Objective： To report the comparative effect of combined medroxyprogesterone acetate （MPA） and external beam pelvic radiotherapy （EBRT） with EBRT alone on local or distant recurrences, overall survival and treatme...Objective： To report the comparative effect of combined medroxyprogesterone acetate （MPA） and external beam pelvic radiotherapy （EBRT） with EBRT alone on local or distant recurrences, overall survival and treatment related toxicities in patients with stage Ic grade 3 endometrial cancer. Methods： A retrospective review of 80 International Federation of Gyne- cology and Obstetrics （FIGO） stage Ic grade 3 endometrial carcinoma patients treated between October 1994 and October 2004 at Renmin Hospital, Wuhan University, China was performed. All patients underwent surgery, of which 40 patients in arm I received combined MPA and EBRT while in arm II 40 patients received only adjuvant EBRT after surgery. The median dose of EBRT in arm I was 50 Gy （range 36-54 Gy） and in arm Ⅱ was 45.2 Gy （range 43.2-50.4 Gy）. Multivariate analysis was performed for the prognostic factors and Kaplan-Meier method was used for overall survival. Results： Of the 80 eligible patients, 40 in each group could be evaluated. The follow-up times ranged from 4-98 months with a median of 45 months. The overall survival rates at five years were 73% among patients treated with combined MPA and EBRT and 28.2% among patients treated with EBRT alone （P 〈 0.001）. The rate of distant metastasis was significantly higher among patients treated with EBRT alone group than combined MPA and EBRT （55% vs 25%, P = 0.006） while no difference in Ioco regional recurrence rates was observed in both treatment groups. Most of the side effects observed in the combined MPA and EBRT group. Age （P 〈 0.001） and the presence of progesterone receptors （P = 0.003） were independent significant prognostic factors for overall surviva} in multiple regression analysis. Conclusion： We has been concluded that the addition of progestagen to external beam pelvic radiotherapy significantly improved survival and reduced distant metastasis among women with stage Ic grade 3 endometrial cancer.展开更多
AIM: To determine the survival of advanced pancreatic cancer patients treated with intraoperative radiotherapy (IORT) combined with external beam radiation therapy (EBRT) following internal drainage (cholecystojejunos...AIM: To determine the survival of advanced pancreatic cancer patients treated with intraoperative radiotherapy (IORT) combined with external beam radiation therapy (EBRT) following internal drainage (cholecystojejunostomy or choledochojejunostomy). METHODS: Eighty-one patients with advanced pancreatic cancer who received IORT combined with EBRT following internal drainage (ID) between 1996 and 2001 were retrospectively analyzed. Among the 81 patients, 18 underwent ID+IORT, 25 ID+IORT+EBRT (meanwhile, given 5-Fu 300 mg/m^2 iv drip, 2f/w), 16 EBRT, 22 had undergone simple internal drainage. The IORT dose was 15-25Gy in a single fraction. The usual EBRT dose was 30-40Gy with a daily fraction of 1.8-2.0 Gy. RESULTS: The complete remission rate, partial remission rate of patients with backache and abdominal pain treated with ID+IORT were 55.5%, 33.3% respectively. Alleviation of pain was observed 2 or 3 wk after IORT. The median survival time (MST) of ID+IORT group was 10.7 mo. The pain remission rate of patients treated with ID+IORT+EBRT was 92%, and their MST was 12.2 mo. The MST of patients treated with EBRT and simple internal drainage was 5.1 mo and 7.0 mo, respectively. The survival curve of ID+IORT group and ID+IORT+EBRT group was significantly better than that of EBRT group (P<0.05). The difference between the ID+IORT+EBRT group and ID group was significant (P<0.05). CONCLUSION: IORT combined with EBRT following internal drainage can alleviate pain, improve quality of life and prolong survival time of patients with advanced pancreatic cancer.展开更多
The additive manufacturing(AM)process plays an important role in enabling cross-disciplinary research in engineering and personalised medicine.Commercially available clinical tools currently utilised in radiotherapy a...The additive manufacturing(AM)process plays an important role in enabling cross-disciplinary research in engineering and personalised medicine.Commercially available clinical tools currently utilised in radiotherapy are typically based on traditional manufacturing processes,often leading to non-conformal geometries,time-consuming manufacturing process and high costs.An emerging application explores the design and development of patient-specific clinical tools using AM to optimise treatment outcomes among cancer patients receiving radiation therapy.In this review,we:•highlight the key advantages of AM in radiotherapy where rapid prototyping allows for patient-specific manufacture•explore common clinical workflows involving radiotherapy tools such as bolus,compensators,anthropomorphic phantoms,immobilisers,and brachytherapy moulds;and•investigate how current AM processes are exploited by researchers to achieve patient tissuelike imaging and dose attenuations.Finally,significant AM research opportunities in this space are highlighted for their future advancements in radiotherapy for diagnostic and clinical research applications.展开更多
Background: Ewing sarcoma is the most common primary malignant tumour in patients younger than 10 years of age. The incidence is less than 1 per 1 million per year. Usually it is located in the diaphysis of long bones...Background: Ewing sarcoma is the most common primary malignant tumour in patients younger than 10 years of age. The incidence is less than 1 per 1 million per year. Usually it is located in the diaphysis of long bones. Prognosis of these tumours has improved dramatically since the introduction of multi-agent chemotherapy, from an erstwhile 10% survival rate to the current 70% for patients with non-metastatic Ewing sarcoma. Method: A retrospective review of patients with histologically confirmed Ewing sarcoma who were treated in the Department of Orthopaedics, B.S. Medical College during the time period from April 2000 to March 2012 was performed. Patients were divided into two groups: Group A included those treated by External Beam Radiotherapy (EBRT) + chemotherapy while Group B included the patients treated with surgery + chemotherapy. Results were analysed depending on the survival rates. Kaplan-Meier survival curves were compared using log-rank test and a multivariate Cox proportional hazards model was calculated. Result: The survival curves of both the groups were not found to be significantly different. Conclusion: Treatment of Ewing tumour has multiple options. No one treatment modality is superior. Survival rates of patients treated by radiation + chemotherapy are not significantly different from those treated with surgery + chemotherapy.展开更多
Background:The COVID-19 pandemic has resulted in unprecedented problems in both cancer management and providing a safe organised workflow for oncological health care systems to operate.The treatment of advanced cervic...Background:The COVID-19 pandemic has resulted in unprecedented problems in both cancer management and providing a safe organised workflow for oncological health care systems to operate.The treatment of advanced cervical cancer stage IIB-IVA has received higher priority in most international guidelines for risk adaptation in relation to COVID-19 situation.There is an urgent need to revise the established standard treatment protocol of concurrent chemo-irradiation followed by brachytherapy,usually delivered over 6-7 weeks,which is associated with technical difficulties and would pose risks to both the patient and treating health care personnel.Aims&Objectives:To propose alternative treatment protocols that are supported by scientific data and may be better suited to meet the needs of the unique situation.Methods:A systematic literature search was performed using PubMed and other search engines.The studies evaluated were those published from 1990 to April 2020.The focus was on scientific rationale and non-inferiority with standards of care.Conclusions:The authors propose Simultaneous Integrated Boost for treatment of large volume disease and Stereotactic Body Radiotherapy boost for smaller tumour volumes,where facilities are available.3DCRT with an integrated or sequential IMRT boost can be considered in institutes with technical limitations.展开更多
Purpose: Owing to the missing recent data regarding cancer case volumes in Kenyan hospitals since 2012, the aim of the study was to fill the gap by providing data for two hospitals in Nairobi, the post year 2012. The ...Purpose: Owing to the missing recent data regarding cancer case volumes in Kenyan hospitals since 2012, the aim of the study was to fill the gap by providing data for two hospitals in Nairobi, the post year 2012. The general situation of radiation oncology and recommendation for improvement of radiotherapy services in the country were also highlighted. Further assessment was to investigate and determine the relationship between age, different types of cancer, and gender for cancer patients undergoing radiotherapy treatment. Materials and Methods: A data compilation, analysis, and evaluation process were conducted at two cancer treatment centers in Kenya followed by an assessment of radiotherapy cancer treatment facilities in the country. The number of the patients treated for cervical, breast prostate, esophagus, rectum, and lung cancer against their ages and gender were also compiled for assessment. Results: The number of cancer patients treated by radiotherapy continuously increased annually and he trends of the graphs in both centers were similar. Cervical cancer was the most common cancer treated by radiotherapy at the two centers, followed by breast and prostate cancer. Different types of cancer assessed were dependent on age and that cancer appeared at younger ages in female cervical and breast cancer patients as opposed to the male prostate cancer. Conclusion: The results indicate a continuous annual increase in cancer patients treated by radiotherapy in Kenya radiotherapy centers. The increase may be attributed to the rising population, limited access to cancer awareness, and the growing adoption of unhealthy lifestyles, among other factors. Female cervical and breast cancer patients contracted the disease at younger ages (46 - 50 years) compared to the male prostate cancer patients with a mean age of 61 - 65 years. Socio-economic factors, the organization of healthcare systems, and a limited workforce have been identified as some of the barriers to the provision of proper radiotherapy services in the country.展开更多
文摘Objective： To report the comparative effect of combined medroxyprogesterone acetate （MPA） and external beam pelvic radiotherapy （EBRT） with EBRT alone on local or distant recurrences, overall survival and treatment related toxicities in patients with stage Ic grade 3 endometrial cancer. Methods： A retrospective review of 80 International Federation of Gyne- cology and Obstetrics （FIGO） stage Ic grade 3 endometrial carcinoma patients treated between October 1994 and October 2004 at Renmin Hospital, Wuhan University, China was performed. All patients underwent surgery, of which 40 patients in arm I received combined MPA and EBRT while in arm II 40 patients received only adjuvant EBRT after surgery. The median dose of EBRT in arm I was 50 Gy （range 36-54 Gy） and in arm Ⅱ was 45.2 Gy （range 43.2-50.4 Gy）. Multivariate analysis was performed for the prognostic factors and Kaplan-Meier method was used for overall survival. Results： Of the 80 eligible patients, 40 in each group could be evaluated. The follow-up times ranged from 4-98 months with a median of 45 months. The overall survival rates at five years were 73% among patients treated with combined MPA and EBRT and 28.2% among patients treated with EBRT alone （P 〈 0.001）. The rate of distant metastasis was significantly higher among patients treated with EBRT alone group than combined MPA and EBRT （55% vs 25%, P = 0.006） while no difference in Ioco regional recurrence rates was observed in both treatment groups. Most of the side effects observed in the combined MPA and EBRT group. Age （P 〈 0.001） and the presence of progesterone receptors （P = 0.003） were independent significant prognostic factors for overall surviva} in multiple regression analysis. Conclusion： We has been concluded that the addition of progestagen to external beam pelvic radiotherapy significantly improved survival and reduced distant metastasis among women with stage Ic grade 3 endometrial cancer.
基金Supported by the Technology Project Entry Foundation of ShaanxiProvince,No.2002K10-G3
文摘AIM: To determine the survival of advanced pancreatic cancer patients treated with intraoperative radiotherapy (IORT) combined with external beam radiation therapy (EBRT) following internal drainage (cholecystojejunostomy or choledochojejunostomy). METHODS: Eighty-one patients with advanced pancreatic cancer who received IORT combined with EBRT following internal drainage (ID) between 1996 and 2001 were retrospectively analyzed. Among the 81 patients, 18 underwent ID+IORT, 25 ID+IORT+EBRT (meanwhile, given 5-Fu 300 mg/m^2 iv drip, 2f/w), 16 EBRT, 22 had undergone simple internal drainage. The IORT dose was 15-25Gy in a single fraction. The usual EBRT dose was 30-40Gy with a daily fraction of 1.8-2.0 Gy. RESULTS: The complete remission rate, partial remission rate of patients with backache and abdominal pain treated with ID+IORT were 55.5%, 33.3% respectively. Alleviation of pain was observed 2 or 3 wk after IORT. The median survival time (MST) of ID+IORT group was 10.7 mo. The pain remission rate of patients treated with ID+IORT+EBRT was 92%, and their MST was 12.2 mo. The MST of patients treated with EBRT and simple internal drainage was 5.1 mo and 7.0 mo, respectively. The survival curve of ID+IORT group and ID+IORT+EBRT group was significantly better than that of EBRT group (P<0.05). The difference between the ID+IORT+EBRT group and ID group was significant (P<0.05). CONCLUSION: IORT combined with EBRT following internal drainage can alleviate pain, improve quality of life and prolong survival time of patients with advanced pancreatic cancer.
基金This research was conducted by the Australian Research Council Industrial Transformation Training Centre in Additive Biomanufacturing(IC160100026).The support of the Gross Foundation is also acknowledged.
文摘The additive manufacturing(AM)process plays an important role in enabling cross-disciplinary research in engineering and personalised medicine.Commercially available clinical tools currently utilised in radiotherapy are typically based on traditional manufacturing processes,often leading to non-conformal geometries,time-consuming manufacturing process and high costs.An emerging application explores the design and development of patient-specific clinical tools using AM to optimise treatment outcomes among cancer patients receiving radiation therapy.In this review,we:•highlight the key advantages of AM in radiotherapy where rapid prototyping allows for patient-specific manufacture•explore common clinical workflows involving radiotherapy tools such as bolus,compensators,anthropomorphic phantoms,immobilisers,and brachytherapy moulds;and•investigate how current AM processes are exploited by researchers to achieve patient tissuelike imaging and dose attenuations.Finally,significant AM research opportunities in this space are highlighted for their future advancements in radiotherapy for diagnostic and clinical research applications.
文摘Background: Ewing sarcoma is the most common primary malignant tumour in patients younger than 10 years of age. The incidence is less than 1 per 1 million per year. Usually it is located in the diaphysis of long bones. Prognosis of these tumours has improved dramatically since the introduction of multi-agent chemotherapy, from an erstwhile 10% survival rate to the current 70% for patients with non-metastatic Ewing sarcoma. Method: A retrospective review of patients with histologically confirmed Ewing sarcoma who were treated in the Department of Orthopaedics, B.S. Medical College during the time period from April 2000 to March 2012 was performed. Patients were divided into two groups: Group A included those treated by External Beam Radiotherapy (EBRT) + chemotherapy while Group B included the patients treated with surgery + chemotherapy. Results were analysed depending on the survival rates. Kaplan-Meier survival curves were compared using log-rank test and a multivariate Cox proportional hazards model was calculated. Result: The survival curves of both the groups were not found to be significantly different. Conclusion: Treatment of Ewing tumour has multiple options. No one treatment modality is superior. Survival rates of patients treated by radiation + chemotherapy are not significantly different from those treated with surgery + chemotherapy.
文摘Background:The COVID-19 pandemic has resulted in unprecedented problems in both cancer management and providing a safe organised workflow for oncological health care systems to operate.The treatment of advanced cervical cancer stage IIB-IVA has received higher priority in most international guidelines for risk adaptation in relation to COVID-19 situation.There is an urgent need to revise the established standard treatment protocol of concurrent chemo-irradiation followed by brachytherapy,usually delivered over 6-7 weeks,which is associated with technical difficulties and would pose risks to both the patient and treating health care personnel.Aims&Objectives:To propose alternative treatment protocols that are supported by scientific data and may be better suited to meet the needs of the unique situation.Methods:A systematic literature search was performed using PubMed and other search engines.The studies evaluated were those published from 1990 to April 2020.The focus was on scientific rationale and non-inferiority with standards of care.Conclusions:The authors propose Simultaneous Integrated Boost for treatment of large volume disease and Stereotactic Body Radiotherapy boost for smaller tumour volumes,where facilities are available.3DCRT with an integrated or sequential IMRT boost can be considered in institutes with technical limitations.
文摘Purpose: Owing to the missing recent data regarding cancer case volumes in Kenyan hospitals since 2012, the aim of the study was to fill the gap by providing data for two hospitals in Nairobi, the post year 2012. The general situation of radiation oncology and recommendation for improvement of radiotherapy services in the country were also highlighted. Further assessment was to investigate and determine the relationship between age, different types of cancer, and gender for cancer patients undergoing radiotherapy treatment. Materials and Methods: A data compilation, analysis, and evaluation process were conducted at two cancer treatment centers in Kenya followed by an assessment of radiotherapy cancer treatment facilities in the country. The number of the patients treated for cervical, breast prostate, esophagus, rectum, and lung cancer against their ages and gender were also compiled for assessment. Results: The number of cancer patients treated by radiotherapy continuously increased annually and he trends of the graphs in both centers were similar. Cervical cancer was the most common cancer treated by radiotherapy at the two centers, followed by breast and prostate cancer. Different types of cancer assessed were dependent on age and that cancer appeared at younger ages in female cervical and breast cancer patients as opposed to the male prostate cancer. Conclusion: The results indicate a continuous annual increase in cancer patients treated by radiotherapy in Kenya radiotherapy centers. The increase may be attributed to the rising population, limited access to cancer awareness, and the growing adoption of unhealthy lifestyles, among other factors. Female cervical and breast cancer patients contracted the disease at younger ages (46 - 50 years) compared to the male prostate cancer patients with a mean age of 61 - 65 years. Socio-economic factors, the organization of healthcare systems, and a limited workforce have been identified as some of the barriers to the provision of proper radiotherapy services in the country.
