Treatment of prostate cancer by hypofractionated radiotherapy

WOS: 000430063900005Technological advances in radiation therapy delivery have permitted the use of high dose per fraction radiotherapy for early stage prostate cancer. Level I evidence supporting the safety and efficasy of hypofractionated radiotherapy is evolving. Moderate and extreme hypofractionation regimens show promising cancer control but long term results of noninferiority studies of both modalities are required before use in routine treatment as standard of care

Nasopharyngeal cancer around the Mediterranean area: Role of newer radiation techniques

Primary radiotherapy has been the mainstay of treatment of patients with nondisseminated nasopharyngeal cancer (NPC). Novel techniques, such as intensity modulated and image guided radiotherapy has the capability to generate steep dose gradients, leading to an improved therapeutic index, especially in NPC. Although it is widely accepted as the treatment of choice in NPC in the modern world, in developing countries the financing of these innovative delivery systems still continues to be a major problem. The purpose of this article is to discuss the difficulties one may experience during the transition from 2D way of thinking to the 3D conformal era and to review the clinical outcome and toxicity profile of these promising new radiation techniques. (C) 2010 Elsevier Ireland Ltd. All rights reserved

Nasopharyngeal cancer around the Mediterranean area: Role of newer radiation techniques

WOS: 000209506700016PubMed ID: 20965745Primary radiotherapy has been the mainstay of treatment of patients with nondisseminated nasopharyngeal cancer (NPC). Novel techniques, such as intensity modulated and image guided radiotherapy has the capability to generate steep dose gradients, leading to an improved therapeutic index, especially in NPC. Although it is widely accepted as the treatment of choice in NPC in the modern world, in developing countries the financing of these innovative delivery systems still continues to be a major problem. The purpose of this article is to discuss the difficulties one may experience during the transition from 2D way of thinking to the 3D conformal era and to review the clinical outcome and toxicity profile of these promising new radiation techniques. (C) 2010 Elsevier Ireland Ltd. All rights reserved

RADIATION INDUCED BRONCIOLITIS OBLITERANS ORGANIZING PNEUMONIA (BOOP) SYNDROME AFTER RADIOTHERAPY FOR BREAST CANCER

Radiation-induced bronchiolitis obliterans organising pneumonia ( BOOP) is a lung disease which is pathologically characterized by the presence of granulation tissue polyps within respiratory bronchioles and alveoler ducts and patchy areas of organizing pneumonia. Etiologic factors include infection, drug administration, collagen vascular disease, hypersensitivity pneumonia, toxic fume inhalation, acute respiratory deficiency syndrome, thyroiditis and radiotherapy and it may also develop idiopathic. Occurence of radiation injury in the lung outside the tangential fields and appearance of patchy infiltrates in both lungs are characteristic. It is assumed that radiation exposure to lung and pleura initiates a lymphocytic stimulation which then triggers a cytokin mediated immunologic reaction and causes the injury in both lungs. We report an early breast cancer patient treated with breast conservation surgery and postoperative breast radiotherapy who later developed BOOP syndrome in both lungs

Treatment outcomes of metastasis-directed treatment using(68)Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)

selek, ugur/0000-0001-8087-3140; Onal, Cem/0000-0002-2742-9021; Zoto Mustafayev, Teuta/0000-0001-6029-1995WOS: 000545850300001PubMed: 32617620Purpose the aim of this study was to evaluate the outcomes of(68)Ga prostate-specific membrane antigen (Ga-68-PSMA) positron-emission tomography (PET)/CT-based metastasis-directed treatment (MDT) for oligometastatic prostate cancer (PC). Methods in this multi-institutional study, clinical data of 176 PC patients with 353 lesions receiving MDT between 2014 and 2019 were retrospectively evaluated. All patients had biopsy proven PC with = 3 acute toxicity, but one patient had a late grade 3 toxicity of compression fracture after spinal SBRT. Conclusion Ga-68-PSMA-PET/CT-based MDT is an efficient and safe treatment for oligometastatic PC patients. Proper patient selection might improve treatment outcomes

Dosimetric comparison of field in field intensity-modulated radiotherapy technique with conformal radiotherapy techniques in breast cancer

WOS: 000278154500006PubMed ID: 20512546The aim of this study was to be able to implement the field-in-field intensity-modulated radiotherapy (FiF) technique in our daily practice for breast radiotherapy. To do this, we performed a dosimetric comparison. Treatment plans were produced for 20 consecutive patients. FiF plans and conformal radiotherapy (CRT) plans were compared for doses in the planning target volume (PTV), the dose homogeneity index (DHI), doses in irradiated soft tissue outside the target volume (SST), ipsilateral lung and heart doses for left breast irradiation, and the monitor unit counts (MU) required for treatment. Averaged values were compared using Student's t-test. With FiF, the DHI is improved 7.0% and 5.7%, respectively (P < 0.0001) over the bilateral and lateral wedge CRT techniques. When the targeted volumes received 105% and 110% of the prescribed dose in the PTV were compared, significant decreases are found with the FiF technique. With the 105% dose, the SST, heart, and ipsilateral lung doses and the MU counts were also significantly lower with the FiF technique. The FiF technique, compared to CRT, for breast radiotherapy enables significantly better dose distribution in the PTV. Significant differences are also found for soft tissue volume, the ipsilateral lung dose, and the heart dose. Considering the decreased MUs needed for treatment, the FiF technique is preferred over tangential CRT

Clinical and histopathological factors associated with Ki-67 expression in breast cancer patients

The aim of the present study was to identify the optimal Ki-67 cut-off value in breast cancer (BC) patients, and investigate the association of Ki-67 expression levels with other prognostic factors. Firstly, a retrospective search was performed to identify patients with stage I-III BC (n=462). A range of Ki-67 index values were then assigned to five groups (= 25%). The correlation between the Ki-67 index and other prognostic factors [age, tumor type, histological and nuclear grade, tumor size, multifocality, an in situ component, lymphovascular invasion (LVI), estrogen and progesterone receptor (ER/PR) expression, human epidermal growth factor receptor (HER-2) status, axillary involvement and tumor stage] were investigated in each group. The median Ki-67 value was revealed to be 20% (range, 1-95%). A young age (= 15% was associated with the largest number of poor prognostic factors (P=0.036). In addition, a Ki-67 value of >= 15% was identified to be statistically significant in association with certain luminal subtypes. The rate of disease-free survival was higher in patients with luminal A subtype BC (P=0.036). Following the correlation analysis for the Ki-67 index and the other prognostic factors, a Ki-67 value of >= 15% was revealed to be the optimal cut-off level for BC patients

Prostatic Duct Adenocarcinoma: Clinical Characteristics, Treatment Options, and Outcomes - a Rare Cancer Network Study

WOS: 000276245900004PubMed ID: 20389142Background: To evaluate the clinical characteristics, contemporary treatment options, and outcome of prostatic duct adenocarcinoma (PDA), we initiated a Rare Cancer Network (RCN) study. Materials and Methods: Six member institutions of the RCN collected clinical data on 31 patients. Treatment consisted of definitive radiotherapy in 14 patients and radical prostatectomy in 16 patients. One patient was treated with androgen deprivation alone. The mean follow-up period was 56 months. Results: Of the 14 patients managed with radiotherapy, 1 patient developed bone metastases and died of prostate cancer, and 1 patient had a biochemical relapse 8 years after definitive radiotherapy. Of the 16 patients who underwent radical prostatectomy, 2 patients developed bone metastases, one of who died of disease. Three patients that relapsed after prostatectomy were successfully salvaged with radiotherapy. The patient that was treated with androgen deprivation alone developed bone metastases at 10 months, was treated with chemotherapy, and was alive after 22 months. Conclusions: Our results suggest that PDA is a cancer with a behavior similar to that of high Gleason grade acinar carcinoma. Good local control can be achieved by either radiation or surgery. Postoperative radiotherapy seems to work as an adjuvant or salvage treatment, and most tumors appear to respond to androgen deprivation