Microwave-Induced Hyperthermia and Radiotherapy in Human Superficial Tumours: Clinical Results with a Comparative Study of Combined Treatment Versus Radiotherapy Alone

1988 ◽  
pp. 152-156 ◽  
Author(s):  
C. E. Lindholm ◽  
E. Kjellen ◽  
P. Nilsson ◽  
T. Landberg ◽  
B. Persson
Keyword(s):  
Comparative Study ◽  
Combined Treatment ◽  
Clinical Results ◽  
Induced Hyperthermia ◽  
Radiotherapy Alone

scholarly journals Cost-effectiveness analysis (CEA) of IMRT plus C12 boost vs IMRT only in adenoid cystic carcinoma (ACC) of the head and neck

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
A D Jensen ◽  
Jürgen Debus
Keyword(s):  
Cost Effectiveness ◽  
Local Control ◽  
Recurrent Disease ◽  
Treatment Options ◽  
Combined Treatment ◽  
Intensity Modulated Radiotherapy ◽  
Experimental Treatment ◽  
Clinical Results ◽  
Particle Therapy ◽  
Combination Regimen

Abstract Background Particle therapy provides steep dose gradients to facilitate dose escalation in challenging anatomical sites which has been shown not only to improve local control but also overall survival in patients with ACC. Cost-effectiveness of intensity-modulated radiotherapy (IMRT) plus carbon ion (C12) boost vs IMRT alone was performed in order to objectivise and substantiate more widespread use of this technology in ACC. Methods Patients with pathologically confirmed ACC received a combination regimen of IMRT plus C12 boost. Patients presenting outside C12 treatment slots received IMRT only. Clinical results were published; economic analysis on patient-level data was carried out from a healthcare purchaser’s perspective based on costs of healthcare utilization. Cost histories were generated from resource use recorded in individual patient charts and adjusted for censoring using the Lin I method. Cost-effectiveness was measured as incremental cost-effectiveness ratio (ICER). Sensitivity analysis was performed regarding potentially differing management of recurrent disease. Results The experimental treatment increased overall costs by € 18,076 (€13,416 – €22,922) at a mean survival benefit of 0.86 years. Despite improved local control, following costs were also increased in the experimental treatment. The ICER was estimated to 26,863 €/LY. After accounting for different management of recurrent disease in the two cohorts, the ICER was calculated to 20,638 €/LY. Conclusion The combined treatment (IMRT+C12 boost) substantially increased initial and overall treatment cost. In view of limited treatment options in ACC, costs may be acceptable though. Investigations into quality of life measures may support further decisions in the future.

Treatment of cancer with radiation and drugs.

1996 ◽  
Vol 14 (12) ◽  
pp. 3156-3174 ◽  
Author(s):  
I F Tannock
Keyword(s):  
Randomized Trials ◽  
Combined Treatment ◽  
Therapeutic Index ◽  
Clinical Results ◽  
Therapeutic Benefit ◽  
Current Status ◽  
Combined Modality Treatment ◽  
Normal Tissues ◽  
Tissue Microenvironment ◽  
Meta Analyses

PURPOSE To review the current status and future prospects of combined treatment of cancer with radiation and drugs. DESIGN A review of (1) mechanisms whereby combined use of radiation and drugs might lead to improved therapeutic benefit for the treatment of cancer; (2) problems related to the design and analysis of clinical trials that evaluate combined modality treatment; and (3) clinical results of larger randomized trials that have compared combined versus single modality treatment for various types of cancer. RESULTS Improvement in the therapeutic index depends on exploitation of the biologic properties that differ between tumors and normal tissues; such properties may include mechanisms of resistance to radiation and drugs, tissue microenvironment, and cell proliferation or repopulation during radiotherapy. To detect or rule out the small but clinically important differences in outcome that might occur will require the performance of large, randomized, controlled trials or patient-based meta-analyses; single-arm studies, small randomized trials, and subgroup analyses of larger trials can generate hypotheses. Clinical gains from combined treatment have been demonstrated in a few sites, with disappointing results in others. In general, more promising results have accrued from concurrent treatment, despite greater toxicity, than from sequential use of drugs and radiation. CONCLUSION Clinical gains from combined treatment with radiation and drugs have been small. New, mechanistically based approaches to combined treatment are required.

Results of primary endovascular treatment compared to endovascular treatment combined with intravenous thrombolysis in patients with stroke

2018 ◽  
Vol 20 (3) ◽  
pp. 49-56
Author(s):  
S. P. Semitko ◽  
A. I. Analeev ◽  
V. P. Klimov ◽  
A. V. Аzarov ◽  
A. E. Vanyukov ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Combined Treatment ◽  
Intravenous Thrombolysis ◽  
Clinical Results ◽  
Endovascular Intervention ◽  
Endovascular Procedure ◽  
Additional Time ◽  
Study Objective ◽  
Intracranial Vessel ◽  
Worse Prognosis

The study objective is to investigate immediate angiographic and clinical results of endovascular treatment of ischemic stroke in patients who had contraindications to the appointment of adjuvant thrombolytic therapy (TLT), and patients who underwent combined treatment (TLT + thrombolysis/thrombextraction).Materials and methods. From 2016 to 2018, selective cerebral arteriography was performed in 48 patients with acute stroke within 4.5 hours from the onset of the disease to ascertain the possibility of endovascular treatment. The main indication was occlusion of a large intracranial vessel (internal carotid artery or middle cerebral artery at the level of M1–M2 segments) according to multislice computed tomography. In the absence of contraindications, TLT was prescribed and selective angiography and thrombaspiration/thrombextraction were performed. In 5 (10.4 %) patients with TLT no occlusion of the intracranial vessel was found, it was interpreted as evidence of effectiveness, these patients were excluded from further analysis.Results. The group of combined treatment (TLT + endovascular procedure) included 18 patients, the group of endovascular treatment without TLT – 25. The severity of stroke in patients who were denied TLT was objectively heavier, which led to a statistically worse prognosis than in patients who were assigned TLT. However, after the endovascular procedure (which was more successful according to a number of indirect criteria), the clinical characteristics of both groups were similar. In patients undergoing endovascular intervention without TLT, thrombaspiration often proved to be an effective, rarely used expensive tools to thrombextraction, decreased the number of attempts of thrombextraction using a stent retriever and there were rare cases of embolization of the distal territory.Conclusion. If it is possible to perform endovascular intervention without TLT and without additional time spent on transportation, it can be a method of choice, providing equal or possibly greater efficacy and safety of treatment in comparison with TLT. Further experience and further research is needed to clarify the value of both methods.

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