Alternating chemotherapy and fractionated radiotherapy were carried out in 32 patients with surgically proven unresectable primary liver cancer (PLC).After initial surgical intervention of hepatic artery ligation and ...Alternating chemotherapy and fractionated radiotherapy were carried out in 32 patients with surgically proven unresectable primary liver cancer (PLC).After initial surgical intervention of hepatic artery ligation and cannulation,the tumor war localized with silver clips.The cisplatin 20 mg was infused via a hepatic artery catheter per day on the first 3 consecutive days.Fractionated radiation(18MV straight linear accelerator)of 250 cGy,twice a day with an interval of 6 hours,was then followed on the 8th,9th and 10th days.The cycle was repeated 3 or 4 times.The shrinkage of tumors and decrease of AFP level were observed in 100%(32/32)and 5% (19/21)of the patients respectively.A second-stage resection was done in 37.5%(12/32)of the patients.The 1-,3- and 5-year survival rates after resection were 96.7% ,67.5% and 67. 5 % respectively.It is suggested that this modality is a choice of therapies which can convert some unresectable large PLC to resectable ones.展开更多
Background & Objective: Hypofractionation has been used in curative setting in breast conservative surgery, but still no adequate information about its application in the adjuvant setting after mastectomy in breas...Background & Objective: Hypofractionation has been used in curative setting in breast conservative surgery, but still no adequate information about its application in the adjuvant setting after mastectomy in breast cancer patients. The aim of this trial was to assess the efficacy and toxicity of hypofractionation radiotherapy (40 Gy in 15 fractions) in post mastectomy breast cancer patients and to compare these results with those of post mastectomy patients treated retrospectively by conventional radiotherapy (50 Gy in 25 fractions) as regard overall survival (OS), disease free survival (DFS), locoregional disease free survival (LDFS), and toxicities. Patients & Methods: One hundred post mastectomy breast cancer patients were included into this study, they were divided into 2 groups, the 1st included 50 patients treated prospectively with hypofractionated radiotherapy regimen (40 Gy in 15 fractions), and the 2nd (control group) included 50 patients treated retrospectively with conventionally fractionated radiotherapy regimen (50 Gy in 25 fractions). Results: The 2 year overall survival were 96% & 94% respectively (p = 0.7), while the disease free survival were 91% & 89.8%, respectively (p = 0.9), and the LDFS were 95.8% & 93.3%, respectively (p = 0.9), G1 acute dermatitis was observed in 22 (44%) & 25 (50%) patients in group I & II respectively, G2 in 8 (16%) & 10 (20%) patients respectively, no G4 skin toxicity was detected. Radiation pneumonitis was observed in 2 patients (4%) only in group II. Conclusion: post-mastectomy hypofractionated radiation therapy achieved comparable survival and toxicity to the conventionally fractionated radiotherapy with the advantage of reducing overall treatment time, treatment burden & cost.展开更多
Radiation therapy has a major role in the management of breast cancers.However,there is no consensus on how to irradiate and on volume definitions,and there are strong differences in strategies according to different ...Radiation therapy has a major role in the management of breast cancers.However,there is no consensus on how to irradiate and on volume definitions,and there are strong differences in strategies according to different centers and physicians.New treatment protocols and techniques have been used with the principal purpose of decreasing lung and heart toxicity and adapting radiation treatment to patients' anatomy.There is evidence that indicates internal mammary chain radiotherapy should be used carefully and that high quality techniques should be used for decreasing the dose delivered to the heart.This review of the literature presents the state of the art on breast cancer radiotherapy,with special focus on the indications,techniques,and potential toxicity.展开更多
Objective: To investigate the therapeutic effects of stereotactic radiotherapy for retroperitoneal metastatic tumor. Methods: From August 1997 to October 2004, 44 patients with retroperitoneal metastatic tumors were t...Objective: To investigate the therapeutic effects of stereotactic radiotherapy for retroperitoneal metastatic tumor. Methods: From August 1997 to October 2004, 44 patients with retroperitoneal metastatic tumors were treated with stereotactic radiotherapy. The planning target volume was encompassed by 90%–95% isodose line. Fractional dose was from 6 Gy to 8 Gy, and they were treated 2–3 times per-week and 4–8 times in all. The total radiation doses of PTV were from 32 Gy to 48 Gy. Re- sults: After the radiotherapy, the pain was obviously relieved in 81.8% patients. Three months after completion of radiotherapy passed and then, abdominal CT was performed to evaluate the results. The whole effective rate was 81.8% [CR 27.7% (12/44) and PR 54.5% (24/44)], and six months after radiotherapy, CR was 27.7% (12/44) and PR was 59.1% (26/44). The middle survival time was 12 months. Conclusion: It is suggested that stereotactic radiotherapy for retroperitoneal metastatic tumor is a safe and effective method.展开更多
Purpose: To prospectively analyze the inter-fractional motion of the prostate in patients with prostate cancer treated with intensity-modulated radiation therapy (IMRT) using image-guided radiotherapy (IGRT) with dail...Purpose: To prospectively analyze the inter-fractional motion of the prostate in patients with prostate cancer treated with intensity-modulated radiation therapy (IMRT) using image-guided radiotherapy (IGRT) with daily cone-beam computed tomography (CBCT) as part of a rescan protocol for large offset, and to evaluate the efficacy of our protocol. Materials and Methods: Eligible patients were treated with the following protocol: 1) magnesium oxide and dimethylpolysiloxane were administered to ensure that patients had regular bowel movements;2) the patients were instructed to have an appropriately distended bladder during the planning CT and daily irradiation;3) the daily CBCT image was fused with the planning CT image using the prostate outline;and 4) if large offset was recognized, a rescan CBCT image was obtained after appropriate countermeasures, such as the discharge of gas and defecation, and re-registration was performed. Three shifts for the inter-fractional motion of the prostate were analyzed, in the fractions which needed the CBCT rescan;the displacement data after the final rescan were used. Results: Sixty-one patients were eligible, and a total of 2302 fractions were available for the analysis. Rescans of the CBCT for large offset were performed in 113 (5%) of the 2302 fractions. After the first rescan, the large offset was resolved in 106 (94%) of the 113 fractions. Excessive rectal gas was the reason for the large offset in 94 (83%) of the 113 fractions. The total mean and standard deviation of the inter-fractional motion of the prostate in the AP, LR, and SI directions were 1.1 ± 2.4, -0.1 ± 2.3, and 0.7 ± 3.0 mm, respectively. Conclusion: Large offset was recognized in 5% of all fractions. Daily CBCT with our rescan protocol could resolve the large offset, which was mainly caused by excessive rectal gas, and it may therefore be promising to reduce the inter-fractional motion of the prostate.展开更多
This study compares and analyzes stereotactic radiotherapy using tomotherapy and linac-based fractionated stereotactic radiotherapy in the treatment of intra-cranial tumors,according to some cases.In this study,linac-...This study compares and analyzes stereotactic radiotherapy using tomotherapy and linac-based fractionated stereotactic radiotherapy in the treatment of intra-cranial tumors,according to some cases.In this study,linac-based fractionated stereotactic radiotherapy and tomotherapy treatment were administered to five patients diagnosed with intra-cranial cancer in which the dose of 18–20 Gy was applied on 3–5 separate occasions.The tumor dosing was decided by evaluating the inhomogeneous index （II） and conformity index （CI）.Also,the radiation-sensitive tissue was evaluated using low dose factors V1,V2,V3,V4,V5,and V10,as well as the non-irradiation ratio volume （NIV）.The values of the II for each prescription dose in the linacbased non-coplanar radiotherapy plan and tomotherapy treatment plan were （0.125±0.113） and （0.090±0.180）,respectively,and the values of the CI were （0.899±0.149） and （0.917±0.114）,respectively.The low dose areas,V1,V2,V3,V4,V5,and V10,in radiation-sensitive tissues in the linac-based non-coplanar radiotherapy plan fell into the ranges 0.3%–95.6%,0.1%–87.6%,0.1%–78.8%,38.8%–69.9%,26.6%–65.2%,and 4.2%–39.7%,respectively,and the tomotherapy treatment plan had ranges of 13.6%–100%,3.5%–100%,0.4%–94.9%,0.2%– 82.2%,0.1%–78.5%,and 0.3%–46.3%,respectively.Regarding the NIV for each organ,it is possible to obtain similar values except for the irradiation area of the brain stem.The percentages of NIV10%,NIV20%,and NIV30%for the brain stem in each patient were 15%–99.8%,33.4%–100%,and 39.8%–100%,respectively,in the fractionated stereotactic treatment plan and 44.2%–96.5%,77.7%–99.8%,and 87.8%–100%,respectively,in the tomotherapy treatment plan.In order to achieve higher-quality treatment of intra-cranial tumors,treatment plans should be tailored according to the isodose target volume,inhomogeneous index,conformity index,position of the tumor upon fractionated stereotactic radiosurgery,and radiation dosage for radiation-sensitive tissues.展开更多
文摘Alternating chemotherapy and fractionated radiotherapy were carried out in 32 patients with surgically proven unresectable primary liver cancer (PLC).After initial surgical intervention of hepatic artery ligation and cannulation,the tumor war localized with silver clips.The cisplatin 20 mg was infused via a hepatic artery catheter per day on the first 3 consecutive days.Fractionated radiation(18MV straight linear accelerator)of 250 cGy,twice a day with an interval of 6 hours,was then followed on the 8th,9th and 10th days.The cycle was repeated 3 or 4 times.The shrinkage of tumors and decrease of AFP level were observed in 100%(32/32)and 5% (19/21)of the patients respectively.A second-stage resection was done in 37.5%(12/32)of the patients.The 1-,3- and 5-year survival rates after resection were 96.7% ,67.5% and 67. 5 % respectively.It is suggested that this modality is a choice of therapies which can convert some unresectable large PLC to resectable ones.
文摘Background & Objective: Hypofractionation has been used in curative setting in breast conservative surgery, but still no adequate information about its application in the adjuvant setting after mastectomy in breast cancer patients. The aim of this trial was to assess the efficacy and toxicity of hypofractionation radiotherapy (40 Gy in 15 fractions) in post mastectomy breast cancer patients and to compare these results with those of post mastectomy patients treated retrospectively by conventional radiotherapy (50 Gy in 25 fractions) as regard overall survival (OS), disease free survival (DFS), locoregional disease free survival (LDFS), and toxicities. Patients & Methods: One hundred post mastectomy breast cancer patients were included into this study, they were divided into 2 groups, the 1st included 50 patients treated prospectively with hypofractionated radiotherapy regimen (40 Gy in 15 fractions), and the 2nd (control group) included 50 patients treated retrospectively with conventionally fractionated radiotherapy regimen (50 Gy in 25 fractions). Results: The 2 year overall survival were 96% & 94% respectively (p = 0.7), while the disease free survival were 91% & 89.8%, respectively (p = 0.9), and the LDFS were 95.8% & 93.3%, respectively (p = 0.9), G1 acute dermatitis was observed in 22 (44%) & 25 (50%) patients in group I & II respectively, G2 in 8 (16%) & 10 (20%) patients respectively, no G4 skin toxicity was detected. Radiation pneumonitis was observed in 2 patients (4%) only in group II. Conclusion: post-mastectomy hypofractionated radiation therapy achieved comparable survival and toxicity to the conventionally fractionated radiotherapy with the advantage of reducing overall treatment time, treatment burden & cost.
文摘Radiation therapy has a major role in the management of breast cancers.However,there is no consensus on how to irradiate and on volume definitions,and there are strong differences in strategies according to different centers and physicians.New treatment protocols and techniques have been used with the principal purpose of decreasing lung and heart toxicity and adapting radiation treatment to patients' anatomy.There is evidence that indicates internal mammary chain radiotherapy should be used carefully and that high quality techniques should be used for decreasing the dose delivered to the heart.This review of the literature presents the state of the art on breast cancer radiotherapy,with special focus on the indications,techniques,and potential toxicity.
文摘Objective: To investigate the therapeutic effects of stereotactic radiotherapy for retroperitoneal metastatic tumor. Methods: From August 1997 to October 2004, 44 patients with retroperitoneal metastatic tumors were treated with stereotactic radiotherapy. The planning target volume was encompassed by 90%–95% isodose line. Fractional dose was from 6 Gy to 8 Gy, and they were treated 2–3 times per-week and 4–8 times in all. The total radiation doses of PTV were from 32 Gy to 48 Gy. Re- sults: After the radiotherapy, the pain was obviously relieved in 81.8% patients. Three months after completion of radiotherapy passed and then, abdominal CT was performed to evaluate the results. The whole effective rate was 81.8% [CR 27.7% (12/44) and PR 54.5% (24/44)], and six months after radiotherapy, CR was 27.7% (12/44) and PR was 59.1% (26/44). The middle survival time was 12 months. Conclusion: It is suggested that stereotactic radiotherapy for retroperitoneal metastatic tumor is a safe and effective method.
文摘Purpose: To prospectively analyze the inter-fractional motion of the prostate in patients with prostate cancer treated with intensity-modulated radiation therapy (IMRT) using image-guided radiotherapy (IGRT) with daily cone-beam computed tomography (CBCT) as part of a rescan protocol for large offset, and to evaluate the efficacy of our protocol. Materials and Methods: Eligible patients were treated with the following protocol: 1) magnesium oxide and dimethylpolysiloxane were administered to ensure that patients had regular bowel movements;2) the patients were instructed to have an appropriately distended bladder during the planning CT and daily irradiation;3) the daily CBCT image was fused with the planning CT image using the prostate outline;and 4) if large offset was recognized, a rescan CBCT image was obtained after appropriate countermeasures, such as the discharge of gas and defecation, and re-registration was performed. Three shifts for the inter-fractional motion of the prostate were analyzed, in the fractions which needed the CBCT rescan;the displacement data after the final rescan were used. Results: Sixty-one patients were eligible, and a total of 2302 fractions were available for the analysis. Rescans of the CBCT for large offset were performed in 113 (5%) of the 2302 fractions. After the first rescan, the large offset was resolved in 106 (94%) of the 113 fractions. Excessive rectal gas was the reason for the large offset in 94 (83%) of the 113 fractions. The total mean and standard deviation of the inter-fractional motion of the prostate in the AP, LR, and SI directions were 1.1 ± 2.4, -0.1 ± 2.3, and 0.7 ± 3.0 mm, respectively. Conclusion: Large offset was recognized in 5% of all fractions. Daily CBCT with our rescan protocol could resolve the large offset, which was mainly caused by excessive rectal gas, and it may therefore be promising to reduce the inter-fractional motion of the prostate.
基金Supported by Nuclear R&D Programs from Ministry of Education,Science,and Technology in Republic of Korea
文摘This study compares and analyzes stereotactic radiotherapy using tomotherapy and linac-based fractionated stereotactic radiotherapy in the treatment of intra-cranial tumors,according to some cases.In this study,linac-based fractionated stereotactic radiotherapy and tomotherapy treatment were administered to five patients diagnosed with intra-cranial cancer in which the dose of 18–20 Gy was applied on 3–5 separate occasions.The tumor dosing was decided by evaluating the inhomogeneous index （II） and conformity index （CI）.Also,the radiation-sensitive tissue was evaluated using low dose factors V1,V2,V3,V4,V5,and V10,as well as the non-irradiation ratio volume （NIV）.The values of the II for each prescription dose in the linacbased non-coplanar radiotherapy plan and tomotherapy treatment plan were （0.125±0.113） and （0.090±0.180）,respectively,and the values of the CI were （0.899±0.149） and （0.917±0.114）,respectively.The low dose areas,V1,V2,V3,V4,V5,and V10,in radiation-sensitive tissues in the linac-based non-coplanar radiotherapy plan fell into the ranges 0.3%–95.6%,0.1%–87.6%,0.1%–78.8%,38.8%–69.9%,26.6%–65.2%,and 4.2%–39.7%,respectively,and the tomotherapy treatment plan had ranges of 13.6%–100%,3.5%–100%,0.4%–94.9%,0.2%– 82.2%,0.1%–78.5%,and 0.3%–46.3%,respectively.Regarding the NIV for each organ,it is possible to obtain similar values except for the irradiation area of the brain stem.The percentages of NIV10%,NIV20%,and NIV30%for the brain stem in each patient were 15%–99.8%,33.4%–100%,and 39.8%–100%,respectively,in the fractionated stereotactic treatment plan and 44.2%–96.5%,77.7%–99.8%,and 87.8%–100%,respectively,in the tomotherapy treatment plan.In order to achieve higher-quality treatment of intra-cranial tumors,treatment plans should be tailored according to the isodose target volume,inhomogeneous index,conformity index,position of the tumor upon fractionated stereotactic radiosurgery,and radiation dosage for radiation-sensitive tissues.
