tumour location, the tumour grade and size, the use of surgery and of radiotherapy, and survival. Radiotherapy is beneficial for high grade tumours, but cannot be recommended for low and intermediate grades. Short communication

  14. Literature review on radiotherapy of face Darier-Ferrand dermato-fibro-sarcomas: about two cases

    International Nuclear Information System (INIS)

    Chami, S.; Mekki, F.

    2011-01-01

    The authors discuss two cases of radiotherapy of Darier-Ferrand dermato-fibro-sarcomas. One patient was 34 year old and the other one 73. The authors discuss the tumour appearance, the consequences of several surgical operations, and the effect of radiotherapy. They outline that diagnosis is generally good in absence of metastases, and that adjuvant radiotherapy was necessary in the two reported cases where surgery was insufficient. Short communication

  15. Status and advances of p53-gene therapy and radiotherapy in malignant tumor

    International Nuclear Information System (INIS)

    Duan Xin; Chinese Academy of Sciences, Beijing; Zhang Hong

    2006-01-01

    Cancer treatment is one of the most important fields in medical research. All strategies such as radio-therapy, chemotherapy, surgery, and gene-based therapy have their own advantages and disadvantages. Nowadays, a novel method which combined p53-gene therapy with radiotherapy plays an important role in the field of cancer research. This review summarized the current state of combined therapies of p53-gene therapy and radiotherapy, possible mechanism and recent progress. (authors)

  16. Stereotactic body radiotherapy for lung cancer: how much does it really cost?

    Science.gov (United States)

    Lievens, Yolande; Obyn, Caroline; Mertens, Anne-Sophie; Van Halewyck, Dries; Hulstaert, Frank

    2015-03-01

    Despite the lack of randomized evidence, stereotactic body radiotherapy (SBRT) is being accepted as superior to conventional radiotherapy for patients with T1-2N0 non-small-cell lung cancer in the periphery of the lung and unfit or unwilling to undergo surgery. To introduce SBRT in a system of coverage with evidence development, a correct financing had to be determined. A time-driven activity-based costing model for radiotherapy was developed. Resource cost calculation of all radiotherapy treatments, standard and innovative, was conducted in 10 Belgian radiotherapy centers in the second half of 2012. The average cost of lung SBRT across the 10 centers (6221&OV0556;) is in the range of the average costs of standard fractionated 3D-conformal radiotherapy (5919&OV0556;) and intensity-modulated radiotherapy (7379&OV0556;) for lung cancer. Hypofractionated 3D-conformal radiotherapy and intensity-modulated radiotherapy schemes are less costly (3993&OV0556; respectively 4730&OV0556;). The SBRT cost increases with the number of fractions and is highly dependent of personnel and equipment use. SBRT cost varies more by centre than conventional radiotherapy cost, reflecting different technologies, stages in the learning curve and a lack of clear guidance in this field. Time-driven activity-based costing of radiotherapy is feasible in a multicentre setup, resulting in real-life resource costs that can form the basis for correct reimbursement schemes, supporting an early yet controlled introduction of innovative radiotherapy techniques in clinical practice.

  17. An ecological treatise

    International Nuclear Information System (INIS)

    Kitschelt, H.

    1984-01-01

    The discussion on the different development paths towards a future energy supply is conducted not only with technical, economic, and ecological arguments but also with political, socio-cultural and philosophical ones. It is also concerned with the construction of social reality, a reorganisation of the relationship between nature and society. This descriptive and analytical study carefully contemplates the contents of the different positions and arguments in the energy controversy. It thereby closes a gap which has continued to exist until now in spite of the numerous publications in point. (orig.) [de

  18. A Treatise on Administration.

    Science.gov (United States)

    Moore, Thomas R.

    1988-01-01

    Expands Henri Fayol's definition of the administrative process to include a humanistic approach involving planning, organizing, implementing, controlling, evaluating, and satisfying functions. This empirical definition differs from some theoretical approaches by looking beyond resource consumption to consider ecological effects on the environment…

  19. Radiotherapy in small countries.

    Science.gov (United States)

    Barton, Michael B; Zubizarreta, Eduardo H; Polo Rubio, J Alfredo

    2017-10-01

    To examine the availability of radiotherapy in small countries. A small country was defined as a country with a population less than one million persons. The economic status of each country was defined using the World Bank Classification. The number of cancers in each country was obtained from GLOBOCAN 2012. The number of cancer cases with an indication or radiotherapy was calculated using the CCORE model. There were 41 countries with a population of under 1 million; 15 were classified as High Income, 15 Upper Middle Income, 10 Lower Middle Income and one Low Income. 28 countries were islands. Populations ranged from 799 (Holy See) to 886450 (Fiji) and the total number of cancer cases occurring in small countries was 21,043 (range by country from 4 to 2476). Overall the total number of radiotherapy cases in small countries was 10982 (range by country from 2 to 1239). Radiotherapy was available in all HIC islands with 80 or more new cases of cancer in 2012 but was not available in any LMIC island. Fiji was the only LMIC island with a large radiotherapy caseload. Similar caseloads in non-island LMIC all had radiotherapy services. Most non-island HIC did not have radiotherapy services presumably because of the easy access to radiotherapy in neighbouring countries. There are no radiotherapy services in any LMIC islands. Copyright © 2017. Published by Elsevier Ltd.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  1. Transition from 2-D radiotherapy to 3-D conformal and intensity modulated radiotherapy

    International Nuclear Information System (INIS)

    2008-05-01

    Cancer is one of the leading causes of death globally and radiotherapy is currently an essential component in the management of cancer patients, either alone or in combination with surgery or chemotherapy, both for cure or palliation. It is now recognized that safe and effective radiotherapy service needs not only substantial capital investment in radiotherapy equipment and specially designed facilities but also continuous investment in maintenance and upgrading of the equipment to comply with the technical progress, but also in training the staff. The recent IAEA-TECDOC publication 'Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects' provides general guidelines for designing and implementing radiotherapy services in Member States. Advances in computer technology have enabled the possibility of transitioning from basic 2- dimensional treatment planning and delivery (2-D radiotherapy) to a more sophisticated approach with 3-dimensional conformal radiotherapy (3-D CRT). Whereas 2-D radiotherapy can be applied with simple equipment, infrastructure and training, transfer to 3-D conformal treatments requires more resources in technology, equipment, staff and training. A novel radiation treatment approach using Intensity Modulated Radiation Therapy (IMRT) that optimizes the delivery of radiation to irregularly shaped tumour volumes demands even more sophisticated equipment and seamless teamwork, and consequentially more resources, advanced training and more time for treatment planning and verification of dose delivery than 3-D CRT. Whereas 3-D CRT can be considered as a standard, IMRT is still evolving. Due to the increased interest of Member States to the modern application of radiotherapy the IAEA has received a number of requests for guidance coming from radiotherapy departments that wish to upgrade their facilities to 3-D CRT and IMRT through Technical Cooperation programme. These requests are expected to increase

  2. Radiotherapy for Oral Cavity Cancer

    International Nuclear Information System (INIS)

    Shim, Jae Won

    1993-01-01

    Eighty five patients of oral cavity cancer, treated with radiation at the Department of Therapeutic Radiology, Korea Cancer Center Hospital, during the period from March 1985 to September 1990 were analyzed retrospectively. Among 85 patients, 37 patients were treated with radiation only and 48 patients were treated with radiation following surgery And 70 patients received external irradiation only by 60 Co with or without electron, the others were 7 patients for external irradiation plus interstitial implantation and 8 patients for external irradiation plus oral cone electron therapy. Primary sites were mobile tongue for 40 patients, mouth floor for 17 patients, palate for 12 patients, gingiva including retromolar trigone for 10 patients, buccal mucosa for 5 patients, and lip for 1 patient. According to pathologic classification, squamous cell carcinoma was the most common (77 patients). According to AJC TNM stage, stage I + II were 28 patients and stage III + IV were 57 patients. Acturial overall survival rate at 3 years was 43.9%, 3 year survival rates were 60.9% for stage I + II, and 23.1% for stage III + IV, respectively. As a prognostic factor, primary T stage was a significant factor (p<0.01). The others, age, location, lymph node metastasis, surgery, radiation dose, and cell differentiation were not statistically significant. Among those factors, radiation plus surgery was more effective than radiation only in T3 + T4 or in any N stage although it was not statistically sufficient(p<0.1). From those results, it was conclusive that definitive radiotherapy was more effective than surgery especially in the view of pertaining of anatomical integrity and function in early stage, and radiation plus surgery was considered to be better therapeutic tool in advanced stage

  3. Radiotherapy for advanced carcinoma of the gallbladder

    International Nuclear Information System (INIS)

    Shimizu, Teppei; Tanaka, Yoshiaki; Iijima, Mitsuharu; Matsuda, Tadayoshi

    1994-01-01

    The results of radiotherapy in 37 patients who were treated for carcinoma of the gallbladder from April 1975 to April 1992 are presented. To analyze the treatment results, patients were divided into four groups depending on treatment modality: intraoperative radiotherapy (IORT) with surgical resection in 9 (resection group), IORT with palliative surgery in 5 (palliative surgery group), hyperthermo-chemo-radiotherapy for inoperable cases in 11 (HCR group), external irradiation for inoperable cases in 12 (ExRT alone group). Most of the patients in the resection group received ExRT. The HCR group showed better local response than the groups treated with palliative surgery and ExRT alone. The mean length of survival in the resection, palliative surgery, HCR and ExRT alone groups was 315 days, 144 days, 246 days and 74 days, respectively. Although no statistically significant difference in survival was observed between the resection and HCR groups, the relapse-free interval of the resection group was significantly longer than that of the other groups. The application of IORT for surgically resectable tumors contributed to improved prognosis and better quality of life. Although IORT for patients with unresectable tumors had little effect on survival, it was considered to play a palliative role in improving the quality of life. The HCR group had a significantly longer survival time and relapse-free interval than the palliative surgery and ExRT alone groups. In conclusion, the application of HCR for inoperable carcinoma of the gallbladder contributed to the improvement of prognosis and quality of life. (author)

  4. Approaches for improving cancer radiotherapy

    International Nuclear Information System (INIS)

    Kalia, Vijay K.

    2013-01-01

    Radiation and cancer are intricately related. Radiotherapy, either alone or in combination with surgery and/or chemotherapy, is used for treatment of 60% of cancers. It will continue to be the mainstay for multi-modality treatment protocols unit new molecular therapies can be developed and brought to the stage of clinical trials. It will continue to be relevant thereafter, to compare the efficacy and cost effectiveness of the novel drugs under development. And it could also be useful as an adjuvant therapy, to augment the effects of novel drugs, at optimum dose levels. However, radiation is a well documented carcinogenic agent. Several studies have shown a statistically significant, though small enhancement in the risk of second malignancies, particularly in long-term survivors. The above discussions suggest that it is imperative to carry out preclinical radiobiological research for increasing tumor cell damage, while reducing the effective radiation doses. Development of radiobiological research programs in our institutions of higher learning such as post graduate medical institutions, cancer centers and universities could lead to the generation of a wealth of radiobiological data with potential clinical applications. Radiobiologists could utilize the infra-structure such as expensive radiotherapy equipment as well as clinical materials. For example, tumour biopsies readily available in the medical and cancer centers. However, if these studies have clinically meaningful implications it will be important to facilitate very close interactions between the basic scientists and clinicians. Some of the approaches for improving radiotherapy of cancer will be very briefly reviewed. Our current work about the effects of radiation-drug and drug-drug interactions for increasing cellular damage and death in brain tumor cells will also be presented. (author)

  5. Radiotherapy for Oligometastatic Lung Cancer

    Directory of Open Access Journals (Sweden)

    Derek P. Bergsma

    2017-09-01

    Full Text Available Non-small cell lung cancer (NSCLC typically presents at an advanced stage, which is often felt to be incurable, and such patients are usually treated with a palliative approach. Accumulating retrospective and prospective clinical evidence, including a recently completed randomized trial, support the existence of an oligometastatic disease state wherein select individuals with advanced NSCLC may experience historically unprecedented prolonged survival with aggressive local treatments, consisting of radiotherapy and/or surgery, to limited sites of metastatic disease. This is reflected in the most recent AJCC staging subcategorizing metastatic disease into intra-thoracic (M1a, a single extra thoracic site (M1b, and more diffuse metastases (M1c. In the field of radiation oncology, recent technological advances have allowed for the delivery of very high, potentially ablative, doses of radiotherapy to both intra- and extra-cranial disease sites, referred to as stereotactic radiosurgery and stereotactic body radiotherapy (or SABR, in much shorter time periods compared to conventional radiation and with minimal associated toxicity. At the same time, significant improvements in systemic therapy, including platinum-based doublet chemotherapy, molecular agents targeting oncogene-addicted NSCLC, and immunotherapy in the form of checkpoint inhibitors, have led to improved control of micro-metastatic disease and extended survival sparking newfound interest in combining these agents with ablative local therapies to provide additive, and in the case of radiation and immunotherapy, potentially synergistic, effects in order to further improve progression-free and overall survival. Currently, despite the tantalizing potential associated with aggressive local therapy in the setting of oligometastatic NSCLC, well-designed prospective randomized controlled trials sufficiently powered to detect and measure the possible added benefit afforded by this approach are

  6. PLANNING NATIONAL RADIOTHERAPY SERVICES

    Directory of Open Access Journals (Sweden)

    Eduardo eRosenblatt

    2014-11-01

    Full Text Available Countries, states and island nations often need forward planning of their radiotherapy services driven by different motives. Countries without radiotherapy services sponsor patients to receive radiotherapy abroad. They often engage professionals for a feasibility study in order to establish whether it would be more cost-beneficial to establish a radiotherapy facility. Countries where radiotherapy services have developed without any central planning, find themselves in situations where many of the available centres are private and thus inaccessible for a majority of patients with limited resources. Government may decide to plan ahead when a significant exodus of cancer patients travel to another country for treatment, thus exposing the failure of the country to provide this medical service for its citizens. In developed countries the trigger has been the existence of highly visible waiting lists for radiotherapy revealing a shortage of radiotherapy equipment.This paper suggests that there should be a systematic and comprehensive process of long-term planning of radiotherapy services at the national level, taking into account the regulatory infrastructure for radiation protection, planning of centres, equipment, staff, education pr

  7. Radiotherapy in Locoregional Recurrent Breast Carcinoma

    International Nuclear Information System (INIS)

    Ha, Sung Whan; Yang, Mi Gyoung; Chung, Woong Ki; Park, Charn Il; Bang, Yung Jue; Kim, Noe Kyung; Choe, Kuk Jin

    1988-01-01

    Thirty eight women with recurrent breast carcinoma involving chest wall and/or regional lymph nodes after surgery with or without systemic therapy were treated with radiation between 1979 and 1986. Among them, 5 patients were excluded from analysis because of incomplete treatment. The median follow up of survivors was 30 months (ranged 1-79 months). Fifteen (45%) patients had their disease confined to the chest wall and eighteen patients had lymph node involvement as some of their locoregional recurrent disease. Within 36 months after the initial treatment, 87% of recurrences manifested themselves. All patients had radiotherapy to at least the site of involvement. In 8 patients, recurrent tumors were treated with complete excision followed by radiation. Of the remaining 25 patients, 18(72%) had complete response (CR) following radiotherapy. The actuarial 3-year survival of all patients following locoregional recurrence was 50%. Three year survival was 24% in those 25 patients who had recurrences within 24 months of the initial treatment. For those 8 patients whose recurrences occurred after more than 24 month disease free interval, the 3-year survival was 100%. For those patients with recurrences confined to chest wall alone, 3-year survival was 57%. The patients who had lymph node involvement as part of their locoregional recurrences had a 43% 3-year survival. The majority of them developed distant metastases. Those patients who had a CR showed 63% 3-year survival. On the other hand, 1 year survival was only 33% for those patients who had a less than CR. Three patients developed carcinoma of the contralateral breast following radiotherapy. Three year survival following locoregional recurrence was 40% for patients whose initial treatment for their primary breast carcinoma was surgery and adjuvant systemic therapy. For those patients whose primary breast carcinoma was treated by surgery alone, the 3-year survival following locoregional recurrence was 71%. In

  8. Metastatic tumor of thoracic and lumbar spine: prospective study comparing the surgery and radiotherapy vs external immobilization with radiotherapy; Metastases do segmento toracico e lombar da coluna vertebral: estudo prospectivo comparativo entre o tratamento cirurgico e radioterapico com a imobilizacao externa e radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Falavigna, Asdrubal; Ioppi, Ana Elisa Empinotti; Grasselli, Juliana [Universidade de Caxias do Sul, RS (Brazil). Faculdade de Medicina]. E-mail: asdrubal@doctor.com; Righesso Neto, Orlando [Faculdade Federal de Ciencias Medicas da Santa Casa de Sao Paulo, SP (Brazil)

    2007-09-15

    Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of pain.(author)

  9. Risk of acute anastomotic leakage after preoperative radiotherapy in rectal cancer

    Directory of Open Access Journals (Sweden)

    Devid Belalla

    2016-11-01

    Full Text Available Objective: To evaluate the preoperative radiotherapy and its role in anastomotic leakage. Methods: A total of 327 patients who had an anterior resection (AR in elective surgery for a rectal carcinoma were selected and operated in our clinic of surgery during the period from 2003 to 2015. Among them, 135 patients had a low anterior resection (LAR and the other 192 had an AR. This is a retrospective study. Chi-squared test was used to evaluate statistical differences and the P < 0.05 was considered statistically significant. Results: A total of 126 patients had radiotherapy before surgery, and 50 of them had a LAR. In the other 201 patients, surgery was the first treatment modality, and 83 of them had a LAR. We had an overall anastomotic leakage of 7.95% or 26% patients. Anastomotic leakage was found in 14 patients with LAR, 9 of which had radiotherapy before surgery. From the 12 patients with AR who had an anastomotic leakage, 6 of them had radiotherapy before surgery. Conclusions: Radiotherapy may affect anastomotic healing and increase the risk of leakage. This risk is higher in low anterior anastomoses where a protective stoma may be considered. A better evaluation and support for patients with preoperative radiotherapy is needed in order to diminish the concomitant risk factors as much as possible.

  10. Radiotherapy in the treatment of solitary plasmacytoma.

    Science.gov (United States)

    Jyothirmayi, R; Gangadharan, V P; Nair, M K; Rajan, B

    1997-05-01

    Solitary plasmacytoma of bone (SPB) and extramedullary plasmacytoma (EMP) are rare. High local control rates are reported with radiotherapy, although the optimal dose and extent of radiotherapy portals remains controversial. Between 1983 and 1993, 30 patients with solitary plasmacytoma were seen at the Regional Cancer Centre, Trivandrum, India. 23 patients had SPB and seven EMP. The mean age was 52 years and the male to female ratio 3.2:1. Diagnosis of SPB was confirmed by biopsy in 16 patients and tumour excision in seven. 20 patients received megavoltage radiotherapy to the bone lesion with limited margins, and one received chemotherapy. Two patients who underwent complete tumour excision received no further treatment. All seven patients with EMP received megavoltage radiotherapy, four following biopsy and three after tumour excision. Local control was achieved in all patients with SPB. Nine progressed to multiple myeloma and one developed a solitary plasmacytoma in another bone. Six patients with EMP achieved local control. Three later progressed to multiple myeloma and one had local relapse. Median time to relapse was 28 months in SPB and 30 months in EMP. 5-year overall survival rates were 82% and 57% for patients with SPB and EMP, respectively. The corresponding progression free survival rates were 55% and 50%, respectively. Age, sex, site of tumour, serum M protein and haemoglobin levels did not significantly influence progression free survival. The extent of surgery, radiotherapy dose or time to relapse were not significant prognostic factors. Radiotherapy appears to be an effective modality of treatment of solitary plasmacytoma. No dose-response relationship is observed, and high local control rates are achieved with limited portals. Progression to multiple myeloma is the commonest pattern of failure, although no prognostic factors for progression are identified. The role of chemotherapy in preventing disease progression needs further evaluation.

  11. [Radiotherapy in node-positive prostate cancer].

    Science.gov (United States)

    Bottke, D; Bartkowiak, D; Bolenz, C; Wiegel, T

    2016-03-01

    There are numerous randomized trials to guide the management of patients with localized (and metastatic) prostate cancer, but only a few (mostly retrospective) studies have specifically addressed node-positive patients. Therefore, there is uncertainty regarding optimal treatment in this situation. Current guidelines recommend long-term androgen deprivation therapy (ADT) alone or radiotherapy plus long-term ADT as treatment options. This overview summarizes the existing literature on the use of radiotherapy for node-positive prostate cancer as definitive treatment and as adjuvant or salvage therapy after radical prostatectomy. In this context, we also discuss several PET tracers in the imaging evaluation of patients with biochemical recurrence of prostate cancer after radical prostatectomy. As for definitive treatment, retrospective studies suggest that ADT plus radiotherapy improves overall survival compared with ADT alone. These studies also consistently demonstrated that many patients with node-positive prostate cancer can achieve long-term survival - and are likely curable - with aggressive therapy. The beneficial impact of adjuvant radiotherapy on survival in patients with pN1 prostate cancer seems to be highly influenced by tumor characteristics. Men with ≤ 2 positive lymph nodes in the presence of intermediate- to high-grade disease, or positive margins, and those with 3 or 4 positive lymph nodes are the ideal candidates for adjuvant radiotherapy (plus long-term ADT) after surgery. There is a need for randomized trials to further examine the potential role of radiotherapy as either definitive or adjuvant treatment, for patients with node-positive prostate cancer.

  12. To understand radiotherapy

    International Nuclear Information System (INIS)

    2009-01-01

    Dealing with the use of radiotherapy for adults, this guide indicates when a radiotherapy is suggested, how it acts, how the treatment is chosen, which are the professionals involved. It describes how an external radiotherapy takes place and its various techniques, the different types of side effects (general, specific to the treated zone, late effects). It indicates which organs can be treated by curie-therapy, the different curie-therapy treatment modalities, how a curie-therapy takes place and which are its side effects. It outlines how to better cope with radiotherapy (how to be supported, the important role of relatives, everyday life questions, rights). It indicates and comments the different measures adopted for the safety and quality of radiotherapy

  13. ORO dental complications of radiotherapy

    International Nuclear Information System (INIS)

    Kaumuri, Sunil

    2014-01-01

    Radiation and radioactivity were discovered more than 100 years ago. Since then, radiation has become important in cancer treatment. Approximately one million people will develop invasive cancer each year. Of these, 40% will receive curative benefit from surgery, radiation, chemotherapy, or a combination modality. Normal body tissues vary in their response to radiation. As with tumors, normal tissues in which cells are quickly dividing may be affected. This causes some of the side effects of radiation treatment. Since radiation is a local treatment, side effects depend on the area of the body being treated. The early effects of radiation may be seen a few days or weeks after treatments have started and may go on for several weeks after treatments have ended. Other effects may not show up until months, or even years, later. As radiotherapy is a viable treatment modality for head and neck cancer, however a wide range of potentially debilitating dental complications may accompany this treatment. The orofacial tissues of dental significance that may be affected by head and neck radiotherapy are the salivary glands, mucous membranes, taste buds, bone and teeth. (author)

  14. External radiotherapy in thyroid cancer

    International Nuclear Information System (INIS)

    Samuel, A.M.; Shah, D.H.

    1999-01-01

    In the management of thyroid carcinoma (TC) of any histological type, surgery is the primary mode of treatment. The second modality for the management is treatment with radioactive iodine ( 131 I), especially, when the tumor has the ability to concentrate 131 I. External radiotherapy has a limited use in differentiated thyroid carcinoma (DTC). It is useful in the management of bulky residual tissue which is not completely resected, metastatic disease which does not concentrated radioiodine and as a palliative treatment for reliving pain in patients with distant metastases. The ER as an adjuvant treatment in both anaplastic and medullary carcinoma has a significant role to play and should be used more frequently than is presently being advocated and practiced

  15. Radiotherapy for early rectal cancer

    International Nuclear Information System (INIS)

    Rich, T.A.

    1988-01-01

    A literature review of 10 series using electrocoagulation, fulguration, or local excision demonstrates that about 70% of all patients had tumors smaller than 3 cm and the remainder had tumors measuring between 4 cm and 7 cm. Although primary tumor size in rectal cancer has little prognostic value per se, it is obviously important when determining the appropriateness of local therapy. Selecting patients for local therapy based on tumor size alone seems reasonable, since the recurrence and survival rates for the patients are similar to those achieved with radical surgery. Since patients treated with local excision alone have predominantly T1 or T2 tumors, a comparison with the data of others illustrates the prognostic utility of the degree of bowel penetration and shows five-year survival rates of 71% to 76% for patients with limited disease. In this chapter, the author describes an additional group of patients who also did well following postoperative radiotherapy after conservative surgical treatment

  16. Intraoperative radiotherapy for pancreatic carcinoma

    International Nuclear Information System (INIS)

    Nishimura, Akira; Iida, Koyo; Sato, Shigehiro; Sakata, Suo

    1986-01-01

    Twenty-eight patients with pancreatic carcinoma, 23 (82 %) of whom had Stage III or IV, received intraoperative radiotherapy (IOR) with curative or non-curative surgery. Electron beams (10 to 18 MeV) with doses of 20 to 40 Gy were delivered to the tumor. Eight of 26 patients with unresectable tumor had postoperative external irradiation of 10.5 to 50 Gy. Abdominal and back pain relief was achieved after IOR in 12 (71 %) and in 6 (60 %) of the 26 patients, respectively. Appetite was promoted in 11 patients. In the case of unresectable carcinoma, survival time tended to prolong in the 8 patients receiving both IOR and postoperative external irradiation. One patient developed perforation of the colon probably caused by IOR. (Namekawa, K.)

  17. Stereotactic radiotherapy for brain metastasis

    International Nuclear Information System (INIS)

    Noel, G.; Daisne, J.F.; Thillays, F.

    2012-01-01

    Stereotactic radiosurgery is now well implanted in the radiotherapy treatment tools of brain metastasis. The dose can be delivered in one or multiple sessions. Results seem equivalent. CT scan and MRI imaging are required to delineate and calculate dosimetry. Doses are variable according to the size of the metastases, localization, pathology or equipment. Stabilization or reduction of tumour size is the rules after stereotactic treatment. Impact in terms of overall survival is more difficult to apprehend because of the general context of the disease. Many questions remain unresolved, such as the usefulness of whole brain irradiation, adaptation of the treatment schedule to tumour pathophysiology, role of stereotactic treatment after surgery of metastases, etc. (authors)

  18. Iznīqī and Jābir, Sirr and Miftāḥ: Two Authors, Four Titles, One Alchemical Treatise

    Directory of Open Access Journals (Sweden)

    Paola Carusi

    2017-03-01

    Full Text Available An alchemical Arabic treatise alternatively entitled Miftāḥ al-ḥikma, Miftāḥ jannāt al-khuld, Sirr al-asrār and Sirr al-sārr wa-sirr al-asrār is attributed in its manuscripts to two different authors: al-Iznīqī and Jābir b. Ḥayyān. In this article I briefly discuss some characteristic aspects of the treatise and its significance for the history of alchemy. These aspects include its ancient and important sources, such as the Muṣḥaf al-jamā‛a (Turba philosophorum and the Kitāb al-Ḥabīb, and its connection with the tradition of the artists and the activity of the workshop and laboratory, which first comes to the fore in Greek alchemy and later in Islamic alchemy. Furthermore, the work includes references to alchemical physical theories in which the influence of Islamic theology may perhaps be traced. This article, which summarises the results of investigations carried out over the last few years, could be considered as a kind of introduction to the edition and translation of the text currently in progress.

  19. Professor Samuel David Gross (1805-1884) and His Innovations in Surgery and Medicine.

    Science.gov (United States)

    Laios, Konstantinos

    2018-06-01

    Professor Samuel David Gross (1805-1884) is considered as one of the founders of American surgery. He was a skillful surgeon who could excellently perform a lithotomy, an amputation, and a cataract surgery. He introduced many new surgical techniques and designed new surgical and medical instruments. He expertise was not limited to surgery alone; he also published studies concerning internal medicine, pathology, experimental physiology, and pharmacology. His most important treatise was his 2-volume work, A System of Surgery, Pathological, Diagnostic, Therapeutic and Operative (1861), which was a standard reference book in surgery in the United States during the second half of 19th century. Gross received many honors during his life. He was active in the operating room until his death.

  20. Paragangliomas: Presentation and management by radiotherapy at the Prince of Wales Hospital

    International Nuclear Information System (INIS)

    Smee, Robert I.; Jayasekara, Jayana; Williams, Janet R.; Hanna, Claire

    2015-01-01

    Paragangliomas are commonly treated with surgery, while radiotherapy is reserved for those that are inoperable or have relapsed. However, this retrospective study aims to determine whether radiotherapy is a viable initial treatment for paragangliomas. Of 73 tumours researched, 44 were diagnosed and treated from January 1967 to December 2012 at the Radiation Oncology Department at the Prince of Wales Hospital and thus were eligible for analysis. Median follow-up time was 3.5 years with a range of 1 to 40 years. Thirty-four tumours were treated with radiotherapy only, and 10 tumours were treated with both surgical resection and radiotherapy. Local control and cause-specific survival were the primary end points measured. Five-year local control rate for the population of 44 lesions was 89%; it was 100% in the group treated by radiotherapy alone, but only 50% in the group treated by surgery followed by radiotherapy, with radiation used for salvage. The difference in control rates between these two subset groups was found to be statistically significant (P < 0.001). Cause-specific survival rates for this eligible population at 5 and 10 years were 98% and 90%, respectively. After initial radiotherapy, 4 patients had improved cranial nerve function, there was clinical improvement in tinnitus, and one new cranial nerve deficit developed where a high dose was used. Radiotherapy has high local control rates and few complications. The local control and complication rates compare favourably to surgery.

  1. Analysis of oral cancer treated by preoperative radiotherapy

    International Nuclear Information System (INIS)

    Hosokawa, Yoichiro; Kaneko, Masayuki; Yasuda, Motoaki

    1997-01-01

    Fifty-eight patients with squamous cell carcinoma of the oral region, treated by preoperative radiotherapy between January 1988 and December 1993, were reviewed to evaluate the relation between prognosis and pathological findings after preoperative radiotherapy. All patients underwent external radiotherapy of up to 40 Gy in 16 fractions (2.5 Gy a day, 4 fractions a week) before surgery, and the average term from the end of preoperative radiotherapy to surgery were 27.3 days. According to pathological findings during surgery, the patients were divided into a radiation effective group and a radiation noneffective group. There was a significant difference in the survival rates of the two groups, but there was no difference in local control rates. After surgery, regional lymph node metastasis and distant metastasis were more common in the radiation noneffective group than in the radiation effective group. It was considered that regional lymph node metastasis after treatment in the noneffective group is the determining factor in the progress. (author)

  2. Radiotherapy in poor risk patients with stage I cancer of the endometrium: results of not giving external beam radiotherapy.

    Science.gov (United States)

    DeCruze, B; Guthrie, D

    1999-01-01

    Poor prognosis (poorly differentiated and/or deep myometrial invasion) Stage I endometrial cancer can have a relapse rate as high as 50%. Traditionally, most clinical oncologists treat these patients with external beam radiotherapy after surgery but there is no evidence to show that this improves survival. The retrospective study looks at the results of not giving external beam radiotherapy in 25 consecutive patients and compares the results with a group of 13 consecutive patients who did have such treatment. The two groups were comparable with regard to age, degree of differentiation and degree of invasion. Survival was comparable in the two groups. There is no evidence of any obvious decrease in survival from withholding external beam radiotherapy, but this was not a prospective randomized controlled trial. This study illustrates that it is essential that the Medical Research Council ASTEC trial should be supported because this will determine the true place of external beam radiotherapy in such patients.

  3. Historical review of radiotherapy

    International Nuclear Information System (INIS)

    Onai, Yoshio

    1993-01-01

    The techniques of radiotherapy have been improved by development of particle accelerators, radionuclides and computers. This paper presents a historical review of the physical and technical aspects of radiotherapy in Japan. Changes in the kinds of radiation, such as X-rays, gamma rays, electrons, neutrons and protons used for external radiotherapy, and the equipment involved are described chronologically, and historical changes in the quality of radiotherapy apparatus are outlined. Patient data acquisition equipment, such as X-ray simulator and X-ray CT, beam modifying devices, patient setup devices, and devices to verify treatment fields and patient doses are reviewed historically. Radiation sources for brachytherapy and internal radiotherapy, and remotely controlled afterloading systems are reviewed chronologically. Historical changes in methods to evaluate absorbed doses, dose monitor systems and beam data acquisition systems are outlined. Changes in methods of calculating dose distributions for external X-ray and electron therapy, brachytherapy and internal radiotherapy by unsealded radionuclides are described and calculation techniques for treatment planning system are reviewed. Annual figures in the numbers of radiotherapy equipment, such as telecobalt and telecesium units, linear accelerators, betatrons, microtrons, stereotactic gamma units, conformation radiotherapy units, remotely controlled afterloading systems, and associated equipment such as X-ray simulators and treatment planning systems are provided, as are changes in the number of accelerators by maximum X-ray energy and maximum electron energy, and in the number of licensed hospitals and clinics using small sealed sources. Changes in techniques of external radiotherapy and brachytherapy are described briefly from the point of view of dose distributions. (author)

  4. Radiological incidents in radiotherapy

    International Nuclear Information System (INIS)

    Hobzova, L.; Novotny, J.

    2008-01-01

    In many countries a reporting system of radiological incidents to national regulatory body exists and providers of radiotherapy treatment are obliged to report all major and/or in some countries all incidents occurring in institution. State Office for Nuclear Safety (SONS) is providing a systematic guidance for radiotherapy departments from 1997 by requiring inclusion of radiation safety problems into Quality assurance manual, which is the basic document for obtaining a license of SONS for handling with sources of ionizing radiation. For that purpose SONS also issued the recommendation 'Introduction of QA system for important sources in radiotherapy-radiological incidents' in which the radiological incidents are defined and the basic guidance for their classification (category A, B, C, D), investigation and reporting are given. At regular periods the SONS in co-operation with radiotherapy centers is making a survey of all radiological incidents occurring in institutions and it is presenting obtained information in synoptic communication (2003 Motolske dny, 2005 Novy Jicin). This presentation is another summary report of radiological incidents that occurred in our radiotherapy institutions during last 3 years. Emphasis is given not only to survey and statistics, but also to analysis of reasons of the radiological incidents and to their detection and prevention. Analyses of incidents in radiotherapy have led to a much broader understanding of incident causation. Information about the error should be shared as early as possible during or after investigation by all radiotherapy centers. Learning from incidents, errors and near misses should be a part of improvement of the QA system in institutions. Generally, it is recommended that all radiotherapy facilities should participate in the reporting, analyzing and learning system to facilitate the dissemination of knowledge throughout the whole country to prevent errors in radiotherapy.(authors)

  5. Aftereffect of radiotherapy of upper aero-digestive tracts in odontological care

    International Nuclear Information System (INIS)

    Schiochet, Luc

    2010-01-01

    In its first part, this thesis proposes a detailed presentation of the upper aero-digestive tract cancer. The author defines the cancerous process, describes anatomic aspects, and discusses epidemiological aspects (occurrence, mortality, survival, and epidemiological data in different countries). In the second part, the author discusses the role of radiotherapy and of dental surgery in taking a cancerous patient into care (general principles of radiotherapy, therapeutic options and choices, association of radiotherapy, chemotherapy and surgery). Principles of radiotherapy are then more precisely addressed: physical principles (X rays, gamma rays, electrons, neutrons, and protons), radioactivity doses, radiotherapy effect, main equipment, radiotherapy techniques (conformational or intensity-modulated radiotherapy, computed tomography, Cyberknife, external radiotherapy, brachytherapy). The third part addresses early oral-facial complications induced by radiotherapy: factors favouring these complications, nervous effects, effects on the blood system and on the skin, hyposialia and xerostomia, radio-induced mucositis of upper aero-digestive tracts. The next part addresses late effects: late cutaneous after-effects, late radio-mucositis, limitation of mouth opening, tooth decays, osteoradionecrosis. The last part addresses the role of the dental surgeon in taking into care a patient whose head and neck have been irradiated: role before irradiation, during irradiation, and after irradiation [fr

  6. Rapidly Growing Esophageal Carcinosarcoma Reduced by Neoadjuvant Radiotherapy Alone

    Directory of Open Access Journals (Sweden)

    Naotaka Ogasawara

    2014-06-01

    Full Text Available Esophageal carcinosarcoma is a rare malignant neoplasm consisting of both carcinomatous and sarcomatous components. It is generally treated by surgery, radiotherapy and chemotherapy according to the protocols used for other esophageal cancers. However, the treatment of esophageal carcinosarcoma by radiotherapy alone before surgery has not been previously described. We report a patient with a rapidly growing esophageal carcinosarcoma that was efficiently reduced by neoadjuvant radiotherapy alone. A previously healthy 69-year-old man was admitted with dysphagia. Initial esophagogastroduodenoscopy (EGD revealed a small nodular polypoid lesion of about 10 mm in the middle esophagus. A second EGD 1 month later showed that the tumor had expanded into a huge mass. A biopsy specimen revealed that the tumor comprised squamous cell carcinoma with spindle cell components, and the tumor was diagnosed as carcinosarcoma which was diagnosed as stage I (T1bN0M0. Due to renal dysfunction, the patient was treated with neoadjuvant radiotherapy (40 Gy without chemotherapy. A third EGD 1 month later revealed remarkable tumor reduction. He then underwent total esophagectomy with regional lymph node dissection (pStage 0, pT1aN0M0. After surgical operation, the patient was followed up without adjuvant therapy. Whole body computed tomography revealed lung metastasis 14 months after surgery, and the patient died 2 months later. The neoadjuvant radiotherapy for esophageal carcinosarcoma was considered to have contributed to the subsequent surgery and his prolonged survival time. Thus, radiotherapy alone might be a suitable neoadjuvant therapy for esophageal carcinosarcomas.

  7. 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.)

  8. Turbinate surgery

    Science.gov (United States)

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  9. Bariatric Surgery

    Science.gov (United States)

    ... often. Each type of surgery has advantages and disadvantages. Bariatric Surgery Benefits Bariatric surgery can improve many ... Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive ...

  10. Lung surgery

    Science.gov (United States)

    ... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using ... Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

  11. Plastic Surgery

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  12. Radiotherapy for esthesioneuroblastoma: is elective nodal irradiation warranted in the multimodality treatment approach?

    Science.gov (United States)

    Noh, O Kyu; Lee, Sang-wook; Yoon, Sang Min; Kim, Sung Bae; Kim, Sang Yoon; Kim, Chang Jin; Jo, Kyung Ja; Choi, Eun Kyung; Song, Si Yeol; Kim, Jong Hoon; Ahn, Seung Do

    2011-02-01

    The role of elective nodal irradiation (ENI) in radiotherapy for esthesioneuroblastoma (ENB) has not been clearly defined. We analyzed treatment outcomes of patients with ENB and the frequency of cervical nodal failure in the absence of ENI. Between August 1996 and December 2007, we consulted with 19 patients with ENB regarding radiotherapy. Initial treatment consisted of surgery alone in 2 patients; surgery and postoperative radiotherapy in 4; surgery and adjuvant chemotherapy in 1; surgery, postoperative radiotherapy, and chemotherapy in 3; and chemotherapy followed by radiotherapy or concurrent chemoradiotherapy in 5. Five patients did not receive planned radiotherapy because of disease progression. Including 2 patients who received salvage radiotherapy, 14 patients were treated with radiotherapy. Elective nodal irradiation was performed in 4 patients with high-risk factors, including 3 with cervical lymph node metastasis at presentation. Fourteen patients were analyzable, with a median follow-up of 27 months (range, 7-64 months). The overall 3-year survival rate was 73.4%. Local failure occurred in 3 patients (21.4%), regional cervical failure in 3 (21.4%), and distant failure in 2 (14.3%). No cervical nodal failure occurred in patients treated with combined systemic chemotherapy regardless of ENI. Three cervical failures occurred in the 4 patients treated with ENI or neck dissection (75%), none of whom received systemic chemotherapy. ENI during radiotherapy for ENB seems to play a limited role in preventing cervical nodal failure. Omitting ENI may be an option if patients are treated with a combination of radiotherapy and chemotherapy. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Radiotherapy for Esthesioneuroblastoma: Is Elective Nodal Irradiation Warranted in the Multimodality Treatment Approach?

    International Nuclear Information System (INIS)

    Noh, O Kyu; Lee, Sang-wook; Yoon, Sang Min; Kim, Sung Bae; Kim, Sang Yoon; Kim, Chang Jin; Jo, Kyung Ja; Choi, Eun Kyung; Song, Si Yeol; Kim, Jong Hoon; Ahn, Seung Do

    2011-01-01

    Purpose: The role of elective nodal irradiation (ENI) in radiotherapy for esthesioneuroblastoma (ENB) has not been clearly defined. We analyzed treatment outcomes of patients with ENB and the frequency of cervical nodal failure in the absence of ENI. Methods and Materials: Between August 1996 and December 2007, we consulted with 19 patients with ENB regarding radiotherapy. Initial treatment consisted of surgery alone in 2 patients; surgery and postoperative radiotherapy in 4; surgery and adjuvant chemotherapy in 1; surgery, postoperative radiotherapy, and chemotherapy in 3; and chemotherapy followed by radiotherapy or concurrent chemoradiotherapy in 5. Five patients did not receive planned radiotherapy because of disease progression. Including 2 patients who received salvage radiotherapy, 14 patients were treated with radiotherapy. Elective nodal irradiation was performed in 4 patients with high-risk factors, including 3 with cervical lymph node metastasis at presentation. Results: Fourteen patients were analyzable, with a median follow-up of 27 months (range, 7-64 months). The overall 3-year survival rate was 73.4%. Local failure occurred in 3 patients (21.4%), regional cervical failure in 3 (21.4%), and distant failure in 2 (14.3%). No cervical nodal failure occurred in patients treated with combined systemic chemotherapy regardless of ENI. Three cervical failures occurred in the 4 patients treated with ENI or neck dissection (75%), none of whom received systemic chemotherapy. Conclusions: ENI during radiotherapy for ENB seems to play a limited role in preventing cervical nodal failure. Omitting ENI may be an option if patients are treated with a combination of radiotherapy and chemotherapy.

  14. Neuropsychological assessment before and after radiotherapy in a child with an intracranial tumor: case report

    Directory of Open Access Journals (Sweden)

    Alessandra Pereira Lopes

    2013-12-01

    Full Text Available INTRODUCTION: Brain tumors are the most common solid tumors and the second largest group of neoplasms diagnosed in childhood. Treatment includes surgery, radiotherapy, and chemotherapy. However, radiotherapy can cause complications, e.g., cognitive deficits. CASE DESCRIPTION: We describe the case of a child diagnosed with a brain tumor evaluated before and after radiotherapy to investigate cognitive decline after treatment. The results showed a decline in Intelligence Quotient (IQ scores and reversal of the predominance of verbal and nonverbal skills. After radiotherapy, the subject showed slowness, academic deficits, and difficulties learning new information. COMMENTS: Even though the post-treatment evaluation showed scores compatible with the average, comparison between pre- and post-treatment evaluations demonstrated the impact of radiotherapy on the subject's cognitive profile. These results highlight the importance of evaluating patients who undergo radiotherapy before and after treatment and understanding neuropsychological scores associated with the subjects' complaints.

  15. Chondrosarcoma of the larynx: treatment with radiotherapy

    International Nuclear Information System (INIS)

    Dailiana, T.; Thanos, L.; Papathanasiou, M.; Alexopoulou, E.; Papaioannou, G.; Kelekis, D.A.; Nomikos, P.; Kapranos, N.

    2002-01-01

    The case of a 50-year-old man with chondrosarcoma of the larynx treated with radiotherapy is reported. The patient presented with hoarseness and dyspnea. He underwent computed tomography (CT), which demonstrated a soft tissue mass of the larynx. Direct laryngoscopy with biopsy established the diagnosis of chondrosarcoma. Although experience with radiotherapy in these cases has been lacking in the literature, it was considered and eventually used, as radical surgery would result in severe cosmetic and functional impairment. Radiation therapy alone resulted in long-term remission of the tumour for more than 3 years. The patient has been followed up using CT and direct laryngoscopy for early detection of recurrence or metastases. (orig.)

  16. 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

  17. Radiotherapy injuries in children

    International Nuclear Information System (INIS)

    Kalifa, G.; Bennet, J.; Couanet, D.; Masselot, J.

    1985-01-01

    Side effects of radiotherapy in pediatrics are reviewed including bone injuries and radio-induced bone tumors; nervous system injuries with emphasis on hypothalamus, pituitary gland, brain and spinal cord; lung, digestive system and urinary tract injuries [fr

  18. The metabolic radiotherapy

    International Nuclear Information System (INIS)

    Begon, F.; Gaci, M.

    1993-01-01

    In this article, the authors recall the principles of the metabolic radiotherapy and present these main applications in the treatment of thyroid cancers, hyperthyroidism, polycythemia, arthritis, bone metastases, adrenergic neoplasms. They also present the radioimmunotherapy

  19. The place of radiotherapy in muco-epidermoid carcinomas of salivary glands in child; Place de la radiotherapie dans les carcinomes mucoepidermoides des glandes salivaires de l'enfant

    Energy Technology Data Exchange (ETDEWEB)

    Thariat, J. [Centre Antoine-Lacassagne, Nice (France); Temam, S. [Institut Gustave-Roussy, Villejuif (France); Orbach, D. [Institut Curie, Paris (France); Nicollas, R.; Penicaud, M. [Hopital La Timone, Marseille (France); Toussaint, B. [CHU, Nancy (France); Makeieff, M. [CHU, Montpellier (France); Laprie, A. [Institut Claudius-Regaud, Toulouse (France); Castillo, L. [CHU, Nice (France); Vedrin, P. [CHC de Cannes, Cannes (France)

    2011-10-15

    As muco-epidermoid carcinomas are the most frequent tumours of salivary glands for child, the authors report the study of the role of radiotherapy. This study is based on a survey performed in 34 paediatric departments. The authors analyse the age and gender, the use of irradiation, the tumour location, the tumour grade and size, the use of surgery and of radiotherapy, and survival. Radiotherapy is beneficial for high grade tumours, but cannot be recommended for low and intermediate grades. Short communication

  20. Clinical practice of radiotherapy

    International Nuclear Information System (INIS)

    Tobias, J.S.

    1992-01-01

    After describing the recent advances in radiotherapy, this brief article presents in tabular form the changing indications for radiotherapy for tumours of the skin, head and neck, adult CNS, lung, thyroid, thymus, breast, female genital tract, soft tissue sarcoma, genitourinary tract, bone sarcoma, Hodgkin's disease, non-Hodgkin lymphoma, multiple myeloma, leukemia and paediatric malignancy. For each tumour type, information is provided for the radiosensitivity, the radiocurability, complications and five-year survival. Combined modality treatment is also briefly discussed. (UK)

  1. Nanoparticle-guided radiotherapy

    DEFF Research Database (Denmark)

    2012-01-01

    The present invention relates to a method and nano-sized particles for image guided radiotherapy (IGRT) of a target tissue. More specifically, the invention relates to nano-sized particles comprising X-ray-imaging contrast agents in solid form with the ability to block x-rays, allowing for simult...... for simultaneous or integrated external beam radiotherapy and imaging, e.g., using computed tomography (CT)....

  2. Clinical practice of radiotherapy

    International Nuclear Information System (INIS)

    Horiuchi, Junichi; Masaki, Norie; Onoyama, Yasuto

    1987-01-01

    This chapter presents in greater detail radiotherapy used in each clinical setting. The descriptions are given under the following sections: the tongue and oral cavity; the maxilla, larynx, and pharynx; brain tumors; the eyes and orbit; pediatric tumors; lung cancer; the esophagus; breast cancer; the abdominal digestive system; the urogenital system; the uterine cervix; the ovaries and vulva; bone and soft tissues; the skin; hematopoietic tumors; lymph node metastases; and radiotherapy as palliative treatment. (Namekawa, K.)

  3. Patients and radiotherapy

    International Nuclear Information System (INIS)

    Eardley, A.

    1986-01-01

    The results of interviews with thirty discharged patients who had undergone radical radiotherapy for cancer of the head and neck are presented. Patients were asked whether their side-effects had got worse or had stayed the same, what effect their side effects had had on eating and drinking and whether they had felt depressed during this period. Measures which could be taken to improve patients' experiences of radiotherapy are discussed. (U.K.)

  4. Radiotherapy and oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sealy, R [Cape Town Univ. (South Africa). Dept. of Radiotherapy

    1982-08-01

    A general review article for the non-radiotherapist. The historical, physical and biological background is briefly reviewed. Mention is made of the effects of fraction size, hyperbaric oxygen, neutron beams and radiation sensitizers. The use of chemotherapy and radiotherapy is discussed, as well as the selection of patients for radiotherapy and the treatment of neck nodes. The author suggests a therapeutic approach to the various disease sites and finally reviews some of the literature on radiation caries and jaw necrosis.

  5. The contribution of radiotherapy in the adult patients with a medulloblastoma: a long mono-institutional experience

    International Nuclear Information System (INIS)

    Bari, B. de; Balducci, M.; Manfrida, S.; Chiesa, S.; Frascino, V.; Valentini, V.; Anile, C.

    2009-01-01

    The medulloblastoma is rare among adults (1% of primitive cerebral tumors). currently, the surgery constitutes the initial therapy approach, followed by the radiotherapy. This summary presents the update of a retrospective analysis in a population of adult patients (>18 years) suffering of a medulloblastoma presented in 2006 at the national congress of the Italian association of oncological radiotherapy. It confirms the efficiency of radiotherapy to treat the adult patients suffering of a medulloblastoma. (N.C.)

  6. Radical radiotherapy for T3 laryngeal cancers

    Energy Technology Data Exchange (ETDEWEB)

    Uno, T. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Itami, J. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Kotaka, K. [International Medical Center of Japan, Tokyo (Japan). Dept. of Radiation Therapy; Toriyama, M. [International Medical Center of Japan, Tokyo (Japan). Dept. of Otolaryngology

    1996-08-01

    From 1974 through 1992, 37 previously untreated patients with T3 laryngeal cancer (supraglottic 15, glottic 22) were treated with initial radical radiotherapy and surgery for salvage. Two-year local control rate with radiotherapy alone, ultimate voice preservation rate, and ultimate local control rate for T3 supraglottic cancer were 33%, 33%, and 60%, respectively. Corresponding figures for T3 glottic cancer were 32%, 23%, and 77%, respecitvely. Five-year cause-specific survival rate for T3 supraglottic cancer and glottic cancer were 47% and 77%, respectively. In T3 supraglottic cancer, none of the 4 patients with subglottic tumor extension attained local control by radiotherapy alone, and local-regional recurrence-free time were significantly shorter in patients with subglottic tumor extension or tracheostomy before radiotherapy. There were no serious late complications such as chondronecrosis, rupture of carotid artery attributed to radical radiotherapy, while 3 patients had severe laryngeal edema requiring total laryngectomy. (orig.) [Deutsch] Von 1974 bis 1992 wurden 37 zuvor nicht behandelte Patienten mit T3-Larynxkarzinomen (15 supraglottisch, 22 glottisch) primaer kurativ bestrahlt und, wenn erforderlich, einer Salvage-Operation unterzogen. Die Zwei-Jahres-Kontrollrate bei alleiniger Strahlentherapie, die Rate der Stimmerhaltung sowie die unter Einschluss der Operation erreichbare lokale Kontrollrate bei supraglottischen T3-Larynxkarzinomen betrugen 33%, 33% und 60%. Bei glottischen T3-Karzinomen wurden jeweils 32%, 23% und 77% erreicht. Die Fuenf-Jahres-Ueberlebensrate betrug 47% bei supraglottischen T3-Karzinomen und 77% bei den glottischen Karzinomen. Im Fall von supraglottischen Karzinomen erreichte keiner der vier Patienten mit subglottischer Tumorausdehnung eine lokale Kontrolle durch alleinige Strahlentherapie. Die lokoregionale rezidivfreie Zeit war bei den Patienten mit subglottischer Tumorausdehnung oder Tracheostomie vor Einleitung der

  7. Experimental and clinical studies with intraoperative radiotherapy

    International Nuclear Information System (INIS)

    Sindelar, W.F.; Kinsella, T.; Tepper, J.; Travis, E.L.; Rosenberg, S.A.; Glatstein, E.

    1983-01-01

    Studies of normal tissue tolerance to intraoperative radiotherapy were done upon 65 dogs subjected to laparotomy and 11 million electron volt electron irradiation in doses ranging from zero to 5,000 rads. Results of studies indicated that intact aorta and vena cava tolerate up to 5,000 rads without loss of structural integrity. Ureteral fibrosis and stenosis develop at doses of 3,000 rads or more. Arterial anastomoses heal after doses of 4,500 rads, but fibrosis can lead to occlusion. Intestinal suture lines heal after doses of 4,500 rads. Bile duct fibrosis and stenosis develop at doses of 2,000 rads or more. Biliary-enteric anastomoses fail to heal at any dose level. A clinical trial of intraoperative radiotherapy combined with radical surgery was performed upon 20 patients with advanced malignant tumors which were considered unlikely to be cured by conventional therapies and which included carcinomas of the stomach, carcinomas of the pancreas, carcinomas involving the hilus of the liver, retroperitoneal sarcomas and osteosarcomas of the pelvis. All patients underwent resection of gross tumor, followed by intraoperative irradiation of the tumor bed and regional nodal basins. Some patients received additional postoperative external beam radiotherapy. Treatment mortality for combined operation and radiotherapy occurred in four of 20 patients. Postoperative complications occurred in four of the 16 surviving patients. Local tumor control was achieved in 11 of the 16 surviving patients, with an over-all median follow-up period of 18 months. The clinical trial suggested that intraoperative radiotherapy is a feasible adjunct to resection in locally advanced tumors, that the resulting mortality and morbidity is similar to that expected from operation alone and that local tumor control may be improved

  8. Long-term results of radiotherapy for pituitary adenomas. Evaluation of tumor control and hypopituitarism after radiotherapy

    International Nuclear Information System (INIS)

    Tsuchida, Emiko; Sakai, Kunio; Matsumoto, Yasuo; Sugita, Tadashi; Sasamoto, Ryuta

    1999-01-01

    To evaluate the results of conventional radiotherapy for pituitary adenomas assessed with computed tomography (CT) or magnetic resonance imaging (MRI). Endpoints include tumor control, normalization of hormone levels in functioning adenomas, and hypopituitarism after radiotherapy as an adverse effect. Forty-two patients were treated with radiotherapy from 1982 to 1995 at Niigata University Hospital. Forty patients were irradiated after surgery because of residual adenomas in 33 patients and tumor regrowth in 7 patients. One patient was treated with radiotherapy alone, and the remaining 1 patient was treated with preoperative radiotherapy. Tumor size and extension were evaluated using CT or MRI, and all tumors were macroadenomas. They consisted of 18 non-functioning and 24 functioning adenomas (growth hormone (GH)-secreting: 11, prolactinomas: 7, concomitant GH and prolactin (PRL)-secreting: 5, gonadotropin-secreting: 1). Treatment was given in 200 cGy daily fraction size and a total dose of 50 Gy was given to most patients. Sixteen patients with GH- and/or PRL-secreting adenomas received bromocriptine. Tumor progression was determined by increase in tumor size as shown by CT or MRI. Hypopituitarism after radiotherapy was evaluated using the functions of corticotropin (ACTH), thyrotropin (TSH), and gonadotropin. Median follow-up time from the end of radiotherapy was 103 months. Tumor progression occurred in 2 out of 42 patients and 10-year progression-free rate for all patients was 93.7%. Normalization of GH levels was obtained in 12 of 16 GH-secreting adenomas with a mean time of 27 months after radiotherapy, and 9 of 12 PRL-secreting adenomas achieved normalization of PRL levels with a mean time of 34 months. One gonadotropin-secreting adenoma achieved normalization of gonadotropin level at 21 months after radiotherapy. The incidence of hypopituitarism after radiotherapy increased with time, and cumulative risk of deficiencies of ACTH, TSH, and gonadotropin at 10

  9. Interest of radiotherapy of rectal cancer with synchronous metastases

    International Nuclear Information System (INIS)

    Tournat, H.; Vendrely, V.; Smith, D.; Capdepont, M.; Maire, J.P.; Cherciu, B.; Laurent, C.; Kantor, G.

    2008-01-01

    Purpose: There is no consensus about the treatment of rectal tumour when there are synchronous metastases. The interest of radiotherapy is debated. Patients and methods: Thirty-seven patients with rectal tumour and synchronous metastases were treated with radiotherapy first between September 1994 and December 2004. We analysed the tolerance, local control, resectability, overall survival of such a therapeutic strategy. Results: The mean follow-up was 30 months. Twenty-four tumors were resectable for both the primary site and the metastases. Thirteen were unresectable at the time of diagnosis. Thirty-three patients were treated with radio chemotherapy, ten with radiotherapy alone. Eighty-six decimal five percent of them had no pelvic symptom six weeks after the treatment. Twenty-one rectal tumours were finally resected. The disease progressed in six cases during the radiotherapy. Surgery of the metastases was possible for 12 patients with tumour initially resectable. Conclusion: Radio chemotherapy is a 'tolerable' treatment, in spite of more frequent urinary or digestive side-effects. But, if there is no surgery, palliative effect of radiotherapy is limited. (authors)

  10. Publication of Renaissance architectural treatises in the Soviet Union in the 1930s: Alexander Gabrichevsky's contribution to the theory and history of architecture

    Directory of Open Access Journals (Sweden)

    Nadejda Podzemskaia

    2016-06-01

    Full Text Available : In just a couple of years in the second half of the 1930s, a considerable corpus of architectural treatises, mostly written in the Renaissance, was translated and published with detailed commentaries in the USSR. This great publishing program was conceived of as part of a new system of architectural training. This article formulates the question of the historical and cultural significance of this publishing project in the wider artistic and political context of the 1920s and 1930s. In discussions about the destiny of classical heritage, two majors tendencies, constructivism, represented by Moisei Ginzburg, and classicism, advocated by Ivan Zholtovsky, show not only their differences, but also their shared positions, such as the criticism of eclecticism. The paper concentrates on the collaboration between Zholtovsky and the art historian and theorist Aleksandr Gabrichevsky. This was a true meeting of minds based on profound mutual understanding and common basic notions of art (such as the ambiguous concept of 'classical art’. Because of the language barrier, Gabrichevsky and his works have remained little known to scholars who work in West-European languages. A disciple of Paul Frankl, during the 1920s he researched the problems of space and time in a broader theoretical and philosophical context at the GAKhN. His main work of the time, The Morphology of Art, demonstrates influences of Friedrich Schelling, Johann Wolfgang Goethe, Henri Bergson and, above all, Georg Simmel. This work could not have been completed nor published at the time. Its recent publication revealed the profound philosophical foundations of Gabrichevsky’s studies of architecture as well as of the project of publishing Renaissance architectural treatises that he organized.

  11. Local Recurrences After Conservative Treatment of Ductal Carcinoma-In-Situ of the Breast Without Radiotherapy: The Effect of Age

    NARCIS (Netherlands)

    Schouten van der Velden, A.P.; Peeters, P.H.M.; Koot, V.C.M.; Hennipman, A.

    2006-01-01

    Background: The main goal in treatment of ductal carcinoma-in-situ (DCIS) of the breast is to prevent local recurrences. Radiotherapy after breast-conserving surgery has been shown to decrease the recurrence rate, although whether all patients should be treated with radiotherapy remains a topic

  12. ACTH deficiency, higher doses of hydrocortisone replacement, and radiotherapy are independent predictors of mortality in patients with acromegaly.

    LENUS (Irish Health Repository)

    Sherlock, M

    2009-11-01

    A number of retrospective studies report that patients with acromegaly have increased morbidity and premature mortality, with standardized mortality ratios (SMR) of 1.3-3. Many patients with acromegaly develop hypopituitarism as a result of the pituitary adenoma itself or therapies such as surgery and radiotherapy. Pituitary radiotherapy and hypopituitarism have also been associated with an increased SMR.

  13. No negative impact of radiotherapy on the incidence of second tumours and mortality in pituitary adenoma patients

    NARCIS (Netherlands)

    Sattler, M.G.; van Beek, A.P.; van den Berg, Gerrit; Sluiter, W.J.; Langendijk, J.; Wolffenbuttel, B.H.; van den Bergh, A.C.

    2010-01-01

    Purpose: Postoperative radiotherapy (PORT) results in excellent local tumour control and improvement of excessive hormonal secretion in pituitary adenoma patients where (repeated) surgery was unsuccessful. Despite this benefit, concerns related to possible long term side effects are often quoted to

  14. Radiotherapy for a cystadenolymphoma of the parotid gland (Warthin's tumor)

    International Nuclear Information System (INIS)

    Stallmann, C.; Vacha, P.; Vesely, H.; Richter, E.; Feyerabend, T.

    2001-01-01

    Background: With 17.6% of all primary parotid neoformations the benign Warthin's tumor (cystadenolymphoma) is the second common parotid gland tumor. Males > 50 years are affected predominantly. After surgery the recurrence rate is less than 5%. Histomorphologically the tumor is characterized by cystoid ducts lined by epithelial cells as well as lymphoid stroma. The lymphoid component has been described as radioresponsive whereas the epithelial parts are less radiosensitive. Since 1960 only one patient treated by primary radiotherapy has been published. Case report: A 77-year-old woman suffered from cystadenolymphoma (maximal diameter 7 cm). Because of its extension and the reduced performance status of the patient surgery was no option. Radiotherapy was performed with a total dose of 50 Gy. Clinically, the tumor regressed completely after 30 Gy, which was confirmed by CT at 6 weeks after completion of radiotherapy. After 6 and 12 months the patient stayed free of tumor. Epicrisis: In our case the cystadenolymphoma was unusually large (7 cm). Radiotherapy with 50 Gy induced complete tumor regression. The good clinical response after 30 Gy suggests that the necessary dose may be lower for less extended cystadenolymphomas. Conclusion: We present a case of cystadenolymphoma treated by radiotherapy with 50 Gy resulting in a complete remission. Due to missing published experiences no common recommendation for the total dose can be given. In the following situations radiotherapy should be considered: 1. high surgical risk of damage to the facial nerve, 2. unfavorable cosmetic outcome after surgery, 3. inoperability for internal risks, 4. refusal of operation. (orig.) [de

  15. 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

  16. Long-term effects of megavoltage radiotherapy in acromegaly

    International Nuclear Information System (INIS)

    Lam, K.S.L.; Wang, C.; Ma, J.T.C.; Yeung, R.T.T.; Choi, P.

    1989-01-01

    The progress of 41 Chinese patients with acromegaly treated with megavoltage radiotherapy was reviewed after a mean follow-up of 4.5 (one-ten) years. Nine received prior surgery. Radiotherapy was delivered by a 3-field technique to a total of 4000-5000 cGy in 25 fractions. By life table analysis successful treatment of growth hormone (GH) hypersecretion, as defined by a mean GH concentration of ≤ 10 mu/L, could be expected in 6, 11, 26, 64 and 67% of the patients after one, two, five, eight and ten years respectively. Median intervals before achieving a mean GH level of ≤ 10 Mu/L were 6.6 and 8.6 years following radiotherapy with the higher (4500-5000 cGy) and lower (4000 cGy) doses respectively, suggesting a tendency towards earlier response following radiotherapy with the higher dose. The prevalence of acquired hypopituitarism in patients followed up for over five years was 40% for gonadotrophins, 30% for TSH and 20% for ACTH deficiency respectively. In the majority of patients, acquired hypopituitarism was not apparent within five years after radiotherapy. No mortality or major side effects were noted following radiotherapy. In 34 patients on longterm bromocriptine treatment, mean GH concentrations were normalised in 26.5% of patients. We conclude that with judicious selection of patients and use of adjunctive medical therapy, megavoltage radiotherapy remains a safe and satisfactory form of treatment for acromegaly especially if expert transphenoidal surgery is not readily available. 19 refs., 3 figs., 2 tabs

  17. Radiotherapy for Merkel cell carcinoma of the skin

    International Nuclear Information System (INIS)

    Tai, P.; Pacella, J.; Yu, E.

    2006-01-01

    We examine the impact of radiotherapy in the treatment of Merkel cell carcinomas (MCC) of the skin. Data at two Canadian institutions (Allan Blair Cancer Centre and Regional Cancer Program) were collected and charts were retrieved from the registry of 1997 to 2005. A total of 79 patients with definite MCC were studied. All expect three had a primary skin lesion. Six patients presented with nodal metastases and three patients with distant metastases. Fourteen patients were referred to the cancer centers at the time of recurrence. The series consisted of 40 males and 39 females with a median age of 80 years (range 48-94). The median follow up was 21 months (range 0.5-150.4). Twenty -two patient ass (group A) received radiotherapy at the time of presentation, being post-operative adjuvant treatment an done being primary treatment without surgery.The 5-year cause-specific survival rate (CSSR) was 42%. The 5-year rates equals the 10-year rate since the CSSR plateaus at a survival of 4,5 years and there after, patients died from causes other than MCC. The 5-year overall survival rate (OSR) was 19% for group A. Fifty-seven patients (group B) had surgery alone without post-operative adjuvant radiotherapy. 5-year and 10-year CSSRs were both 63% (P=0.8, using the logrank test when comparing the two groups of patients). The 5-year OSR was 30% and the 10-year OSR was 13% (P=0.6, group A versus group B). Morbidity from radiotherapy was minimal. Only patient had lymphoedema of the arm (which required a pressure garment) after axillary dissection and radiotherapy of 50 Gy in fractions over 35 days. Radiotherapy after surgical excision is well tolerated. It is recommended there are high risk factors for recurrence and radiotherapy should be started as soon as possible after referral. (author)

  18. A federal audit of the Belgian radiotherapy departments in breast cancer treatment

    International Nuclear Information System (INIS)

    Houtte, Paul van; Bourgois, Nicolas; Renard, Francoise; Huget, Philippe; D'hoore, William; Scalliet, Pierre

    2007-01-01

    Background: The Belgian Federal College of Radiotherapy carried out an external audit of breast cancer patient documentation in the 26 Belgian radiotherapy centres. The objective was to assess compliance with the recommendations regarding minimal requirements for documentation of radiotherapy prescription and administration. All centres volunteered to take part in this audit. Methods: Two experienced radiation oncologists site-visited the departments over a 6 month period (Sept. 2003-Feb. 2004), with a list of items to be verified, including details on the surgery, the pathological report, details on systemic treatments, details on the radiotherapy prescription (and consistency with therapeutic guidelines) and delay surgery/radiotherapy. Findings: Three hundred and eighty-nine patients files were reviewed, for a total of 399 breast cancers (10 patients with bilateral cancer). Mean age was 57.8 y (range 29-96). Breast conservative surgery (BCS) was used in 71%; radical mastectomy in 29%. A complete pathological report was present in all files but 2 (99.5% conformity). 5.2% were treated for DCIS, 61.6% for pT1, 28.2% for pT2 and 5% for pT3-4. Data regarding resection margins were specified to be free in 76.2%, tangential in 12% (within 2 mm) and positive for DCIS in 3.8% or invasive cancer in 1.5% (no information, on margins in 6.5%). The pT stage was always specified, and consistent with the macroscopic and microscopic findings. Hormonal receptors were routinely assessed (94.7%), as well as Her2neu (87.4%). Axillary surgery was carried out in 92%, either by sentinel node biopsy or by complete clearance, in which case the median number of nodes analysed was 12 for all centres together (7-17). All radiotherapy prescriptions were in line with evidence-based standards of therapy (i.e., irradiation of breast after BCS or after mamectomy (in case of pN+), but one. The mean delay between surgery and radiotherapy was 5.5 weeks (SD 11days). Conclusion: There was a high

  19. Delayed airway stenosis after radiotherapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yuta, Atsushi; Tatematsu, Masanori; Ishinaga, Hajime; Harada, Teruhiko; Majima, Yuichi [Mie Univ., Tsu (Japan). School of Medicine

    2002-03-01

    Seven cases of delayed airway stenosis after radiotherapy for early staged head and neck cancers during 1989 and 1999 were evaluated (aged 54-77 yrs, 6 male and a female). The cases included five glottic laryngeal cancers (T1a, T1b, and three T2), a subglottic laryngeal cancer, and an unknown origin, but strongly suspected laryngeal cancer, with neck metastasis. Radio injury was found from 3 months to 47 months after radiotherapy. {sup 60}Co for radiotherapy was used in all seven cases, although {sup 60}Co radionuclide was changed to Liniac in 1997. The total dose was 60 Gy for 3 cases, and 70 Gy for 4 cases. Tracheostomy was performed in 3 cases due to bilateral vocal cord impairment. Background, treatment, and response to radiotherapy were compared to those of 90 patients of a control group with early staged laryngeal cancer who did not fail radiation injury during the same period. As a result, radionuclide ({sup 60}Co), total dose, cervical surgery, antiinflammatory drugs, laryngeal edema during radiotherapy were risk factors. The intensity and the period of mucositis by radiotherapy was important for indicating delayed airway stenosis. (author)

  20. Delayed airway stenosis after radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Yuta, Atsushi; Tatematsu, Masanori; Ishinaga, Hajime; Harada, Teruhiko; Majima, Yuichi

    2002-01-01

    Seven cases of delayed airway stenosis after radiotherapy for early staged head and neck cancers during 1989 and 1999 were evaluated (aged 54-77 yrs, 6 male and a female). The cases included five glottic laryngeal cancers (T1a, T1b, and three T2), a subglottic laryngeal cancer, and an unknown origin, but strongly suspected laryngeal cancer, with neck metastasis. Radio injury was found from 3 months to 47 months after radiotherapy. 60 Co for radiotherapy was used in all seven cases, although 60 Co radionuclide was changed to Liniac in 1997. The total dose was 60 Gy for 3 cases, and 70 Gy for 4 cases. Tracheostomy was performed in 3 cases due to bilateral vocal cord impairment. Background, treatment, and response to radiotherapy were compared to those of 90 patients of a control group with early staged laryngeal cancer who did not fail radiation injury during the same period. As a result, radionuclide ( 60 Co), total dose, cervical surgery, antiinflammatory drugs, laryngeal edema during radiotherapy were risk factors. The intensity and the period of mucositis by radiotherapy was important for indicating delayed airway stenosis. (author)

  1. What information should patients be given before radiotherapy?

    International Nuclear Information System (INIS)

    Bergerot, Ph.

    2009-01-01

    Following a number of accidents at radiotherapy units, at Epinal and Toulouse hospitals in particular, and the problems encountered in the summer 2008, mainly caused by a shortage of radiation physicians and probably due to legislation that bears little relation to reality, a national radiotherapy monitoring committee was set up on 15 December 2008 in the presence of Roselyne Bachelot-Narquin, France's Minister for Health and Sport. A first progress report was submitted to the Minister in May 2009. Twelve members sit on this national monitoring committee, including a CISS representative and a person that has received radiotherapy treatment. This demonstrates the seriousness and the commitment required of users on this issue. Radiotherapy, one of the main treatments for cancer, is a loco-regional treatment that uses radiation capable of destroying cancer cells. It can be used on its own, or before, during or after another treatment method (surgery or a medical treatment such as chemotherapy, for example). The decision to treat a patient by means of radiotherapy is based on the opinions of health care professionals discussed at a multidisciplinary team meeting, the minutes of which are sent to the various doctors involved. The radiotherapy treatment prescribed (the technique, total radiation dose, length of the treatment, number of sessions, etc.) is adapted to the individual situation of each patient. It is designed to be as effective as possible in light of the tumour pathology, while protecting neighbouring organs as far as is possible. (author)

  2. Postoperative radiotherapy for intracranial meningioma

    International Nuclear Information System (INIS)

    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. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, A.E.; Reyes, F.I.; Faiman, C.

    1987-07-01

    Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy.

  4. Outcome and late complications of radiotherapy in patients with unicentric Castleman disease

    International Nuclear Information System (INIS)

    Neuhof, Dirk; Debus, Juergen

    2006-01-01

    Castleman disease is a rare lymphoproliferative disorder. Surgery is considered standard therapy for the unicentric type. However, case reports have documented favorable responses to radiotherapy. The aim of this study was to analyse the clinical outcomes of five patients with unicentric Castleman disease treated with radiotherapy between 1991 and 2005. Mediastinal lymph nodes were the most common site of disease (four patients). Three patients were treated with radiotherapy alone, two patients with surgery and radiotherapy. Patients were treated with radiotherapy doses ranging from 40 Gy to 50 Gy. The median follow-up was 12 months (range, 3-175 months). During follow-up only one patient had progressive disease and died of Castleman disease. At the time of last follow-up two patients were in complete remission, one patient in partial remission, and one patient had stable disease. One patient showed serious acute and late toxicities. At the end of radiotherapy a paraneoplastic pemphigus vulgaris occurred, and eight to 11 months after radiotherapy a stenosis of the esophagus, of the left bronchus, and of the trachea due to scars. The study shows that unicentric Castleman disease is successfully treated with radiotherapy. However, for detection of possible complications as pemphigus vulgaris or stenosis of the esophagus or trachea an accurate follow-up is necessary

  5. Primary radiotherapy of prolactinomas. Eight- to 15-year follow-up

    International Nuclear Information System (INIS)

    Mehta, A.E.; Reyes, F.I.; Faiman, C.

    1987-01-01

    Eight women with amenorrhea, galactorrhea, and hyperprolactinemia, of whom six had macroadenomas and two had microadenomas, were treated with conventional (cobalt-60) external radiotherapy, and their progress was monitored for eight to 15 years. Normoprolactinemia was established in five of these patients after two to 13 years (median, nine years). A recurrence was treated surgically in one patient, and stable prolactin values and roentgenographic features have been maintained in two patients. Hypopituitarism has developed in only one patient to date, and no other complications of radiotherapy have been observed. These findings, together with the few previous reports on the long-term effects of radiotherapy on macroprolactinomas, have been compared with the long-term results following surgery or dopamine agonist therapy. The normalization of prolactin values is considerably delayed following radiotherapy compared with the other two therapeutic modalities. However, radiotherapy affords permanent normalization without recurrence in a larger percentage of patients than does surgery and avoids the considerable ongoing cost and inconvenience of daily drug ingestion. The long-term development of hypopituitarism appears to be an acceptably small risk of radiotherapy. Thus, conventional radiotherapy is an attractive treatment option, particularly for macroprolactinomas; adjunctive bromocriptine can be used while awaiting the longer-term benefits of radiotherapy

  6. Radiotherapy for superficial esophageal cancer of poor risk patients

    International Nuclear Information System (INIS)

    Kagami, Yoshikazu; Ikeda, Hiroshi; Murayama, Shigeyuki; Yamaguchi, Hajime; Tachimori, Yuji; Kato, Hoichi; Watanabe, Hiroshi; Tokuue, Kouichi; Sumi, Minako; Kawashima, Mitsuhiko; Imai, Atsushi; Nakayama, Shuji

    1997-01-01

    Purpose/Objective: The reported incidence of superficial esophageal cancer (SEC) has steadily increased in Japan as result of endoscopic examination has been become common. In Japan, treatment of SEC is endoscopical mucosal resection (EMR) for mucosal cancer or esophagectomy with 3 fields lymph nodes resection for submucosal cancer. Radiotherapy is little place for the management of SEC. Because of some reasons, we treated patients with SEC by radiotherapy alternative to surgery. Purpose of this report is to evaluate efficacy of radiotherapy for SEC. Methods and Materials: Between 1989 to 1996, eighteen patients with SEC were treated with radiotherapy at our hospital. Reasons of radiotherapy that was chosen as the primary methods of treatment were refusal of surgery in one patient, poor medical condition in 4 patients and double primary cancer in 13 patients (head and neck: 11, simultaneously: 11). No patients had indication of EMR. Diagnosis was made by endoscopy and radiography. Some patients were examined with endoscopic ultrasound. Two patients (11.1%) had tumor limited to the mucosa and 16 patients (88.9%) had tumor invaded the submucosa. Seven of these tumors (38.9%) were multicentric. All patients had squamous cell carcinoma. There were 17 male patients and one female patient. The age range was 49 years to 87 years with a median of 62 years. Stage of all patients was T1N0M0 according to UICC staging system. Ten patients underwent external radiotherapy (Ex) (50 Gy - 66 Gy) alone and 8 patients did both Ex and intracavitary radiotherapy (IC) (30-60 Gy of Ex with 5-15 Gy of IC). No patients received chemotherapy. Duration of follow-up was 6 months to 96 months with a median of 30 months. Results: The overall survival rate was 55.9% in 3-year and 14% in 5-year, and the cause-specific 5-year survival rate was 100%. Causes of death were malignant tumor other than esophageal cancer in 4 patients, intercurrent disease other than malignant tumor in 3 patients and no

  7. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  8. Clinical experience with intraoperative radiotherapy for locally advanced colorectal cancer

    International Nuclear Information System (INIS)

    Shibamoto, Yuta; Takahashi, Masaharu; Abe, Mitsuyuki

    1988-01-01

    Intraoperative radiotherapy (IORT) was performed on 20 patients with colorectal cancer. IORT with a single dose of 20 to 40 Gy was delivered to the residual tumor, tumor bed, and/or lymphnode regions. Although most of the patients had advanced lesions, local control was achieved in 67 % of the patients when IORT was combined with tumor resection, and 4 patients survived more than 5 years. There were no serious complications, except for contracture or atrophy of the psoas muscle seen in 2 patients. IORT combined with external beam radiotherapy should be a useful adjuvant therapy to surgery for locally advanced colorectal cancer. (author)

  9. Non-randomized clinical study comparing chemotherapy plus radiotherapy with radiotherapy alone in neoadjuvant therapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kayahara, Hiroaki; Okuda, Mamiko; Terakado, Nagaaki; Shintani, Satoru; Hamakawa, Hiroyuki [Ehime Univ., Shigenobu (Japan). School of Medicine

    2002-06-01

    Neoadjuvant therapy plays an important role for organ preservation and survival rate in the treatment of oral cancer. We clinically compared the effect of neoadjuvant radiotherapy and chemoradiotherapy in patients with oral cancer. We retrospectively examined 47 patients diagnosed with oral squamous cell carcinoma who underwent neoadjuvant therapy followed by curative surgery in the oral and maxillofacial surgery department of Ehime University Hospital. We divided them into two groups: radiotherapy alone (24 cases) and chemoradiotherapy (23 cases). The patients in the radiotherapy group underwent irradiation of 32.6{+-}5.0 Gy (mean {+-}SD). The patients in the chemoradiotherapy group received a low-dose fraction of cisplatin (8 mg/mm{sup 2}/day, 5 days a week; total dose: 139.4{+-}67.1 mg) and 5-fluorouracil (300 mg/mm{sup 2}/day, 5 days a week; total dose: 5,900{+-}1,839.8 mg) combined with simultaneous irradiation of 31.0{+-}3.2 Gy. None of the 24 patients had a complete response to radiotherapy alone and 12 (50%) had a partial response. Six (26%) of the 23 patients had a complete response to chemoradiotherapy and 12 (52%) had a partial response. The primary control rate (82.6%) to chemoradiotherapy was higher than that (67.5%) to radiotherapy alone although no significant difference was found. The 5-year survival rate was 64.3% in the radiotherapy group and 62.8% in the chemoradiotherapy group. The findings of the present study suggest that while the combination of radiation and cisplatin/5-fluorouracil in neoadjuvant therapy for oral cancer may not bring a significant benefit to improve survival rate, the primary local control rate is improved in comparison with radiotherapy alone. (author)

  10. Advice concerning radiotherapy

    International Nuclear Information System (INIS)

    1984-01-01

    Dutch National cancer incidence figures were calculated by using the reliable data on cancer incidence in the Eindhoven area and population forecasts and information obtained from the Central Bureau of Statistics. Several radiotherapy departments suffer from under capacity (a lack of resources and understaffing). Data have also shown that 35% of cancer patients receive radiotherapy, instead of 50%. Calculations have been made by the committee on the present and future needs with regard to equipment and staff. In 1983, the number of megavoltage therapy units amounted to 38, but should have been 65. It should be 80 in 1990 and 90 in 2000. Since building and installing such equipment is a lengthy process a considerable effort is needed to make up for the arrears. The committee advocates the extension of the system of regional cooperation in cancer care (comprehensive cancer centres), in which radiotherapy departments play a crucial role. Working parties from the committee provided a comprehensive description of current radiotherapy practice with reference to physical, technical, clinical and management aspects. Another working party assessed the results of cancer treatment with regard to many different tumour sites. Recent and expected developments were analysed or indicated. The Radiotherapy Committee commissioned an external team to conduct a project to achieve a picture of future developments using methods different to those of the committee's. An interim advice has been added on this subject. (Auth.)

  11. Definitive and adjuvant radiotherapy for sinonasal squamous cell carcinomas: a single institutional experience

    International Nuclear Information System (INIS)

    Duru Birgi, Sumerya; Teo, Mark; Dyker, Karen E.; Sen, Mehmet; Prestwich, Robin J D

    2015-01-01

    The aim of this study was to evaluate the disease outcomes of patients treated with definitive and adjuvant radiotherapy for squamous cell carcinomas of the nasal cavity and paranasal sinuses in a single institution. Between 2007–2012 patients were retrospectively identified from electronic databases who had undergone surgery and adjuvant radiotherapy or definitive radiotherapy for sinonasal squamous cell carcinomas with curative intent. Fourty three patients with sinonasal squamous cell carcinoma were identified (22 nasal cavity, 21 paranasal sinuses). 31/43 (72 %) had T3 or T4 disease; nodal stage was N0 in 38, N1 in 4, Na/b in 0 and N2c in 1 patient. Median age was 67 years (range 41–86). 18 (42 %) received definitive and 25 (58 %) adjuvant radiotherapy. Radiotherapy was delivered using either conventional radiotherapy (n = 39) or intensity modulated radiotherapy (n = 4). Elective neck radiotherapy was delivered to two patients. Chemotherapy was delivered to 6/43 (14 %) of patients. Two-year local control, regional control, distant metastases free survival, progression free survival, cause specific survival and overall survival were 81 %, 90 %, 95 %, 71 %, 84 % and 80 % respectively. There was no significant difference in outcome comparing patients who underwent surgery and adjuvant radiotherapy with patients receiving definitive radiotherapy (2 year locoregional disease free survival 75 % and 70 % respectively, p = 0.98). Pooly differentiated tumours were significantly associated with inferior disease outcomes. Local, regional, combined local and regional, and distant failure occurred in 7 (16 %), 3 (7 %), 1 (2 %) and 2 (5 %) of patients; all 3 regional recurrences were in patients with nasal cavity squamous cell carcinomas who had not undergone elective neck treatment. Definitive or adjuvant radiotherapy provides an effective treatment for sinonasal malignancies. The main pattern of failure remains local, suggesting the need for investigation of

  12. Long-term effects of radiotherapy for acromegaly on circulating prolactin

    International Nuclear Information System (INIS)

    Ciccarelli, E.; Corsello, S.M.; Besser, G.M.; Wass, J.A.H.; Plowman, P.N.; Jones, A.E.; Touzel, R.; Rees, L.H.

    1989-01-01

    In 61 acromegalic patients, serum PRL was assessed (off medical treatment) before and 2 to 12 (mean 6 p years after external beam radiotherapy. Before radiotherapy elevated PRL levels were present in 22 of 35 males (63%) and 12 of 26 females (46%) and were above 1000 mU/l in 11 males and 5 females. When studied for up to 5 years after radiotherapy, 22 or 23 (96%) patients who had not had surgery and who had normal PRL preradiotherapy showed an increased PRL level and this was also seen in 17 or 27 (63%) who had hyperprolactinaemic initially. In contrast, 10 of 27 patients (37%) who had elevated pre-radiotherapy levels (all greater than 1000 mU/l) had a reduction in PRL values after radiotherapy. In all 11 patients who underwent surgery before radiotherapy, an increase in PRL was seen after radiotherapy. In the 21 patients followed for 10-12 years, the peak PRL value occurred 1-6 years after radiotherapy. After this, a progressive reduction of PRL to normal was seen. Normal levels were reached 4 to 10 years after radiotherapy. No correlation was found between pretreatment PRL values and final GH values in the whole group, nor between changes in PRL and the development of Impaired ACTH or TSH secretion. Thus, different patterns of PRL behaviour suggest that radiotherapy treatment may either produce hyperprolactinemia from mild hypothalamic damage or ablate PRL secreting cells if they were present in the tumour before treatment. These changes do not predict final GH results or the development of hypopituitarism after radiotherapy. (author)

  13. Long-term effects of radiotherapy for acromegaly on circulating prolactin

    Energy Technology Data Exchange (ETDEWEB)

    Ciccarelli, E.; Corsello, S.M.; Besser, G.M.; Wass, J.A.H. (Department of Endocrinology, St. Bartholomew' s Hospital, West Smithfield, London (UK)); Plowman, P.N.; Jones, A.E. (Department of Radiotherapy, St. Bartholomew' s Hospital, West Smithfield, London (UK)); Touzel, R.; Rees, L.H. (Department of Chemical Endocrinology, St. Bartholomew' s Hospital, West Smithfield, London (UK))

    1989-01-01

    In 61 acromegalic patients, serum PRL was assessed (off medical treatment) before and 2 to 12 (mean 6 p) years after external beam radiotherapy. Before radiotherapy elevated PRL levels were present in 22 of 35 males (63%) and 12 of 26 females (46%) and were above 1000 mU/l in 11 males and 5 females. When studied for up to 5 years after radiotherapy, 22 or 23 (96%) patients who had not had surgery and who had normal PRL preradiotherapy showed an increased PRL level and this was also seen in 17 or 27 (63%) who had hyperprolactinaemic initially. In contrast, 10 of 27 patients (37%) who had elevated pre-radiotherapy levels (all greater than 1000 mU/l) had a reduction in PRL values after radiotherapy. In all 11 patients who underwent surgery before radiotherapy, an increase in PRL was seen after radiotherapy. In the 21 patients followed for 10--12 years, the peak PRL value occurred 1--6 years after radiotherapy. After this, a progressive reduction of PRL to normal was seen. Normal levels were reached 4 to 10 years after radiotherapy. No correlation was found between pretreatment PRL values and final GH values in the whole group, nor between changes in PRL and the development of Impaired ACTH or TSH secretion. Thus, different patterns of PRL behaviour suggest that radiotherapy treatment may either produce hyperprolactinemia from mild hypothalamic damage or ablate PRL secreting cells if they were present in the tumour before treatment. These changes do not predict final GH results or the development of hypopituitarism after radiotherapy. (author).

  14. Chemotherapy disruption of efficient radiotherapy

    International Nuclear Information System (INIS)

    Nervi, C.; Friedman, M.

    1974-01-01

    Studies on the use of chemotherapy in combination with radiotherapy are reviewed. Some topics discussed are: indications for the use of combined chemotherapy and radiotherapy; improvement of the therapeutic ratio following the use of methotrexate; advantages of preirradiation and postirradiation chemotherapy; side effects following simultaneous chemotherapy and radiotherapy; and effects of chemotherapy on cure rate of radiosensitive and radioresistant tumors. (U.S.)

  15. Radiotherapy for stage IV oropharyngeal cancer

    International Nuclear Information System (INIS)

    Nakamura, Kaori; Akimoto, Tetsuo; Motegi, Atsushi

    2008-01-01

    Fifty-seven patients with stage IVA-B oropharyngeal cancer treated by definitive radiotherapy in our facility from January 1993 to August 2005 were retrospectively analyzed. The age of the patients was 34-84 (median 62) years old. Thirty-four were male and 14 were female. Subsite of the tumor was anterior: 16, lateral: 39, posterior: 1, and superior: 1. Forty-nine patients were treated with chemotherapy. Induction chemotherapy (ICT) was done in 25 patients, ICT+concurrent chemoradiotherapy (CCRT) in 15 patients, and CCRT in 9 patients. A dose of 60-82 Gy (median 72 Gy) by hyperfractionated radiotherapy, at 1.2 Gy/fraction twice a day, was delivered in 37 patients, and 60-72 Gy (median 66 Gy) with a conventional daily fractionation in 20 patients. Salvage surgery was performed in 5 patients as a part of primary treatment after radiotherapy. The 5-year cause-specific survival rate and disease-free survival rate were 52.9% and 51.4%, respectively. By univariate analysis, the impact of age, sex, T-stage, N-stage, histological differentiation, chemotherapy and fractionation of radiation therapy on survivals were evaluated. T-stage, N-stage and histological differentiation were significantly covariate correlated with survival. The treatment results were not satisfactory. Further investigation of the treatment strategy to improve the treatment outcome of advanced oropharyngeal cancer is desired. (author)

  16. Radiotherapy for the medulloblastoma

    International Nuclear Information System (INIS)

    Gose, Kyuhei; Imajo, Yoshinari; Imanaka, Kazufumi

    1983-01-01

    Eighteen patients with medulloblastoma, treated between 1972 and 1981, at Kobe University School of Medicine, were retrospectively studied. Of those completing post operative irradiation, 50% have survived for 2 years, 15% for 5 years and mean survival periods was 22.2 months. 13 out of 18 patients developed local recurrence and spinal dissemination. The mean time from the initial radiotherapy to recurrence was 8.5 months. It was suggested that posterior fossa should recieve 5,000 rad, the spine should 2,000 rad and recurrences should be treated by the combination of radiotherapy and chemotherapy. (author)

  17. Arterial disease after radiotherapy

    International Nuclear Information System (INIS)

    Bigot, J.M.; Mathieu, D.; Reizine, D.

    1983-01-01

    Disease of the large arterial vessels is a relatively unknown complication of radiotherapy. However, it should be considered in the same manner as the other complications of irradiation when a tumour recurrence is suspected. The experimental studies of Kirkpatrick and Konings, demonstrating the synergy between irradiation and hypercholesterolemia in the precocity and gravity of vascular complications are recalled. The different localisations reported in the litterature are discussed: coronary, pulmonary, thoracic aorta, supra aortic, renal, digestive and ilio-femoral arteries. Finally, the difficulty of diagnosis of post-radiotherapy without clinical, radiological or anatomopathological confirmation, is underlined [fr

  18. Second cancers following radiotherapy

    International Nuclear Information System (INIS)

    Tubiana, M.

    1983-01-01

    Published reports have shown that there is an increased incidence of second malignancies, particularly sarcomas, following high dose radiotherapy in cancer treatment. However, this increased risk is very small and is relatively negligeable when one considers the beneficial effects of radiotherapy in cancer treatment. This incidence of radiation induced cancer appears to be higher in certain groups of patients, such as children and patients with Hodgkin's disease. In view of scarcity of published data, controlled surveys remain necessary for the quantitative assessment of the cancer risk in various subgroups of irradited patients [fr