BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,qualit...BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.展开更多
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 pa...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.展开更多
Many patients with hepatocellular carcinoma(HCC) present with advanced disease,not amenable to curative therapies such as surgery,transplantation or radiofrequency ablation. Treatment options for this group of patient...Many patients with hepatocellular carcinoma(HCC) present with advanced disease,not amenable to curative therapies such as surgery,transplantation or radiofrequency ablation. Treatment options for this group of patients include transarterial chemoembolization(TACE) and radiation therapy. Especially TACE,delivering a highly concentrated dose of chemotherapy to tumor cells while minimizing systemic toxicity of chemotherapy,has given favorable results on local control and survival. Radiotherapy,as a therapeutic modality of internal radiation therapy with radioisotopes,has also achieved efficacious tumor control in advanced disease. On the contrary,the role of external beam radiotherapy for HCC has been limited in the past,due to the low tolerance of surrounding normal liver parenchyma. However,technological innovations in the field of radiotherapy treatment planning and delivery,have provided the means of delivering radical doses to the tumor,while sparing normal tissues. Advanced and highly conformal radiotherapy approaches such as stereotactic body radiotherapy and proton therapy,evaluated for efficacy and safety for HCC,report encouraging results. In this review,we present the role of radiotherapy in hepatocellular carcinoma patients not suitable for radical treatment.展开更多
Objective: To observe the effect of Lianbai liquid (连柏液) in prevention and treatment of acute radiation dermal injury. Method: From May 2000 to December 2005, 126 cancer patients were randomly divided into a preven...Objective: To observe the effect of Lianbai liquid (连柏液) in prevention and treatment of acute radiation dermal injury. Method: From May 2000 to December 2005, 126 cancer patients were randomly divided into a prevention group of 75 cases given externally topical application of Lianbai liquid since the first radiotherapy, and a control group Ⅰ of 51 cases given only advice after radiotherapy; while the other 92 cancer patients who had already had grade Ⅲ acute radiation-induced dermal injury were randomly divided into a treatment group of 54 cases treated by externally topical use of Lianbai liquid, and a control group Ⅱ of 38 cases treated by topical use of norfloxacin. Clinical evaluation was carried out according to the CTC.V2.0 standard stipulated by NCI for classifying acute radiation dermal injury. Results: The incidence of skin reaction was 32.0% in the prevention group and 92.2% in the control group Ⅰ, with an obvious difference between the two groups (χ2=54.163, P<0.01). Mild radioactive reaction (grade Ⅰ and Ⅱ) was 28.0% (21/75) in the prevention group and 70.6% (36/51) in the control group Ⅰ, with a remarkable difference between the two groups (χ2=22.226, P<0.01). The effective rate for grade Ⅲ dermal injury was 92.6% (50/54) in the treatment group and 65.9% (25/38) in the control group Ⅱ, with a remarkable difference between the two groups (χ2=6.018, P=0.024). The wound-healing time was 11.07±2.21 days in the treatment group and 18.08±1.76 days in the control group Ⅱ, with a remarkable difference between the two groups (u=16.932, P<0.01). Conclusion: Lianbai liquid can effectively prevent the radiation dermatitis, and treat grade Ⅲ acute radiation dermal injury with obvious curative effect.展开更多
AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy(HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0 Mx. T...AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy(HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0 Mx. The patients received3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity.RESULTS: The acute radiation induced skin toxicity was as following: grade Ⅰ 27.6%, grade Ⅱ 7.8% and grade Ⅲ 2.6%. No significant correlation was noted between toxicity grading and chemotherapy(P = 0.154, χ2 test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively(P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions(P = 0.47, χ2test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse.CONCLUSION: There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions.展开更多
BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits ...BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded that hypofractionated radiotherapy is a simple and effective protocol in patients with high-risk breast cancer regarding tumor control and survival.展开更多
OBJECTIVE To evaluate the curative effect of external beam radiothera-py (EBRT) and brachytherapy (BT) for tongue carcinoma. METHODS From 1991 to 2003, 35 patients received EBRT and BT in our department. We analyzed t...OBJECTIVE To evaluate the curative effect of external beam radiothera-py (EBRT) and brachytherapy (BT) for tongue carcinoma. METHODS From 1991 to 2003, 35 patients received EBRT and BT in our department. We analyzed their curative and side effects retrospectively. RESULTS Local control was 80%. The 3-year overall (OS) and disease specific survival (DSS) rates were 75% and 79%. One patient developed metastases. Three patients (9%) developed different late complications. CONCLUSIONS Local regional control, survival, and complications in patients with tongue carcinoma treated by EBRT and BT have been satis-factory.展开更多
Positron emission tomography/Computer tomography (PET/CT) is a multimodality imaging diagnostic technique that analyzes the uptake and retention of different radiopharmaceuticals by cells providing metabolic informati...Positron emission tomography/Computer tomography (PET/CT) is a multimodality imaging diagnostic technique that analyzes the uptake and retention of different radiopharmaceuticals by cells providing metabolic information on biochemical processes. PET/CT has been used for radiotherapy planning, providing useful information to the Radio-oncologist about the localization, size and metabolic activity of tumor lesions. In this paper, we show advantages of the 18F-FDG PET/CT respect to simple CT imaging for target volume delineation in patients with diagnosis of Squamous Head and Neck Carcinoma that has been scheduled to undergo a hypofractionated radiotherapy treatment. On ten studied patients, the target volume defined from PET/CT images was less extensive than those defined from simple CT images. In six patients the target volume was significantly less extensive and in two of them a new lymph node disease was reported, re-staging and corresponding target volume was also delineated with less extensive margins from PET/CT images. A greater accuracy in delineating the volumes and improving the distribution of doses in the planning of the radiant treatment in these patients was possible, allowing a high precision in the delivery of the prescribed dose to the target volume diminishing the maximum dose to the adjacent healthy tissues. In conclusion we show that the use of 18F-FDG PET/CT was superior than the simple CT as the primary modality of imaging for hypofractioned radiotherapy treatment planning in patients with Squamous Head and Neck Carcinoma.展开更多
Background:Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter d...Background:Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods: Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study, radiotherapy induced toxicity was evaluated. Results: In this study, the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity (telangectasia, hyperpigmentation, and subcutaneous fibrosis) was assessed and showed that most patients had grade 0 toxicity with no grade 3 toxicity at all. Regarding pulmonary toxicity, 5 patients (9.3%) developed acute pneumonitis and as regards chronic lung toxicity, it was evident in only 3 patients, 2 patients (3.7%) were grade 1 and 1 patient (1.9%) was grade 2. Cardiac toxicity was evident in 2 patients (7.1%) of the left breast cancer patients. Regarding lymphoedema, most patients that showed lymphoedema were grade 1. Conclusion: The results confirm the safety and feasibility of adjuvant hypofractionated whole breast radiotherapy in breast cancer patients in terms of acute and late toxicity.展开更多
<strong>Aim:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> We endeavored to describe the epidemiological profile of pr...<strong>Aim:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> We endeavored to describe the epidemiological profile of prostatic cancer, and to evaluate its diagnostic and therapeutic aspects. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> We conducted a descriptive retrospective study on the conformational radiotherapy of prostatic adenocarcinoma at the Dalal Jamm University Hospital, Senegal from June 2018 to December 2019. We included 62 consecutive patients. The average age of the patients was 68.9 years. The average consultation time was 7.6 months. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Symptom manifestation and high PSA triggered the diagnosis of cancer in 74.2% and 25.8% of patients, respectively. Symptoms: pollakiuria (72.3%), bone pain (8%) and erectile dysfunction (4.8%). The digital rectal examination: normal (33.8%), nodular (30.6%), induration (24.1%), and shielding (11.3%). The mean PSA level was 90.6 ng/ml. Histology: adenocarcinoma was the most common (98.6%). The Gleason score: <7 (45.1%), =7 (35.5%), and >7 (19.4%). The majority of patients were in the high-risk group (70.9%) and 7 patients (11.2%) were metastatic at diagnosis. Therapy: first radical prostatectomy (20.9%), first-line curative radiotherapy (67.8%), adjuvant (21%) and palliative radiotherapy in 7 patients (11.2%): patients having received palliative radiotherapy had an estimated decline in symptoms of 80%. Hormone therapy was performed in 88.8% of patients, with average duration of 12.5 months. After a mean follow-up of 15 months, 59 patients were alive, including 45 cases (81.8%) in complete remission;3 patients with metastasis at the first visit (having received palliative ra</span><span><span style="font-family:Verdana;">diotherapy) died. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The collected data show a profile of prostate cancer that is specific to the sub-Saharan context in which the discovery is still late. Also in comparison to developed countries, the therapeutic means</span></span><span style="font-family:Verdana;"> necessary to fight against this cancer are limited, even though three-dimensional conformational radiotherapy remains an effective and essential treatment;this study provided fundamental data in the area of insufficient data/tools.</span></span></span></span>展开更多
<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> The therapeutic standard for oligoprogressive prostate cancer resistant to c...<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> The therapeutic standard for oligoprogressive prostate cancer resistant to castration is second-generation hormone therapy. This systemic treatment is expensive. There are oligoprogressive lesions accessible to radiotherapy. </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> To study the impact of radiotherapy of oligoprogressive </span><span><span style="font-family:Verdana;">lesions on the implementation of second generation hormone therapy. </span><b><span style="font-family:Verdana;">Pa</span></b></span><b><span style="font-family:Verdana;">t</span><span style="font-family:Verdana;">ients and Methods:</span></b><span style="font-family:Verdana;"> A retrospective study from 2012 to 2020 was carried</span><span style="font-family:Verdana;"> out. All patients with oligoprogressive prostate cancer who had received radiotherapy on one or more lesions in progression were collated. Survival was calculated using the Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 8 patients were treated with stereotactic and conformational radiotherapy between August 2012 and August 2020 in the context of oligoprogressive prostate cancer resistant to castration. The median age at diagnosis of oligoprogression was 73 years with a median PSA level of 3.11 ng/ml. Nine lesions were diagnosed with PET scan PSMA. All the lesions were treated by radiotherapy with different regimens. After a median follow-up of 12.5 months, 7 patients showed a biochemical response to treatment with a median decrease in PSA of 67%. The median survival without clinical or biochemical progression was 7 months. The median survival without the need for further systemic treatment was 9 months. During the follow-up period, six patients received second-generation hormone therapy to treat their relapse, and the other two showed no clinical or biochemical relapse. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Radiotherapy may be an alternative to delay the introduction of difficult-to-access second-generation hormone therapy in developing countries. A prospective study could validate this therapeutic approach.</span></span>展开更多
Background: Ureterosigmoidostomy was the first form of continent urinary diversion and had broad popularity during the first half of the 20th century. Primary enthusiasm was followed by disappointment when serious pro...Background: Ureterosigmoidostomy was the first form of continent urinary diversion and had broad popularity during the first half of the 20th century. Primary enthusiasm was followed by disappointment when serious problems such as pyelonephritis, electrolyte imbalance, renal calculi and renal function deterioration become evident. In the 1950s these life threatening complications led to avoid this urinary diversion in favor of uretro-intestinal conduits. Objectives: Our aim was to evaluate our experience in ureterocolic shunt after radical cystectomy for bladder cancer. Methodology: This study was conducted in surgical oncology department, South Egypt cancer institute, Assiut university;in the period from January 2012 to January 2017 and including 115 patients (75 males & 40 females). Results: This is retrospective study including 115 patients (75 males & 40 females). Operative time was 130 minutes ranging between 2 to 2.5 hours. Average blood loss was 450 ml. After removal of rectal tube all patients were continent except 15 patients who were improved after 1 - 3 days. Within a month 12 patients had night incontinence and 5 patients had day time incontinence. After that day and night continence gradually improved in all patients except two females who had persistent night soiling and was in need for night time rectal tube. Conclusion: Ureterosigmoidostomy regains the interest of surgical oncology and urologist because of its simplicity and absence of appliance as many patients refusing cutaneous stoma and others are not suitable for orthotopic substitutes.展开更多
<strong>Objective:</strong><span style="font-family:""><span style="font-family:Verdana;"> Concurrent chemoradiation value of the resected salivary tumor adjuvant conte...<strong>Objective:</strong><span style="font-family:""><span style="font-family:Verdana;"> Concurrent chemoradiation value of the resected salivary tumor adjuvant context against regular radiation therapy alone. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective randomized clinical trial. </span><b><span style="font-family:Verdana;">Patients:</span></b><span style="font-family:Verdana;"> 48 patients were randomized to either adjuvant postoperative radiology alone versus concurrent chemoradiotherapy (weekly cisplatin 40 mg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> for 6 cycles) “with resected high-risk salivary tumors of the large and minor salivary gland”. </span><b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Outcome</span></b> <b><span style="font-family:Verdana;">Measures:</span></b><span style="font-family:Verdana;"> Recurrent locoregional Free survival, distant free survival, and overall survival. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of the 48 participants in the study 31 patients had parotid gland tumors. 23 patients received solely adjuvant radiation while 25 patients received concurrent chemoradiotherapy. In the chemoradiation group, platinum-based regimens were employed in all. The mean age in both groups was 48 years. Adenoid cystic carcinoma was the primary pathogenic form of both arms 56% (28 cases). Stage II patients were 35% and 32%, stage III was 39% and 48% and stage VIa were 26% and 20% in the radiation arm and chemoradiotherapy arm respectively. 40 of 48 patients (83%) had close or positive surgical margins and 30 of 48 patients (62%) have a perineural invasion. Both risk variables are more or less well balanced in both arms with no statistical difference. The 2- and 4-year estimates of the locoregional recurrence-free survival rate in the chemoradiation group were 95% and 73%, compared to 77.4% and 43.6% in the radiation arm respectively (p = 007). In the two-and four-year-old chemoradiation arm distant free metastases were 100% and 59% compared to 68% and 39% respectively in the radiation arm (p = 0.08). The overall survival estimates for 2 and 4 years were 93% and 78% respectively in the Chemoradiation Group but in the radiation-alone group were 95% and 48% respectively. The statistically significant differences were p = 0.009 by log-rank testing. Treatment was generally tolerated, although, in the chemoradiation group adverse symptoms, mainly mucositis increased. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Adding weekly cisplatin as a radiosensitizer for locally advanced stage or high-grade salivary gland cancer with adjuvant conventional radiation looks to be helpful and justifies further exploration in selected patients.</span></span>展开更多
Purpose: Our prospective phase II trial aims to show the feasibility of adjuvant paclitaxel-based concurrent chemoradiotherapy (CCRT) following doxorubicin and cyclophosphamide (AC) to get the survival benefit of taxa...Purpose: Our prospective phase II trial aims to show the feasibility of adjuvant paclitaxel-based concurrent chemoradiotherapy (CCRT) following doxorubicin and cyclophosphamide (AC) to get the survival benefit of taxanes addition and avoid delay of radiotherapy. Patients and Methods: A total of 63 patients with pT1-2, and pN1-3, M0 breast cancer underwent conservative surgery followed by adjuvant 4 cycles AC followed by 4 cycles Paclitaxel 175 mg/m2 every 3 weeks. Adjuvant radiotherapy started during the first and second cycle of paclitaxel (CCRT). Toxicities evaluated at the base time, weekly during radiation therapy and every 3 months for 24 months for skin, pulmonary, cardiac, lymphedema, subcutaneous fibrosis and cosmoses. Survival reported at 2-year median follow-up. Results: At median follow up time of 24 months (6 - 30), we did not report any toxicity postpone or stop treatment and only two patients had grade III acute dermatitis. Fifty-two patients (82.5%) had satisfactory cosmoses and none of the patients developed local recurrence. Conclusion: Three-weekly paclitaxel during radiotherapy is considered safe without significant complications and acceptable cosmoses with excellent local control and could be considered to avoid radiotherapy delay.展开更多
<strong>Background:</strong><span style="font-family:Verdana;"> Post-operative breast radiotherapy is used to reduce recurrence</span><span style="font-family:"">...<strong>Background:</strong><span style="font-family:Verdana;"> Post-operative breast radiotherapy is used to reduce recurrence</span><span style="font-family:""><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to investigate the outcomes of </span><span style="font-family:Verdana;">Deep</span><span style="font-family:Verdana;"> Inspiration Breath-Hold (DIBH) technique with indigenous </span><span style="font-family:Verdana;">breath holding</span><span style="font-family:Verdana;"> indicator scale in 3DCRT for breast cancer radiotherapy over </span><span style="font-family:Verdana;">Free</span><span style="font-family:Verdana;"> Breathing (FB) technique. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> An observational study </span><span style="font-family:Verdana;">conducted</span> </span><span style="font-family:""><span style="font-family:Verdana;">at the </span><span style="font-family:Verdana;">Department</span><span style="font-family:Verdana;"> of Radiation Oncology </span></span><span style="font-family:""><span style="font-family:Verdana;">at </span><span style="font-family:Verdana;">National</span><span style="font-family:Verdana;"> Institute of Cancer Research and Hospital, Dhaka and Square Hospital Limited, Dhaka, Bangladesh from June 2015 to May 2016. A total of 60</span></span><span style="font-family:""><span style="font-family:Verdana;"> confirmed breast cancer patients who underwent adjuvant radiotherapy were included. An indigenous reproducible plastic tool (Perspex) was used as </span><span style="font-family:Verdana;">breath holding</span><span style="font-family:Verdana;"> indicator scale with </span></span><span style="font-family:Verdana;">DIBH</span><span style="font-family:""><span style="font-family:Verdana;"> technique in 3DCRT</span><i><span style="font-family:Verdana;">. </span></i><span><span style="font-family:Verdana;">Paired sample t-test was used to compare with </span><span style="font-family:Verdana;">FB</span><span style="font-family:Verdana;"> technique. </span><b><span style="font-family:Verdana;">Results:</span></b><i> </i><span style="font-family:Verdana;">The mean age of patients </span><span style="font-family:Verdana;">w</span></span></span><span style="font-family:Verdana;">as</span><span style="font-family:Verdana;"> 47.32 (SD ± 8.33) years.</span><span style="font-family:""><span style="font-family:Verdana;"> In </span><span style="font-family:Verdana;">FB</span><span style="font-family:Verdana;"> technique, Mean Heart Dose (MHD) was 413.27 cGy while in </span><span style="font-family:Verdana;">DIBH</span><span style="font-family:Verdana;"> technique, it was 254.91 cGy (P < 0.001). The mean heart V20</span></span><span style="font-family:Verdana;"> and </span><span style="font-family:""><span style="font-family:Verdana;">V30 </span><span style="font-family:Verdana;">were</span><span style="font-family:Verdana;"> 5.5%, 4.37%</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">in FB and</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">3.13%, 2.36% in DIBH respectively. In </span><span style="font-family:Verdana;">FB</span><span style="font-family:Verdana;"> technique LADMD, LAD</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">0.2</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">cm</span><sup><span style="font-family:Verdana;">3</span></sup><span style="font-family:Verdana;">, ILMD </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> ILV20 </span><span style="font-family:Verdana;">w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:Verdana;"> 1698.17</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">cGy, 2852.53 cGy, 1155.31 cGy </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> 28.62% while in </span><span style="font-family:Verdana;">DIBH</span><span style="font-family:Verdana;"> technique, it was reduced to 1164.01 cGy, 2132.24 cGy, 1007.98 cGy and 23.39% respectively. Similarly, the lung-CLMD and breast-CLMD </span><span style="font-family:Verdana;">w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> reduced from 38.37 cGy and 55.18 cGy to 24.64 cGy and 33.82 cGy respectively (P < 0.001). The mean difference for breast-CLMD was 21.36 cGy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The use of indigenous </span><span style="font-family:Verdana;">breath holding</span><span style="font-family:Verdana;"> indicator scale with DIBH had better outcomes on breast cancer radiotherapy.</span></span>展开更多
<strong>Context:</strong> <span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">Technological advances have imp...<strong>Context:</strong> <span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">Technological advances have improved the toxicities of radiotherapy. We are evaluating the 3D technique in prostate cancer. </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Retrospective study from January 2015 to December 2015 with 29 files. Survival was calculated by Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We collected 29 patient records over the study period. The median age was 75 years with the following extremes: 54 years and 83 years. The median PSA level was 12 ng/ml with a range of 3.05 to 79 ng/ml. Gleason score analysis showed 6 patients (20.69%) with a score of 6 (3 + 3), 23 patients (79.31%) with a score of 7 including 12 patients (41.38%) with grade 3 and 11 patients (37.93%) with grade 4. The median dose delivered was 74 Gy, with a mean dose of 73.79 Gy and extremes of 70 Gy for the minimum and 76 Gy for the maximum. Hormone therapy was combined with radiotherapy in 17 patients (58.62%). Sev</span><span style="font-family:Verdana;">en patients (24.14%) had grade 1 acute bladder toxicity and one patient</span><span style="font-family:Verdana;"> (3.45%) </span><span style="font-family:Verdana;">had grade 2 acute toxicity. Late bladder toxicity was grade 1 in 5 patients</span><span style="font-family:Verdana;"> (17.24%), grade 2 in 3 patients (10.34%) and grade 3 in 1 patient (3.45%). </span><span style="font-family:Verdana;">Late rectal toxicity, grade 2 in 3 patients (10.34%), grade 3 in 1 patient, was noted. Overall survival at 2 years was 100% and 89.65% at 5 years. Relapse-free </span><span><span style="font-family:Verdana;">survival at 2 years was 82.76% and 62.07% at 5 years. There were 3 deaths (10.34%) of which only one was related to prostate cancer. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span></span></span></span></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Radiotherapy, like surgery, is a fundamental option for the treatment of </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">prostate cancers, particularly those that are locally advanced. It is gaining in importance with the improvement of techniques (IMRT, VMAT…) and new fractionations which contribute to the reduction of toxicities and the comfort of patients (shorter spread).</span></span></span>展开更多
Objective: To study the inhibiting effect of Endostar combined with ginsenoside Rg3 on breast cancer tumor growth in tumor-bearing mice. Methods: Female mice were selected as experimental animals, and breast cancer tu...Objective: To study the inhibiting effect of Endostar combined with ginsenoside Rg3 on breast cancer tumor growth in tumor-bearing mice. Methods: Female mice were selected as experimental animals, and breast cancer tumor-bearing mouse models were established and then divided into group A, B, C and D that respectively received saline, recombinant human endostatin, ginsenosides Rg3 and recombinant human endostatin combined with Rg3 intervention; 7 d, 14 d and 21 d after intervention, tumor tissue volume was measured; 21 d after intervention, mice were killed, tumor tissue was collected, and m RNA contents of angiogenesis molecules, invasion molecules, autophagy marker molecules and autophagy signaling pathway molecules were detected. Results: At 7 d, 14 d and 21 d after intervention, tumor tissue volume of group B, C and D was lower than that of group A, and tumor tissue volume of group D was lower than that of group B and C; m RNA contents of VEGFA, VEGFB, VEGFC, MMP2, MMP9, p62, m TOR, PI3 K, Akt, JNK and Beclin-1 in tumor tissue of group B, C and D were significantly lower than those of group A, and LC3-II/LC3-I was significantly higher than that of group A; m RNA contents of VEGFA, VEGFB, VEGFC, MMP2, MMP9, p62, m TOR, PI3 K, Akt, JNK and Beclin-1 in tumor tissue of group D were significantly lower than those of group B and C, and LC3-II/LC3-I was higher than that of group B and C. Conclusions: Endostar combined with ginsenoside Rg3 has stronger inhibiting effect on breast cancer tumor growth in tumor-bearing mice than single drug, and it can inhibit angiogenesis and cell invasion, and enhance cell autophagy.展开更多
Objective To investigate the effects of quercetin and X-ray on collagen synthesis of cultured human keloid-derived fibroblast and the mechanism.Methods Collagen synthesis of cultured human keloid and normal fibroblast...Objective To investigate the effects of quercetin and X-ray on collagen synthesis of cultured human keloid-derived fibroblast and the mechanism.Methods Collagen synthesis of cultured human keloid and normal fibroblasts were detected by hydroxyproline colorimetric analysis. Immunocytochemical staining was used to investigate collagen I and III expression. mRNA expression of collagen I and III, and transforming growth factor (TGF)-β1 were assayed by reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR. Results Quercetin inhibited the collagen synthesis of both keloid and normal fibroblasts in a dose-dependent manner. Immunocytochemical staining indicated that collagen I and III were down-regulated by quercetin and X-ray (P<0.05), particularly collagen I (P<0.05). mRNA expression of both collagen I and III in quercetin groups significantly decreased compared with that in control group (P<0.05), especially in the group treated with both quercetin and X-ray (P<0.01). mRNA level of TGF-β1 gene was down-regulated by quercertin (P<0.05). Conclusions Quercetin will probably be one of the new medicines which could effectively treat keloid. Quercetin combined with X-ray could reduce the dose of radiation.展开更多
The existing interventional therapy robots for the microwave ablation of liver tumors have a poor clinical applicability with a large volume, low positioning speed and complex automatic navigation control. To solve ab...The existing interventional therapy robots for the microwave ablation of liver tumors have a poor clinical applicability with a large volume, low positioning speed and complex automatic navigation control. To solve above problems, a composite configuration interventional therapy robot with passive and active joints is developed. The design of composite configuration reduces the size of the robot under the premise of a wide range of movement, and the robot with composite configuration can realizes rapid positioning with operation safety. The cumulative error of positioning is eliminated and the control complexity is reduced by decoupling active parts. The navigation algorithms for the robot are proposed based on solution of the inverse kinematics and geometric analysis. A simulation clinical test method is designed for the robot, and the functions of the robot and the navigation algorithms are verified by the test method. The mean error of navigation is 1.488 mm and the maximum error is 2.056 mm, and the positioning time for the ablation needle is in 10s. The experimental results show that the designed robot can meet the clinical requirements for the microwave ablation of liver tumors. The composite configuration is proposed in development of the interventional therapy robot for the microwave ablation of liver tumors,which provides a new idea for the structural design of medical robots.展开更多
文摘BACKGROUND Gastrointestinal tumors are a major cause of cancer-related deaths and have become a major public health problem.This study aims to provide a scientific basis for improving clinical treatment effects,quality of life,and prognosis of patients with gastrointestinal tumors.AIM To explore the clinical effect of the multidisciplinary diagnosis and treatment(MDT)nutrition intervention model on patients with gastrointestinal tumors.METHODS This was a case control study which included patients with gastrointestinal tumors who received radiotherapy at the Department of Oncology between January 2021 and January 2023.Using a random number table,120 patients were randomly divided into MDT and control groups with 60 patients in each group.To analyze the effect of MDT on the nutritional status and quality of life of the patients,the nutritional status and quality of life scores of the patients were measured before and after the treatment.RESULTS Albumin(ALB),transferrin(TRF),hemoglobin(Hb),and total protein(TP)levels significantly decreased after the treatment.The control group had significantly lower ALB,TRF,Hb,and TP levels than the MDT group,and the differences in these levels between the two groups were statistically significant(P<0.05).After the treatment,the MDT group had significantly more wellnourished patients than the control group(P<0.05).The quality of life total score,somatic functioning,role functioning,and emotional functioning were higher in the MDT group than in the control group.By contrast,pain,fatigue,nausea,and vomiting scores were lower in the MDT group than in the control group(P<0.05).CONCLUSION MDT nutritional intervention model effectively improves the nutritional status and quality of life of the patients.The study provides a rigorous theoretical basis for improving the prognosis of cancer patients.In the future,we intend to provide additional treatment methods for improving the quality of life of patients with cancer.
文摘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.
文摘Many patients with hepatocellular carcinoma(HCC) present with advanced disease,not amenable to curative therapies such as surgery,transplantation or radiofrequency ablation. Treatment options for this group of patients include transarterial chemoembolization(TACE) and radiation therapy. Especially TACE,delivering a highly concentrated dose of chemotherapy to tumor cells while minimizing systemic toxicity of chemotherapy,has given favorable results on local control and survival. Radiotherapy,as a therapeutic modality of internal radiation therapy with radioisotopes,has also achieved efficacious tumor control in advanced disease. On the contrary,the role of external beam radiotherapy for HCC has been limited in the past,due to the low tolerance of surrounding normal liver parenchyma. However,technological innovations in the field of radiotherapy treatment planning and delivery,have provided the means of delivering radical doses to the tumor,while sparing normal tissues. Advanced and highly conformal radiotherapy approaches such as stereotactic body radiotherapy and proton therapy,evaluated for efficacy and safety for HCC,report encouraging results. In this review,we present the role of radiotherapy in hepatocellular carcinoma patients not suitable for radical treatment.
文摘Objective: To observe the effect of Lianbai liquid (连柏液) in prevention and treatment of acute radiation dermal injury. Method: From May 2000 to December 2005, 126 cancer patients were randomly divided into a prevention group of 75 cases given externally topical application of Lianbai liquid since the first radiotherapy, and a control group Ⅰ of 51 cases given only advice after radiotherapy; while the other 92 cancer patients who had already had grade Ⅲ acute radiation-induced dermal injury were randomly divided into a treatment group of 54 cases treated by externally topical use of Lianbai liquid, and a control group Ⅱ of 38 cases treated by topical use of norfloxacin. Clinical evaluation was carried out according to the CTC.V2.0 standard stipulated by NCI for classifying acute radiation dermal injury. Results: The incidence of skin reaction was 32.0% in the prevention group and 92.2% in the control group Ⅰ, with an obvious difference between the two groups (χ2=54.163, P<0.01). Mild radioactive reaction (grade Ⅰ and Ⅱ) was 28.0% (21/75) in the prevention group and 70.6% (36/51) in the control group Ⅰ, with a remarkable difference between the two groups (χ2=22.226, P<0.01). The effective rate for grade Ⅲ dermal injury was 92.6% (50/54) in the treatment group and 65.9% (25/38) in the control group Ⅱ, with a remarkable difference between the two groups (χ2=6.018, P=0.024). The wound-healing time was 11.07±2.21 days in the treatment group and 18.08±1.76 days in the control group Ⅱ, with a remarkable difference between the two groups (u=16.932, P<0.01). Conclusion: Lianbai liquid can effectively prevent the radiation dermatitis, and treat grade Ⅲ acute radiation dermal injury with obvious curative effect.
文摘AIM: To evaluate the effect of chemotherapy to the acute toxicity of a hypofractionated radiotherapy(HFRT) schedule for breast cancer. METHODS: We retrospectively analyzed 116 breast cancer patients with T1, 2N0 Mx. The patients received3-D conformal radiotherapy with a total physical dose of 50.54 Gy or 53.2 Gy in 19 or 20 fractions according to stage, over 23-24 d. The last three to four fractions were delivered as a sequential tumor boost. All patients were monitored for acute skin toxicity according to the European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group criteria. The maximum monitored value was taken as the final grading score. Multivariate analysis was performed for the contribution of age, chemotherapy and 19 vs 20 fractions to the radiation acute skin toxicity.RESULTS: The acute radiation induced skin toxicity was as following: grade Ⅰ 27.6%, grade Ⅱ 7.8% and grade Ⅲ 2.6%. No significant correlation was noted between toxicity grading and chemotherapy(P = 0.154, χ2 test). The mean values of acute toxicity score in terms of chemotherapy or not, were 0.64 and 0.46 respectively(P = 0.109, Mann Whitney test). No significant correlation was also noted between acute skin toxicity and radiotherapy fractions(P = 0.47, χ2test). According to univariate analysis, only chemotherapy contributed significantly to the development of acute skin toxicity but with a critical value of P = 0.05. However, in multivariate analysis, chemotherapy lost its statistical significance. None of the patients during the 2-years of follow-up presented any locoregional relapse.CONCLUSION: There is no clear evidence that chemotherapy has an impact to acute skin toxicity after an HFRT schedule. A randomized trial is needed for definite conclusions.
文摘BACKGROUND Adjuvant radiotherapy is given following surgery in breast cancer patients. Hypofractonated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material and Methods 244 patients with high-risk breast cancer (stage IIB, stage III and stage IA with any of the following criteria: lymphovascular invasion, hormonal receptor negative, young age) who underwent Breast conservative surgery (BCS) or Modified radical mastectomy (MRM) were enrolled in this study. All patients received adjuvant radiotherapy with different hypofractionation schedules either 3900 cGY/13 fractions or 4240 cGY/16 fractions or 4005 cGY/15 fractions using linear accelerator with 6 MV photon beam. Lateral/Medial tangential and Ipsilateral supraclavicular fields were employed and the ipsilateral axilla was also irradiated if required to the same dose with posteroanterior field. Patients were followed every 3 mons for the first 2 years and every 6 mons thereafter. Outcomes were analyzed in terms of tumor control and survival. Results 244 patients with high-risk breast cancer requiring postoperative radiotherapy to the intact breast or chest wall were treated. The mean age was 48 years (range 28 - 69 years). The 5-year locoregional free survival of all patients was 93.8% the local relapse reported in 15 patients (6.2%) 7 patients at site of operated scar & 8 patients at the regional lymph nodes. The median follow up period was 75 months ranged from 49 to 102 months. Distant metastasis free survival was 92.2%, the distant metastasis reported in 19 patients which represent (7.8%) of all patients, median survival is 75 months ranged from 49 to 102 months and overall survival was 88.6%. Conclusion It is concluded that hypofractionated radiotherapy is a simple and effective protocol in patients with high-risk breast cancer regarding tumor control and survival.
文摘OBJECTIVE To evaluate the curative effect of external beam radiothera-py (EBRT) and brachytherapy (BT) for tongue carcinoma. METHODS From 1991 to 2003, 35 patients received EBRT and BT in our department. We analyzed their curative and side effects retrospectively. RESULTS Local control was 80%. The 3-year overall (OS) and disease specific survival (DSS) rates were 75% and 79%. One patient developed metastases. Three patients (9%) developed different late complications. CONCLUSIONS Local regional control, survival, and complications in patients with tongue carcinoma treated by EBRT and BT have been satis-factory.
文摘Positron emission tomography/Computer tomography (PET/CT) is a multimodality imaging diagnostic technique that analyzes the uptake and retention of different radiopharmaceuticals by cells providing metabolic information on biochemical processes. PET/CT has been used for radiotherapy planning, providing useful information to the Radio-oncologist about the localization, size and metabolic activity of tumor lesions. In this paper, we show advantages of the 18F-FDG PET/CT respect to simple CT imaging for target volume delineation in patients with diagnosis of Squamous Head and Neck Carcinoma that has been scheduled to undergo a hypofractionated radiotherapy treatment. On ten studied patients, the target volume defined from PET/CT images was less extensive than those defined from simple CT images. In six patients the target volume was significantly less extensive and in two of them a new lymph node disease was reported, re-staging and corresponding target volume was also delineated with less extensive margins from PET/CT images. A greater accuracy in delineating the volumes and improving the distribution of doses in the planning of the radiant treatment in these patients was possible, allowing a high precision in the delivery of the prescribed dose to the target volume diminishing the maximum dose to the adjacent healthy tissues. In conclusion we show that the use of 18F-FDG PET/CT was superior than the simple CT as the primary modality of imaging for hypofractioned radiotherapy treatment planning in patients with Squamous Head and Neck Carcinoma.
文摘Background:Adjuvant radiotherapy has increased disease-free and overall survival rates in breast cancer. Conventionally fractionated radiotherapy delivers 50 Gy over 5 weeks which is the standard approach. A shorter duration of hypofractionated radiotherapy (HFRT) will be more convenient for patients and treatment providers if found safe and equally effective. Material and Methods: Fifty-four breast cancer patients who underwent breast conservative surgery (BCS) were enrolled in this study. The patients received 4005 cGy/15 fractions. A boost to the tumor bed was administered in all patients. In this study, radiotherapy induced toxicity was evaluated. Results: In this study, the median age of our patients was 48 years with age ranged from 28 to 69 years. Acute skin toxicity was assessed, and it was noted that grade 2 skin toxicity was shown in only 6 patients (11.1%) at the end of radiotherapy and disappeared after 6 weeks of treatment. Late skin toxicity (telangectasia, hyperpigmentation, and subcutaneous fibrosis) was assessed and showed that most patients had grade 0 toxicity with no grade 3 toxicity at all. Regarding pulmonary toxicity, 5 patients (9.3%) developed acute pneumonitis and as regards chronic lung toxicity, it was evident in only 3 patients, 2 patients (3.7%) were grade 1 and 1 patient (1.9%) was grade 2. Cardiac toxicity was evident in 2 patients (7.1%) of the left breast cancer patients. Regarding lymphoedema, most patients that showed lymphoedema were grade 1. Conclusion: The results confirm the safety and feasibility of adjuvant hypofractionated whole breast radiotherapy in breast cancer patients in terms of acute and late toxicity.
文摘<strong>Aim:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> We endeavored to describe the epidemiological profile of prostatic cancer, and to evaluate its diagnostic and therapeutic aspects. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> We conducted a descriptive retrospective study on the conformational radiotherapy of prostatic adenocarcinoma at the Dalal Jamm University Hospital, Senegal from June 2018 to December 2019. We included 62 consecutive patients. The average age of the patients was 68.9 years. The average consultation time was 7.6 months. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Symptom manifestation and high PSA triggered the diagnosis of cancer in 74.2% and 25.8% of patients, respectively. Symptoms: pollakiuria (72.3%), bone pain (8%) and erectile dysfunction (4.8%). The digital rectal examination: normal (33.8%), nodular (30.6%), induration (24.1%), and shielding (11.3%). The mean PSA level was 90.6 ng/ml. Histology: adenocarcinoma was the most common (98.6%). The Gleason score: <7 (45.1%), =7 (35.5%), and >7 (19.4%). The majority of patients were in the high-risk group (70.9%) and 7 patients (11.2%) were metastatic at diagnosis. Therapy: first radical prostatectomy (20.9%), first-line curative radiotherapy (67.8%), adjuvant (21%) and palliative radiotherapy in 7 patients (11.2%): patients having received palliative radiotherapy had an estimated decline in symptoms of 80%. Hormone therapy was performed in 88.8% of patients, with average duration of 12.5 months. After a mean follow-up of 15 months, 59 patients were alive, including 45 cases (81.8%) in complete remission;3 patients with metastasis at the first visit (having received palliative ra</span><span><span style="font-family:Verdana;">diotherapy) died. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The collected data show a profile of prostate cancer that is specific to the sub-Saharan context in which the discovery is still late. Also in comparison to developed countries, the therapeutic means</span></span><span style="font-family:Verdana;"> necessary to fight against this cancer are limited, even though three-dimensional conformational radiotherapy remains an effective and essential treatment;this study provided fundamental data in the area of insufficient data/tools.</span></span></span></span>
文摘<strong>Background:</strong><span style="font-family:""><span style="font-family:Verdana;"> The therapeutic standard for oligoprogressive prostate cancer resistant to castration is second-generation hormone therapy. This systemic treatment is expensive. There are oligoprogressive lesions accessible to radiotherapy. </span><b><span style="font-family:Verdana;">Objectives:</span></b><span style="font-family:Verdana;"> To study the impact of radiotherapy of oligoprogressive </span><span><span style="font-family:Verdana;">lesions on the implementation of second generation hormone therapy. </span><b><span style="font-family:Verdana;">Pa</span></b></span><b><span style="font-family:Verdana;">t</span><span style="font-family:Verdana;">ients and Methods:</span></b><span style="font-family:Verdana;"> A retrospective study from 2012 to 2020 was carried</span><span style="font-family:Verdana;"> out. All patients with oligoprogressive prostate cancer who had received radiotherapy on one or more lesions in progression were collated. Survival was calculated using the Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 8 patients were treated with stereotactic and conformational radiotherapy between August 2012 and August 2020 in the context of oligoprogressive prostate cancer resistant to castration. The median age at diagnosis of oligoprogression was 73 years with a median PSA level of 3.11 ng/ml. Nine lesions were diagnosed with PET scan PSMA. All the lesions were treated by radiotherapy with different regimens. After a median follow-up of 12.5 months, 7 patients showed a biochemical response to treatment with a median decrease in PSA of 67%. The median survival without clinical or biochemical progression was 7 months. The median survival without the need for further systemic treatment was 9 months. During the follow-up period, six patients received second-generation hormone therapy to treat their relapse, and the other two showed no clinical or biochemical relapse. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Radiotherapy may be an alternative to delay the introduction of difficult-to-access second-generation hormone therapy in developing countries. A prospective study could validate this therapeutic approach.</span></span>
文摘Background: Ureterosigmoidostomy was the first form of continent urinary diversion and had broad popularity during the first half of the 20th century. Primary enthusiasm was followed by disappointment when serious problems such as pyelonephritis, electrolyte imbalance, renal calculi and renal function deterioration become evident. In the 1950s these life threatening complications led to avoid this urinary diversion in favor of uretro-intestinal conduits. Objectives: Our aim was to evaluate our experience in ureterocolic shunt after radical cystectomy for bladder cancer. Methodology: This study was conducted in surgical oncology department, South Egypt cancer institute, Assiut university;in the period from January 2012 to January 2017 and including 115 patients (75 males & 40 females). Results: This is retrospective study including 115 patients (75 males & 40 females). Operative time was 130 minutes ranging between 2 to 2.5 hours. Average blood loss was 450 ml. After removal of rectal tube all patients were continent except 15 patients who were improved after 1 - 3 days. Within a month 12 patients had night incontinence and 5 patients had day time incontinence. After that day and night continence gradually improved in all patients except two females who had persistent night soiling and was in need for night time rectal tube. Conclusion: Ureterosigmoidostomy regains the interest of surgical oncology and urologist because of its simplicity and absence of appliance as many patients refusing cutaneous stoma and others are not suitable for orthotopic substitutes.
文摘<strong>Objective:</strong><span style="font-family:""><span style="font-family:Verdana;"> Concurrent chemoradiation value of the resected salivary tumor adjuvant context against regular radiation therapy alone. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective randomized clinical trial. </span><b><span style="font-family:Verdana;">Patients:</span></b><span style="font-family:Verdana;"> 48 patients were randomized to either adjuvant postoperative radiology alone versus concurrent chemoradiotherapy (weekly cisplatin 40 mg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> for 6 cycles) “with resected high-risk salivary tumors of the large and minor salivary gland”. </span><b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Outcome</span></b> <b><span style="font-family:Verdana;">Measures:</span></b><span style="font-family:Verdana;"> Recurrent locoregional Free survival, distant free survival, and overall survival. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of the 48 participants in the study 31 patients had parotid gland tumors. 23 patients received solely adjuvant radiation while 25 patients received concurrent chemoradiotherapy. In the chemoradiation group, platinum-based regimens were employed in all. The mean age in both groups was 48 years. Adenoid cystic carcinoma was the primary pathogenic form of both arms 56% (28 cases). Stage II patients were 35% and 32%, stage III was 39% and 48% and stage VIa were 26% and 20% in the radiation arm and chemoradiotherapy arm respectively. 40 of 48 patients (83%) had close or positive surgical margins and 30 of 48 patients (62%) have a perineural invasion. Both risk variables are more or less well balanced in both arms with no statistical difference. The 2- and 4-year estimates of the locoregional recurrence-free survival rate in the chemoradiation group were 95% and 73%, compared to 77.4% and 43.6% in the radiation arm respectively (p = 007). In the two-and four-year-old chemoradiation arm distant free metastases were 100% and 59% compared to 68% and 39% respectively in the radiation arm (p = 0.08). The overall survival estimates for 2 and 4 years were 93% and 78% respectively in the Chemoradiation Group but in the radiation-alone group were 95% and 48% respectively. The statistically significant differences were p = 0.009 by log-rank testing. Treatment was generally tolerated, although, in the chemoradiation group adverse symptoms, mainly mucositis increased. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Adding weekly cisplatin as a radiosensitizer for locally advanced stage or high-grade salivary gland cancer with adjuvant conventional radiation looks to be helpful and justifies further exploration in selected patients.</span></span>
文摘Purpose: Our prospective phase II trial aims to show the feasibility of adjuvant paclitaxel-based concurrent chemoradiotherapy (CCRT) following doxorubicin and cyclophosphamide (AC) to get the survival benefit of taxanes addition and avoid delay of radiotherapy. Patients and Methods: A total of 63 patients with pT1-2, and pN1-3, M0 breast cancer underwent conservative surgery followed by adjuvant 4 cycles AC followed by 4 cycles Paclitaxel 175 mg/m2 every 3 weeks. Adjuvant radiotherapy started during the first and second cycle of paclitaxel (CCRT). Toxicities evaluated at the base time, weekly during radiation therapy and every 3 months for 24 months for skin, pulmonary, cardiac, lymphedema, subcutaneous fibrosis and cosmoses. Survival reported at 2-year median follow-up. Results: At median follow up time of 24 months (6 - 30), we did not report any toxicity postpone or stop treatment and only two patients had grade III acute dermatitis. Fifty-two patients (82.5%) had satisfactory cosmoses and none of the patients developed local recurrence. Conclusion: Three-weekly paclitaxel during radiotherapy is considered safe without significant complications and acceptable cosmoses with excellent local control and could be considered to avoid radiotherapy delay.
文摘<strong>Background:</strong><span style="font-family:Verdana;"> Post-operative breast radiotherapy is used to reduce recurrence</span><span style="font-family:""><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">The aim of this study was</span><span style="font-family:Verdana;"> to investigate the outcomes of </span><span style="font-family:Verdana;">Deep</span><span style="font-family:Verdana;"> Inspiration Breath-Hold (DIBH) technique with indigenous </span><span style="font-family:Verdana;">breath holding</span><span style="font-family:Verdana;"> indicator scale in 3DCRT for breast cancer radiotherapy over </span><span style="font-family:Verdana;">Free</span><span style="font-family:Verdana;"> Breathing (FB) technique. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> An observational study </span><span style="font-family:Verdana;">conducted</span> </span><span style="font-family:""><span style="font-family:Verdana;">at the </span><span style="font-family:Verdana;">Department</span><span style="font-family:Verdana;"> of Radiation Oncology </span></span><span style="font-family:""><span style="font-family:Verdana;">at </span><span style="font-family:Verdana;">National</span><span style="font-family:Verdana;"> Institute of Cancer Research and Hospital, Dhaka and Square Hospital Limited, Dhaka, Bangladesh from June 2015 to May 2016. A total of 60</span></span><span style="font-family:""><span style="font-family:Verdana;"> confirmed breast cancer patients who underwent adjuvant radiotherapy were included. An indigenous reproducible plastic tool (Perspex) was used as </span><span style="font-family:Verdana;">breath holding</span><span style="font-family:Verdana;"> indicator scale with </span></span><span style="font-family:Verdana;">DIBH</span><span style="font-family:""><span style="font-family:Verdana;"> technique in 3DCRT</span><i><span style="font-family:Verdana;">. </span></i><span><span style="font-family:Verdana;">Paired sample t-test was used to compare with </span><span style="font-family:Verdana;">FB</span><span style="font-family:Verdana;"> technique. </span><b><span style="font-family:Verdana;">Results:</span></b><i> </i><span style="font-family:Verdana;">The mean age of patients </span><span style="font-family:Verdana;">w</span></span></span><span style="font-family:Verdana;">as</span><span style="font-family:Verdana;"> 47.32 (SD ± 8.33) years.</span><span style="font-family:""><span style="font-family:Verdana;"> In </span><span style="font-family:Verdana;">FB</span><span style="font-family:Verdana;"> technique, Mean Heart Dose (MHD) was 413.27 cGy while in </span><span style="font-family:Verdana;">DIBH</span><span style="font-family:Verdana;"> technique, it was 254.91 cGy (P < 0.001). The mean heart V20</span></span><span style="font-family:Verdana;"> and </span><span style="font-family:""><span style="font-family:Verdana;">V30 </span><span style="font-family:Verdana;">were</span><span style="font-family:Verdana;"> 5.5%, 4.37%</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">in FB and</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">3.13%, 2.36% in DIBH respectively. In </span><span style="font-family:Verdana;">FB</span><span style="font-family:Verdana;"> technique LADMD, LAD</span></span><span style="font-family:""> </span><span style="font-family:Verdana;">0.2</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">cm</span><sup><span style="font-family:Verdana;">3</span></sup><span style="font-family:Verdana;">, ILMD </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> ILV20 </span><span style="font-family:Verdana;">w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:Verdana;"> 1698.17</span><span style="font-family:""> </span><span style="font-family:""><span style="font-family:Verdana;">cGy, 2852.53 cGy, 1155.31 cGy </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> 28.62% while in </span><span style="font-family:Verdana;">DIBH</span><span style="font-family:Verdana;"> technique, it was reduced to 1164.01 cGy, 2132.24 cGy, 1007.98 cGy and 23.39% respectively. Similarly, the lung-CLMD and breast-CLMD </span><span style="font-family:Verdana;">w</span></span><span style="font-family:Verdana;">ere</span><span style="font-family:""><span style="font-family:Verdana;"> reduced from 38.37 cGy and 55.18 cGy to 24.64 cGy and 33.82 cGy respectively (P < 0.001). The mean difference for breast-CLMD was 21.36 cGy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The use of indigenous </span><span style="font-family:Verdana;">breath holding</span><span style="font-family:Verdana;"> indicator scale with DIBH had better outcomes on breast cancer radiotherapy.</span></span>
文摘<strong>Context:</strong> <span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">Technological advances have improved the toxicities of radiotherapy. We are evaluating the 3D technique in prostate cancer. </span><b><span style="font-family:Verdana;">Materials and Methods:</span></b><span style="font-family:Verdana;"> Retrospective study from January 2015 to December 2015 with 29 files. Survival was calculated by Kaplan-Meier method. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">We collected 29 patient records over the study period. The median age was 75 years with the following extremes: 54 years and 83 years. The median PSA level was 12 ng/ml with a range of 3.05 to 79 ng/ml. Gleason score analysis showed 6 patients (20.69%) with a score of 6 (3 + 3), 23 patients (79.31%) with a score of 7 including 12 patients (41.38%) with grade 3 and 11 patients (37.93%) with grade 4. The median dose delivered was 74 Gy, with a mean dose of 73.79 Gy and extremes of 70 Gy for the minimum and 76 Gy for the maximum. Hormone therapy was combined with radiotherapy in 17 patients (58.62%). Sev</span><span style="font-family:Verdana;">en patients (24.14%) had grade 1 acute bladder toxicity and one patient</span><span style="font-family:Verdana;"> (3.45%) </span><span style="font-family:Verdana;">had grade 2 acute toxicity. Late bladder toxicity was grade 1 in 5 patients</span><span style="font-family:Verdana;"> (17.24%), grade 2 in 3 patients (10.34%) and grade 3 in 1 patient (3.45%). </span><span style="font-family:Verdana;">Late rectal toxicity, grade 2 in 3 patients (10.34%), grade 3 in 1 patient, was noted. Overall survival at 2 years was 100% and 89.65% at 5 years. Relapse-free </span><span><span style="font-family:Verdana;">survival at 2 years was 82.76% and 62.07% at 5 years. There were 3 deaths (10.34%) of which only one was related to prostate cancer. </span><b><span style="font-family:Verdana;">Conclusion:</span></b></span></span></span></span></span></span><span><span><b><span style="font-family:""> </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Radiotherapy, like surgery, is a fundamental option for the treatment of </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">prostate cancers, particularly those that are locally advanced. It is gaining in importance with the improvement of techniques (IMRT, VMAT…) and new fractionations which contribute to the reduction of toxicities and the comfort of patients (shorter spread).</span></span></span>
基金supported by Linyi City Science and Technology Development Plan in 2014(No.201413010)
文摘Objective: To study the inhibiting effect of Endostar combined with ginsenoside Rg3 on breast cancer tumor growth in tumor-bearing mice. Methods: Female mice were selected as experimental animals, and breast cancer tumor-bearing mouse models were established and then divided into group A, B, C and D that respectively received saline, recombinant human endostatin, ginsenosides Rg3 and recombinant human endostatin combined with Rg3 intervention; 7 d, 14 d and 21 d after intervention, tumor tissue volume was measured; 21 d after intervention, mice were killed, tumor tissue was collected, and m RNA contents of angiogenesis molecules, invasion molecules, autophagy marker molecules and autophagy signaling pathway molecules were detected. Results: At 7 d, 14 d and 21 d after intervention, tumor tissue volume of group B, C and D was lower than that of group A, and tumor tissue volume of group D was lower than that of group B and C; m RNA contents of VEGFA, VEGFB, VEGFC, MMP2, MMP9, p62, m TOR, PI3 K, Akt, JNK and Beclin-1 in tumor tissue of group B, C and D were significantly lower than those of group A, and LC3-II/LC3-I was significantly higher than that of group A; m RNA contents of VEGFA, VEGFB, VEGFC, MMP2, MMP9, p62, m TOR, PI3 K, Akt, JNK and Beclin-1 in tumor tissue of group D were significantly lower than those of group B and C, and LC3-II/LC3-I was higher than that of group B and C. Conclusions: Endostar combined with ginsenoside Rg3 has stronger inhibiting effect on breast cancer tumor growth in tumor-bearing mice than single drug, and it can inhibit angiogenesis and cell invasion, and enhance cell autophagy.
文摘Objective To investigate the effects of quercetin and X-ray on collagen synthesis of cultured human keloid-derived fibroblast and the mechanism.Methods Collagen synthesis of cultured human keloid and normal fibroblasts were detected by hydroxyproline colorimetric analysis. Immunocytochemical staining was used to investigate collagen I and III expression. mRNA expression of collagen I and III, and transforming growth factor (TGF)-β1 were assayed by reverse transcription-polymerase chain reaction (RT-PCR) and real-time PCR. Results Quercetin inhibited the collagen synthesis of both keloid and normal fibroblasts in a dose-dependent manner. Immunocytochemical staining indicated that collagen I and III were down-regulated by quercetin and X-ray (P<0.05), particularly collagen I (P<0.05). mRNA expression of both collagen I and III in quercetin groups significantly decreased compared with that in control group (P<0.05), especially in the group treated with both quercetin and X-ray (P<0.01). mRNA level of TGF-β1 gene was down-regulated by quercertin (P<0.05). Conclusions Quercetin will probably be one of the new medicines which could effectively treat keloid. Quercetin combined with X-ray could reduce the dose of radiation.
基金Supported by National Natural Science Foundation of China(Grant No.2013BAI01B01)Science and Technology Planning Project of Beijing Education Commission of China(Grant No.KM201310017002)
文摘The existing interventional therapy robots for the microwave ablation of liver tumors have a poor clinical applicability with a large volume, low positioning speed and complex automatic navigation control. To solve above problems, a composite configuration interventional therapy robot with passive and active joints is developed. The design of composite configuration reduces the size of the robot under the premise of a wide range of movement, and the robot with composite configuration can realizes rapid positioning with operation safety. The cumulative error of positioning is eliminated and the control complexity is reduced by decoupling active parts. The navigation algorithms for the robot are proposed based on solution of the inverse kinematics and geometric analysis. A simulation clinical test method is designed for the robot, and the functions of the robot and the navigation algorithms are verified by the test method. The mean error of navigation is 1.488 mm and the maximum error is 2.056 mm, and the positioning time for the ablation needle is in 10s. The experimental results show that the designed robot can meet the clinical requirements for the microwave ablation of liver tumors. The composite configuration is proposed in development of the interventional therapy robot for the microwave ablation of liver tumors,which provides a new idea for the structural design of medical robots.
