15 research outputs found
Estimating radiation therapy toxicity and tolerability with comprehensive assessment parameters in geriatric cancer patients.
Cancer prevalance and incidence is increasing with aging of populations and age is a critical factor in decision-making for anti-cancer treatment. However it is believed that chronological age is not enough to guide management in elderly cancer patients. Multidisciplinary evaluation and comprehensive geriatric assessment has gained importance regarding the treatment selection especially for definitive anti-cancer therapy recently. We here aimed to analyse the effect of the comprehensive geriatric assessment parameters on radiotherapy toxicity and tolerability in a series of geriatric cancer patients in Turkey
Is there any impact of PET/CT on radiotherapy planning in rectal cancer patients undergoing preoperative IMRT?
Background/aim: To investigate the effect of positron emission
tomography-computed tomography (PET/CT)-based contouring on dosimetric
parameters in rectal cancer patients undergoing preoperative
intensity-modulated radiation therapy (IMRT).
Materials and methods: Preoperative radiation therapy plans with
conformal radiotherapy (CRT) or IMRT were created and examined according
to the CT-and PET/CT-based contouring of 20 rectal cancer patients,
retrospectively.
Results: The target volumes delineated with PET/CT were significantly
larger than the volumes created by CT (P = 0.043). Dose delivered to
98\% of the planning target volume was high in IMRT planning contouring
with CT and PET/CT compared with CRT planning, but the difference was
not statistically significant (P = 0.056). Percent volumes receiving
105\% of dose and 110\% of dose were low in IMRT planning when compared
with CRT (P < 0.0001 and P = 0.044, respectively). The volumes receiving
45 Gy for the small intestine, femur heads, and bladder and the maximum
dose received by the bladder were significantly lower in IMRT.
Conclusion: We showed that the target volumes created with PET/CT are
significantly larger than the target volumes created with CT and that
IMRT provides lower radiation exposure to the tumor-free tissues
compared to the CRT planning. The dosimetric results primarily favor
IMRT planning in rectal cancer patients and consequently present the
significant alteration in target volumes
Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma.
To investigate high conformality on target coverage and the ability on creating strict lung dose limitation of intensity-modulated radiation therapy in malignant pleural mesothelioma
Circulating gelatinases are not prognostic of treatment response and survival in locally advanced rectal cancer patients undergoing preoperative chemoradiotherapy
Purpose: To investigate whether the serum levels of matrix
metalloproteinases (MMPs) are predictive on treatment response and
survival in locally advanced rectal cancer (LARC) patients undergoing
preoperative chemoradiotherapy.
Patients and Methods: Serum MMP-2 and MMP-9 was analyzed by
enzyme-linked immunosorbent assay and obtained before, midway, and
1-month after the end of preoperative radiotherapy treatment. The
prognostic significance of serum MMP-2 and MMP-9 levels and their
association with other pathological findings for LARC patients were
evaluated.
Results: Serum levels of MMP-2 or MMP-9 were found to decrease with
increasing clinical stage and negative correlation was statistically
significant (P < 0.05). There was no statistically significant
difference in tumor response and survival between the low and high MMP-2
and MMP-9 groups. MMP-2 and MMP-9 were not correlated with
local-regional recurrence.
Conclusions: We propose that serum levels of MMP-2 and MMP-9 are not
predictive on treatment response and survival in LARC patients
Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma
Purpose: To investigate high conformality on target coverage and the
ability on creating strict lung dose limitation of intensity-modulated
radiation therapy in malignant pleural mesothelioma.
Patients and Methods: Twenty-four radiation therapy plannings were
evaluated and compared with dosimetric outcomes of conformal radiation
therapy and intensity-modulated radiation therapy. Hemithoracal
radiation therapy was performed on 12 patients with a fraction of 1.8 Gy
to a total dose of 50.4 Gy. All organs at risk were contoured.
Radiotherapy plannings were differed according to the technique;
conformal radiation therapy was planned with conventionally combined
photon-electron fields, and intensity-modulated radiation therapy was
planned with 7 to 9 radiation beam angles optimized in inverse planning.
Strict dose-volume constraints were applied.
Results: Intensity-modulated radiation therapy was statistically
superior in target coverage and dose homogeneity (intensity-modulated
radiation therapy-planning target volume 95 mean 100\%; 3-dimensional
conformal radiation therapy-planning target volume 95 mean 71.29\%, P =
.0001; intensity-modulated radiation therapy-planning target volume 105
mean 11.14\%; 3-dimensional conformal radiation therapy-planning target
volume 105 mean 35.69\%, P = .001). The dosimetric results of the
remaining lung was below the limitations on intensity-modulated
radiation therapy planning data (intensity-modulated radiation
therapy-lung mean dose mean 7.5 {[}range: 5.6\%-8.5\%];
intensity-modulated radiation therapy-lung V5 mean 55.55\% {[}range:
47\%-59.9\%]; intensity-modulated radiation therapy-lung V20 mean 4.5\%
{[}range: 0.5\%-9.5\%]; intensity-modulated radiation therapy-lung V13
mean 13.43\% {[}range: 4.2\%-22.9\%]).
Conclusion: With a complex and large target volume of malignant pleural
mesothelioma, intensity-modulated radiation therapy has the ability to
deliver efficient tumoricidal radiation dose within the safe dose limits
of the remaining lung tissue
Prognostic significance of early complete response in patients with locally advanced rectal cancer undergoing preoperative chemoradiotherapy: Multicentric study of Turkish Society for Radiation Oncology Group (TROD)
22nd National Cancer Congress -- APR 19-23, 2017 -- Antalya, TURKEYWOS: 000541436400004PubMed: 32519956Background/Aims: To assess the effect of various parameters on the oncologic outcomes, including the time interval between therapy and surgery (S) in locally advanced rectal cancer (LARC) patients receiving preoperative chemoradiotherapy (CRT). Materials and Methods: the data of 914 LARC patients who received preoperative CRT between 1994 and 2015 were collected retrospectively. Patients received 45-50.4 Gy RT with 5FU based chemotherapy (CT). They all underwent radical resection followed by maintenance CT. Clinical and pathologic variables were compared between the pCR and no-pCR groups. Survival was estimated by the Kaplan-Meier method and Cox proportional hazard model was used in multivariate analysis. Results: After median follow-up of 60.5 (range=12-297.6) months, median overall survival (OS) was 58.75 months and disease-free survival (DFS) 53.32 months. pCR was observed in 18.9% of all cases. pCR, lymphovascular invasion and metastatic lymph node ratio (mLNR) were significantly associated with OS and DFS on multivariate analysis. the 5-year OS and DFS rates were better in pCR group (95.3% vs 80.7% for OS, p<0.0001 and 87.4% vs 71% for DFS, p<0.0001). pCR patients with 4-8 weeks interval had lower rates of distant metastasis (9% vs 20%, p=0.01) and any recurrences (13.6% vs 29.6%, p=0.001) than the remaining. Both OS and DFS were better in favor of pCR achieved at 4-8 week interval time (p<0.0001 for each). Conclusion: pCR after preoperative CRT in LARC correlated with better oncologic outcome. the best OS and DFS durations were achieved in patients who experienced pCR after 4-8-weeks interval before surgery
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