Three-Dimensional Conformal and Intensity Modulated Dynamic Radiotherapy in Juvenile Nasopharyngeal Angiofibroma

Objective: Juvenile Nasopharyngeal Angiofibroma (JNA) is a benign neoplasm with a high vascularity component, greater craniofacial involvement in adolescent patients, and aggressive local behaviour. In unresectable patients, radiotherapy is a therapeutic option for local control. Our aim in this study was to analyze the clinical benefit and local control provided by two modalities of radiotherapy: the Three-Dimensional Conformal (3DC) technique and volumetric modulated arc therapy (VMAT), applied to pediatric patients with JNA considered unresectable and non-recurrent. Methods: In retrospective study, the information was recorded from pediatric patients with a diagnosis of non-recurrent and unresectable JNA treated with radiotherapy at the Oncology Hospital of the National Medical Center SXXI of Mexico City, from March 2010 to March 2021. Radiotherapy management and its association with clinical outcomes of tumour control, and symptoms were assessed. In addition, an evaluation of acute and chronic toxicity was performed. Results: It was found that the median age was 14 years. 9 patients (37.5%) underwent 3DC and 15 (62.5%) VMAT. In terms of local control, and progression-free survival, we did not find significant difference between radiotherapy modalities (p ≤ 0.57). Acute toxicity for both modalities presented statistical differences for radio epithelitis (p = 0.03). Only Grade I and II radiation-induced acute toxicity was observed. Regarding chronic toxicity, statistical significance was observed for craniofacial hypoplasia, in relation to its absence in the VMAT group (p = 0.001). Conclusion: The VMAT presents improvements in dosimetry parameters that improve patient toxicity. In both techniques adequate tumour control was observed, however, the rarity of the disease is a limitation to establish the most appropriate therapeutic technique.

Stereotactic conformal radiotherapy of hepatic metastases:clinical analysis of 8 cases

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Dosimetric study of five-field intensity-modulated radiotherapy compared with conventional three-dimensional conformal radiotherapy for rectal cancer

Objective： The aim of the study was to compare the difference of dose distribution in clinical target volume and organ at risk （OAR） between five-field intensity-modulated radiotherapy （IMRT） and conventional three-dimensional conformal radiotherapy （3DCRT） in the radiotherapy of rectal cancer. Methods： Fifteen patients with rectal cancer treated with radio- therapy （RT） were retrospectively analyzed. Among the patients, seven received RT preoperatively and 8 postoperatively. The target volume and the OARs such as the small bowel, bladder and femoral heads were contoured for each patient. 3DCRT-plan and IMRT-plan were performed for each patient respectively, with the prescribed dose covering at least 95% of the planning target volume （PTV）. The conformity index （CI） and homogeneity index （HI） were used for evaluation of the dose distribution in the target volume, and the Dx% （the lowest dose to the x% volume of the OARs that received the highest dose of irradiation） and the mean dose were used for evaluation of the dose to OARs. Paired-T test was used for companson of the difference between the two plans. Results： In the IMRT-plan and 3DCRT-plan, the CI were 0.94 and 0.87 （P = 0.000） and the HI were 1.13 and 1.17, respectively （P = 0.001）. For small bowel, the D30%, D50% and the mean dose were 19.67 Gy, 15.13 Gy and 18.81 Gy in the IMRT-plan and 25.20 Gy, 22.20 Gy and 22.89 Gy in the 3DCRT-plan, respectively （P 〈 0.001 for all pairs of parameters）. For bladder, the D30%, D50%, and the mean dose were 24.80 Gy, 34.20 Gy and 28.70 Gy in the IMRT- plan, and 35.07 Gy, 44.67 Gy and 35.68 Gy in the 3DCRT-plan, respectively （P 〈 0.001 for all pairs of parameters）. For femoral heads, the D5% in the IMRT-plan and 3DCRT-plan were 40.6 Gy and 40.47 Gy, respectively （P = 0.936）, and the mean dose were 30.14 Gy and 25.57 Gy, respectively （P = 0.001）. Conclusion： Five-field IMRT-plan is better than 3DCRT-plan in the conformity and the dose homogeneity within target volume and also better in sparing the small bowel and bladder.

Clinical Research on Three-Dimensional Conformal Radiotherapy of Non-Small Cell Lung Cancer

OBJECTIVE To investigate the clinical efficacy and toxic effect of the 3-dimensional conformal radiation therapy （3DCRT） for non- small cell lung cancer （NSCLC）. METHODS Fifty-two patients with the Stage-I and IV NSCLC were treated with 3DCRT. Cross analysis of the clinical data was conducted in the comparison between the 52 cases with 3DCRT and the other 50 cases with the conventional radiation therapy （CRT）. In the 3DCRT group, only the primary tumor and positive lymph-node draining area were included in the clinical target area, setting 4 to 6 coplanar or non-coplanar irradiation fields, with 2 Gy or 3 Gy/fraction, 1 fraction a day and 5 fractions per week. The total dose ranged from a test dose （DT） of 66 Gy to 72 Gy. In the CRT group, the field area contained the primary tumor plus the homolateral hilum of the lung, the mediastinum superior or hol-mediastinum, and opposed anteroposterior irradiation. When the dosage reached DT 36-40 Gy, an oblique portal administered radiation was conducted in order to avoid injuring the spinal cord. The DT was 1.8-2.0 Gy/fraction, 1 fraction a day, 5 fractions per week, with a total dose of 60 Gy to 70 Gy. RESULTS The therapeutic effect （CR ＋ PR） was 90.4% in the 3DCRT group, and was 72% in the CRT group. There was statistically significant difference between the two groups, P 〈 0.01. There was a clinical symptom improvement attained by 96.5% and 86.4% respectively in the two groups, and there was a statistically significant difference between the groups, P 〈 0.01. The 6-month, 1 and 2-year overall survival rates were 92.3%, 75.0% and 42.3% in the 3DCRT group, and 76%, 60% and 30% in the CRT group, respectively. There was a significant difference in the 6-month overall survival rate between the groups, P 〈 0.05. There was no obvious significant difference in the 1 and 2-year overall survival rates between the two groups, P 〉 0.05. The toxic reaction was 12.5% and 23.7% respectively in the 3DCRT and CRT groups. Acute radioactive esophagitis and leucopenia were markedly lower in the 3DCRT group than in the CRT group. There was a statistically significant difference between the groups, P 〈 0.05. No toxic reaction of Stage-III and over was found in the 3DCRT group during radiation therapy. CONCLUSION The 3DCRT method has a satisfactory shortterm efficacy and improvement of clinical symptoms in treating NSCLC, with a mild toxic reaction and good tolerance in patients. It can be used for enhancing the tumor-control rate and bettering the quality of life.

Evaluation of whole-course three-dimensional conformal radiotherapy combined with late-course accelerated hyperfractionated radiotherapy for esophageal carcinoma patients

Objective： The aim of the study was to evaluate the therapeutic effect and safety of whole-course three-dimensional conformal radiotherapy （3DCRT） combined with late-course accelerated hyperfractionated radiotherapy （LCAFR） on patients with esophageal carcinoma. Methods： one hundred and one patients with esophageal carcinoma were divided into two groups. Observing group （49 cases） were treated by whole-course 3DCRT. Patients in control group （52 cases） were treated by conventional radiotherapy. Clinical efficiencies and radiation toxicities were compared between two groups. Results： The side effects including radiation esophagitis （63.2%） and tracheitis （49.0%） decreased in observing group, but there was no significant difference between two groups （69.2% and 55.7% in controls）. The 1-, 2-and 3-year tumor local control rates and overall survival rates in the observing group were significantly improved compared with the control group, being respectively 87.8%, 75.5%, 63.3% vs 71.2%, 55.8%, 42.3% and 85.7%, 71.4%, 46.7% vs 69.2%, 51.9%, 26.9% （all P 0.05）. Conclusion： The therapeutic effect of whole-course 3DCRT combined with LCAFR for esophageal carcinomas is superior to conventional radiotherapy.

Clinical study of three dimensional conformal radiotherapy combined with intracavitary brachytherapy in the treatment of cervical cancer

Objective: The aim of our study was to evaluate the outcome and complications of cervical cancer patients undergoing conventional intracavitary brachytherapy (ICBT) treated with 3D-conformal radiotherapy (3DCRT). Methods: Sixty cervical cancer patients were divided randomly into the conformal group and the conventional group. Thirty patients treated with 3D-conformal radiotherapy in the 3DCRT group, when the whole pelvic received DT 40 Gy, a planning CT scan of each patient was obtained and the second 3DCRT therapy plan was taken. Then, continued to irradiate to 50 Gy. At last, 3DCRT was boosted at local involved volumes to the total dose of 60 Gy. When 3DCRT was combined with intracavitary brachytherapy, the dose of brachytherapy to point A was 30 Gy/5 fractions. In the conventional group, after a total tumor dose of 40 Gy was delivered by the whole pelvic irradiation, the four-field technique was used to irradiate the total pelvic and regional nodes (median dose of 10 Gy), and the involved volumes were boosted to 60 Gy and the dose of brachytherapy to point A was 30 Gy-36 Gy/5-6 fractions. Moreover, both groups were combined with intracavitary brachytherapy respectively. Results: The 1, 2, 3-year survival rates for the 3DCRT group and the conventional group were 96.7%, 93.3%, 90.0% and 86.6%, 76.7%, 70% respectively (P = 0.04, P = 0.02 and P = 0.02). There was a statistically significant difference between the two groups. Compared to the two groups each other in toxic effects, except for the I-II grade rectal and bladder reaction and pelvic fibrosis which was lower in the 3DCRT group (P = 0. 007, P = 0. 006 and P = 0. 015), the side effects were similar and well tolerated in two groups. Conclusion: The all-course 3DCRT combined with intracavitary brachytherapy can be considered as an effective and feasible approach to cervical cancer and may significantly improve the survival rate and reduce the late toxicity. This new role for 3DCRT merits need further evaluation with large patient numbers and longer follows up.

Dosimetric study comparing intensity modulated and conformal pelvic radiotherapy boost plans in locally advanced cancer cervix in NCI-Cairo

Objective:This study was to compare 5 field conformal technique to the intensity modulated radiotherapy (IMRT) 8 fields technique in boosting locally advanced cancer cervix cases after external beam radiotherapy with respect to target volume coverage and dose to normal tissues. Methods:We conducted a single institutional comparative dosimetric analysis of 10 patients with cancer cervix who was presented to radiotherapy department in National Cancer Institute, Cairo in period between June 2012 to September 2012 and received a CRT boost in the place of planned brachytherapy after large field pelvic radiotherapy (PRT) with concurrent chemotherapy were retrospectively identified. All tumors were situated in the low central pelvis. Two plans were done for every patient; one using the 8 fields IMRT and the second one using 5 fields' 3DCRT the two techniques were then compared using dose volume histogram (DVH) analysis for the PTV, bladder, rectum and both femoral heads. Results:Comparing different DVHs, it was found that the planning target volume (PTV) was adequately covered in both plans while it was demonstrates that the 8 fields IMRT technique carried less doses reaching OARs (rectum, bladder, both femoral heads). Conclusion:From the present study, it is concluded that IMRT technique spared more efficiently OARs than CRT technique but both techniques covered the PTV adequately so whenever possible IMRT technique should be used.

Effects of three-dimensional conformal radiotherapy on the esophageal carcinoma

Objective： Radiation therapy is an important component of the multidisciplinary management of esophageal carcinoma. Three-dimensional conformal radiation therapy requires the precise definition of the target volume. We aimed to compare the treatment results and radiation toxicities between three-dimensional conformal radiotherapy （3D-CRT） and conventional radiotherapy （CR） for patients with cervical and thoracic esophageal carcinoma. Methods： From June 2004 to December 2006, a random study was performed on 106 patients treated with 3D-CRT or CR, 53 patients in each group. The patients in CR group received conventional radiotherapy in 2.0 Gy/f, 5 f/week and total dose was 66-70 Gy in 6.5 or 7 weeks. The patients in 3D-CRT group were treated by 3D-CRT in 2.0 Gy/f, 5 f/week and total dose was 64-70 Gy in 6 weeks. The local control rates, survival rates and radiation toxicities for the two groups were investigated. Results： The 1-year and 3-year local control rates were 83.0% and 60.4% in 3D-CRT group and 64.2% （x^2 = 4.853, P = 0.028） and 32.1% （x^2 = 9.812, P = 0.002） in CR group. The 1-year and 3-year survival rates were 73.6% and 50.9% in 3D-CRT group and 54.7% （x^2 = 4.102, P = 0.043） and 32.1% （x^2 = 3.886, P = 0.049） in CR group. Between the two groups, there was no significant difference in radiation toxicities. Conclusien： The 1-year and 3-year local control rates and survival rates of patients with esophageal carcinoma treated by 3D-CRT is superior to CR. However, longer-term results and radiation toxicity need further study which involves more patients and prolonged follow-up.

3D conformal radiotherapy combined with transcatheter arterial chemoembolization for hepatocellular carcinoma

AIM: To compare transcatheter arterial chemoembolization (TACE) and 3D conformal radiotherapy (3D-CRT) with TACE monotherapy in hepatocellular carcinoma (HCC). METHODS: We searched all the eligible studies from the Cochrane Library, PubMed, Medline, Embase, and CNKI. The meta-analysis was performed to assess the survival benefit, tumor response, and the decline in alpha-fetoprotein (AFP) level. According to the heterogeneity of the studies, pooled OR with 95% CI were calculated using the fixed-effects or random-effects model. An observed OR > 1 indicated that the addition of 3D-CRT to TACE offered survival benefits to patients that could be considered statistically significant. Statistical analyses were performed using Review Manager Software. RESULTS: Ten studies met the criteria to perform a meta-analysis including 908 HCC participants, with 400 patients in the TACE/3D-CRT combination group and 508 in the TACE alone group. TACE combined with 3D-CRT significantly improved 1-, 2- and 3-year overall survival compared with TACE monotherapy (OR = 1.87, 95% CI: 1.37-2.55, P < 0.0001), (OR = 2.38, 95% CI: 1.78-3.17, P < 0.00001) and (OR = 2.97, 95% CI: 2.10-4.21, P < 0.00001). In addition, TACE plus 3DCRT was associated with a higher tumor response (complete remission and partial remission) (OR = 3.81; 95% CI: 2.70-5.37; P < 0.00001), and decline rates of AFP level (OR = 3.24, 95% CI: 2.09-5.02, P < 0.00001). CONCLUSION: This meta-analysis demonstrated that TACE combined with 3D-CRT was better than TACE monotherapy for patients with HCC, which needs to be confirmed by large multicenter trials. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

Late course three-dimensional conformal radiotherapy for esophageal carcinoma

Objective： The aim of our study was to evaluate the clinical results and acute side effects of late course three-dimensional conformal radiotherapy （3DCRT） for esophageal carcinoma. Methods： From January 2004 to October 2006, 70 patients with esophageal carcinoma received late course 3DCRT. Their clinical data were analyzed retrospectively. The short-term clinical results, acute side effects, local control rates and survival rates were evaluated. Results： The complete response rate was 62.9%, partial response rate was 35.7%, and the overall response rate was 98.6%. The 1-, 2-and 3-year local control rates were 77.1%, 51.4% and 45.7%, respectively. The 1-, 2-and 3-year overall survival rates were 75.7%, 54.3% and 38.6%, respectively. The median survival time was 26 months. Conclusion： The technique of late course 3DCRT is an effective treatment for esophageal carcinoma and tend to improve the overall survival rate.

Three-Dimensional Conformal Radiotherapy for Rectal Cancer and the Changes in Cancer Multi-biomarkers

OBJECTIVE To investigate the clinical efficacy of three-dimensional conformal radiotherapy （3D-CRT） for locally advanced or postoperatively relapsed rectal cancer, and to examine the changes in cancer multi-biomarkers. METHODS Sixty patients with locally advanced or postoperatively relapsed rectal cancer were randomly divided into two groups after 40 Gy external radiation, namely a late-course 3D-CRT group and a conventional radiotherapy group that served as the control. There were 30 patients in each group. For patients in the 3D-CRT group, multi-biomarkers were measured before and after radiotherapy and after relapse. RESULTS Response rates in the 3D-CRT and the control groups were 86.7% （26/30） and 70% （21/30） respectively, without a significant difference （P〉0.05）. The 1-, 2- and 3-year survival rates were 80%, 53.3% and 36.7% in the 3D-CRT group; in the control group the rates were 56.7%, 40% and 13.3% respectively, with a significant difference （P=0.0213）. CEA, CA19-9, CA242 and FER decreased after radiotherapy in the 3D-CRT group, P〈0.01, indicating a significant difference. The values after relapse were higher than those without relapse, P〈0.01, indicating a significant difference. CONCLUSION Conventional radiotherapy with a 3D-CRT boost gives better therapeutic effect to patients with locally advanced or postoperatively locally relapsed rectal cancer. A multi-biomarker protein chip diagnosis system can be utilized as an effective tool to determine the therapeutic effect and prognosis.

A study of transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy for local advanced pancreatic cancer

Objective: To evaluate the clinical effect of transarterial infusion chemotherapy of gemcitabine plus three dimen- sional conformal radiotherapy on patients with local advanced pancreatic cancer. Methods: Fifty-one patients with local ad- vanced pancreatic cancer from June 2002 to February 2004 were enrolled, twenty-four patients of combined group were treat- ed with transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy, while twenty-seven patients of control group were treated only with transarterial infusion chemotherapy of gemcitabine. Results: There were significant statistical differences between two groups in clinical benefit response (91.7% versus 74.1%, P < 0.01) and overall remission rate (70.8% versus 33.3%, P < 0.01). The 6-month survival rate, 12-month survival rate and 24-month survival rate of combined group were 83.3%, 62.5% and 37.5% respectively, while that of control group were 55.6%, 33.3% and 11.1% respectively. This showed significant difference between the two groups. Conclusion: Transarterial infusion chemotherapy of gemcitabine plus three dimensional conformal radiotherapy may be better than single transarterial infusion chemotherapy of gemcitabine in improving survival rates and elongating survival time of patients with local advanced pancreatic cancer.

Concurrent gemcitabine and cisplatin combined with 3D conformal radiotherapy for stage III non-small cell lung cancer

Objective： To study the toxicities and efficacy of concurrent gemcitabine plus cisplatin combined with three-dimensional conformal radiotherapy for stage Ⅲ non-small cell lung cancer （NSCLC）. Methods： Thirty-six patients with pathologically diagnosed NSCLC received radiotherapy and concurrent chemotherapy. There were 22 patients with stage Ilia and 14 patients with IIIb. Radiotherapy was given a total of 60-70 Gy in conventional fractionation. Chemotherapy included gemcitabine （600 mg/m^2） and cisplatin （20 mg/m^2）, once per week. Results： Thirty-two patients received a total dose of 60-72 Gy. Two patients received 56 Gy and another two patients received 58 Gy. Thirty-four patients received 4-6 weeks of chemotherapy, while two patients received only 2 weeks of chemotherapy. The overall response rate （CR ＋ PR）, complete response rate （CR）, partially response rate （PR） were 83.3% （30/36）, 11.1% （4/36） and 72.2% （26/36） respectively. The median follow-up duration was 18.4 months. The 1- and 2-year overall survival rates were 77.8% （28/36） and 55.6% （20/36）, respectively. Conclusion： Concurrent gemcitabine and cisplatin combined with three-dimensional conformal radiotherapy for stage III non-small cell lung cancer is effective and well tolerated. Lone-term results need further study.

Clinical observation of gemcitabine and concomitant three-dimensional conformal radiotherapy in the treatment of locally advanced non-small cell lung cancer

Objective： To evaluate the clinical effect of gemcitabine and concurrent three-dimensional conformal radiation therapy （3D-CRT） for locally advanced non-small cell lung cancer （NSCLC）. Methods： From April 2002 to June 2005, 38 patients with inoperable stage Ⅲ NSCLC were treated with gemcitabine and 3D-CRT simultaneously. Chemotherapy consisted of intravenously gemcitabine 350 mg/m^2 on days 1, 8, 15, 22, 29, 36.3D-CRT was delivered up to a total dose of 60-64 Gy with a 2.0 Gy dose fraction per day, 5 days per week. Results： The overall response rates of primary tumor and mediastinum metastatic node were 86.8% （33/38） and 90.6% （29/32） respectively, and 91.7% （22/24） and 78.6% （11/14） for squamous cell carcinoma and adenocarcinoma respectively. The acute side effects of patients were mostly myelosuppression, nausea, vomiting, radiation-induced esophagitis and pneumonitis （RTOG 1/11）, however, all of them were cured. Conclusion： Concurrent application of gemcitabine and 3D-CRT can improve the overall response rate for locally advanced NSCLC without aggravating the side effects.

Stereotactic body radiotherapy in pancreatic adenocarcinoma

Background:Stereotactic body radiotherapy(SBRT)in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding tissue.This review aimed at the SBRT application in the treatment of pancreatic cancer.Data sources:We retrieved articles published in MEDLINE/PubMed from January 2017 to December 2022.Keywords used in the search included:“pancreatic adenocarcinoma”OR“pancreatic cancer”AND“stereotactic ablative radiotherapy(SABR)”OR“stereotactic body radiotherapy(SBRT)”OR“chemoradiotherapy(CRT)”.English language articles with information on technical characteristics,doses and fractionation,indications,recurrence patterns,local control and toxicities of SBRT in pancreatic tumors were included.All articles were assessed for validity and relevant content.Results:Optimal doses and fractionation have not yet been defined.However,SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to CRT.Furthermore,the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic adenocarcinoma.Conclusions:SBRT is an effective modality for patients with pancreatic cancer,supported by clinical practice guidelines as it has demonstrated good tolerance and good disease control.SBRT opens a possibility of improving outcomes for these patients,both in neoadjuvant treatment and with radical intent.

Stereotactic Radiotherapy Planning Using Modified Dynamic Conformal Arcs under Considering the Possibility for Amended Visual Organ Displacement Resulting from Early Tumor Shrinkage during Treatment for Perioptic Involvement of Myeloma

Treatment planning of radiotherapy for skull base involvement of multiple myeloma presenting with visual impairment should be optimized to alleviate symptoms immediately and sufficiently while minimizing toxicities. Two such patients were treated with fractionated stereotactic radiotherapy by using Dynamic Conformal Arcs (DCA) under image guidance based on bony anatomy alignment. DCA planning was optimized after considering the possibility for amendment of visual organ displacement resulting from early tumor shrinkage during treatment through 1) the use of a target volume with modified geometry as a surrogate for leaf adaptation in order to improve target coverage, and 2) manual adjustment of a subset of leaf positions to reduce the dose gradient immediately inside the target boundary facing the visual organs and to eliminate an undesirable dose hotspot. In both cases, anticipated geometric changes in the target volume associated with improvement of visual organ displacement toward the target centroid were observed before the completion of treatment. Favorable visual functional outcomes as well as local tumor control were achieved during 14 months and 4 months follow-up periods. Notably, inexorable visual loss in one patient was fully reversed within one month after radiotherapy. We described the modification techniques for DCA planning in detail.

Management of Hepatocellular Carcinoma Patients with Portal Vein Thrombosis Using Three-Dimensional Conformal Radiotherapy

Objective: To determine the possible therapeutic gain of using three-dimensional conformal radiotherapy (3D-CRT) as a treatment option for portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC) and to evaluate the tolerance and toxicity of using such treatment. Materials and methods: Sixty two patients were enrolled in this prospective study between June 2013 and August 2015. The clinical target volume (CTV) was the PVTT and the prescribed dose was 50 Gy/25 fractions. The median follow-up time was 7.4 months. Results: The thrombus crude response rate was 40.4% and the only significant prognostic factor for response was the thrombus size. Responders had significant better survival compared to non-responders with a median survival of 12.5 and 8 months respectively (P Conclusions: The results of this study suggest that radiotherapy should be considered as a safe treatment option for HCC patients with PVTT. It is effective not only for PVTT local control but also for survival, although prospective randomized trials are needed to confirm these results.

Three-Tesla Magnetic Resonance and Computed Tomography Imaging in Three-Dimensional Conformal Radiotherapy for Localized Prostate Cancer

Aims and background: we evaluate CT-3Tesla MRI fusion in conformal radiotherapy for localized prostate cancer.Methods: 18 consecutive patients underwent a 3T MRI scan under radiotherapy planning conditions, after the CT scan. Bowel and bladder preparation were prescribed. CT and MR images were automatically fused;prostate and seminal vesicles were contoured on CT and on MRI, organs at risk were defined on CT-MRI fusion. Late rectal and sexual toxicity, differences in target volume between MRI and CT and differences in rectal and penile bulb dose distribution based on CT only or on CT-MRI fusion were evaluated.Results: one patient experienced a late rectal toxicity;no patient had sexual toxicity. The difference between the mean MRI and CT target volumes was statistically significant (p = 0.0001 paired Student's t-test). The dose-volume histogram (DVH) analysis shows a significant reduction of the dose received by the rectum and the penile bulb in MRI-plans compared to CT-plans.Conclusions: 3 Tesla MRI scan under radiotherapy planning conditions along with bowel preparation significantly improves the definition of the target volume sparing normal tissue irradiation.

The clinical observation of three-dimensional conformal radiotherapy combined with FOLFOX chemotherapy for rectal cancer of postoperative local recurrence

Objective The aim of this study was to explore the three-dimensional conformal radiotherapy combined with FOLFOX scheme chemotherapy in the treatment of postoperative recurrence of rectal cancer.

Evaluation of the optimal field arrangement for conformal radiotherapy for prostate cancer patients

Objective:The aim of this study was to evaluate the optimal field arrangement for conformal radiotherapy (CFRT) for prostate cancer patients.Methods:Thirty patients with prostate cancer of different grades and stages were treated with 3D conformal radiotherapy to minimize the dose to bladder,rectum and head of both femora using four fields (4F),five fields (5F),six fields (6F) and ARC techniques to minimize the risk of over dose to bladder,rectum and femoral heads.Patients received a total dose between 76 to 78 Gy given in 38 to 39 fractions over 7.5 to 8 weeks.Results:It was observed that V95,D95,D50 and D5 values for planning target volume (PTV) were comparatively higher when planned by 5 fields technique than when planned by fixed field technique (91%,91%,90% and 91.4% for skip-scan technique versus 85%,87%,86% and 88% by fixed field).The organs like rectum and urinary bladder get much higher dose when treated by fixed field techniques than rotation or 5 fields technique,when comparison was made for V95,V50 and DM values for rectum and urinary bladder obtained by 5 fields technique planning and 4/6 field planning,the value for 5 fields technique was found to be lower than 4/6 field technique (1%,70% and 51% versus 13%,91% and 55% for rectum and 4%,25% and 51% versus 16%,38% and 56% for urinary bladder respectively).Conclusion:Similarly for femoral heads,planning by full rotational technique had been observed to be beneficial as compared to when planning was done by fixed field technique (0%,0% and 29% versus 0%,1% and 28%).