32 research outputs found
Late gastrointestinal tissue effects after hypofractionated radiation therapy of the pancreas
Background
To consolidate literature reports of serious late gastrointestinal toxicities after hypofractionated radiation treatment of pancreatic cancer and attempt to derive normal tissue complication probability (NTCP) parameters using the Lyman-Kutcher-Burman model.
Methods
Published reports of late grade 3 or greater gastrointestinal toxicity after hypofractionated treatment of pancreatic cancer were reviewed. The biologically equivalent dose in 1.8 Gy fractions was calculated using the EQD model. NTCP parameters were calculated using the LKB model assuming 1–5 % of the normal tissue volume was exposed to the prescription dose with α/β ratios of 3 or 4.
Results
A total of 16 human studies were examined encompassing a total of 1160 patients. Toxicities consisted of ulcers, hemorrhages, obstructions, strictures, and perforations. Non-hemorrhagic and non-perforated ulcers occurred at a rate of 9.1 % and were the most commonly reported toxicity. Derived NTCP parameter ranges were as follows: n = 0.38–0.63, m = 0.48–0.49, and TD50 = 35–95 Gy. Regression analysis showed that among various study characteristics, dose was the only significant predictor of toxicity.
Conclusions
Published gastrointestinal toxicity reports after hypofractionated radiotherapy for pancreatic cancer were compiled. Median dose was predictive of late grade ≥ 3 gastrointestinal toxicity. Preliminary NTCP parameters were derived for multiple volume constraints
Neoadjuvant treatment of pancreatic adenocarcinoma: a systematic review and meta-analysis of 5520 patients
The investigation of 125I seed implantation as a salvage modality for unresectable pancreatic carcinoma
Are neoliberalist behaviours reflective of bullying? New perspectives on influences on sustainability and global citizenship
The global sustainability crisis facing humanity is a cultural crisis with neoliberal culture, the primary driver. The necessity for global change away from neoliberal systems is well established with cultural systems pursued through sustainability seen as the most viable options to alleviate this global crisis. Whilst the goals of neoliberalism and sustainability are systemic and universal, those implementing them work at a specific level with individuals, groups and/or collectives. The literature fails, however, to provide specific examples of why, on a practical level, social change agents often struggle to implement sustainability goals. One of the primary reasons for these struggles can be found in an examination of human behaviour, for instance personality types, group dynamics and/or interpersonal or group communication skills (or lack thereof). This exploratory paper will investigate the existence of a nexus between neoliberalist and adult bullying behaviours to initiate discussion on the barriers this combination may have on social change for sustainability and global citizenship. This examination is warranted as the propensity in the neoliberalist system to support the use of bullying behaviours by its advocates is a complex, nuanced and underresearched topic. There are implications here for policy development, social and urban planning, education and governance for sustainability and global citizenship
Outdoor Leisure and the Sustainability Agenda: Critical Pedagogy on Neo-liberalism and the Employment Obsession in Higher Education
Complete remission of pancreatic head desmoid tumor treated by COX-2 inhibitor—a case report
After cultural literacy: new models of intercultural competency for life and work in a VUCA world
Radiobiological model-based approach to determine the potential of dose-escalated robust intensity-modulated proton radiotherapy in reducing gastrointestinal toxicity in the treatment of locally advanced unresectable pancreatic cancer of the head
Comparison of different radiotherapy techniques for locally advanced pancreatic tumors
Radiotherapy (RT) associated with systemic therapy is the standard treatment for Locally Advanced Pancreatic Cancer (LAPC). The aim of this study was to compare the efficacy of different RT techniques using the clinical data reported in the literature. Clinical data was collected from scientific papers searched in the databases PubMed and ScienceDirect. Thirty-four documents published between 1997 and 2015 were found and met the inclusion criteria: locally advanced adenocarcinoma, unresectable and no metastasis. Values of Complete Response (CR), Partial Response (PR), Stable Disease (SD), Pro gression Disease, Progression Free Survival (PFS), and Overall Survival (OS) for Three-Dimensional Conformal Radiation Therapy (3DCRT), Intensity Modulated Radiation Therapy (IMRT) and Stereotactic Body Radiotherapy (SBRT) in the treatment of LAPC were collected. For all RT techniques, Response Rate (RR), defined as the sum of CR and PR, was for 3DCRT 25.2% ± 9.5 [range: 5.0%–49.0%], for IMRT 33.5% ± 10.5 [range: 10.6%–55.6%] and for SBRT 52.2% ± 17.7 [range: 13.3%–69.5%]. For all studied techniques, Local Control (LC), defined as the sum of RR and SD, ranged from 47% to 100%; PFS ranged from 4 to 12 months and OS ranged from 6 to 20 months. A significant improvement in overall response rate was obtained with SBRT compared to 3DRCT and IMRT. However, LC, PFS and OS were similar among the three RT techniques.info:eu-repo/semantics/publishedVersio