Radiation therapy and treatment results of malignant tumors of the lower jam

Abstract Introduction Little has been published about the choroidal vascular changes that occur years after radiation exposure. The aim of this study was to review the histological changes observed in the choroidal vasculature following radiotherapy for uveal melanoma. Methods Records from a single institution were retrospectively reviewed from June 7, 2007 to June 7, 2017; 101 patients with a diagnosis of uveal melanoma that underwent enucleation had their records reviewed. Out of these, a total of 26 eyes had undergone plaque brachytherapy prior to enucleation, which had been performed at a mean time of 7.2 years (range from 0 years to 30 years) after the initial plaque placement. A histopathologic analysis was conducted on all 26 eyes with special emphasis on the choroidal changes. Of these 26 eyes, 18 demonstrated evidence of radiation-induced vasculopathy. Results Of the 18 eyes, 10/18 (55%) had radiation retinopathy and 16/18 (89%) had radiation choroidal vasculopathy. One patient had a phthisical eye, and the choroid could not be evaluated because the characteristics of the vasculature could not be determined. Nine cases had vitreous hemorrhage (50%), all cases had radiation retinopathy, and 8/9 (89%) had radiation choroidopathy. Of the 16 cases with radiation choroidal vasculopathy, 3/16 (19%) had only intratumoral radiation choroidal vasculopathy, 3/16 (19%) had only extratumoral radiation choroidal vasculopathy, and, thus, 10/16 (32%) had both intratumoral and extratumoral radiation choroidal vasculopathy. In patients with radiation choroidal vasculopathy, 2/16 (13%) had hyalinization of the choroidal vessels. Another 3/16 (19%) cases with radiation choroidal vasculopathy had ectatic vessels. The other 11/16 (68%) had evidence of both hyalinization of the choroidal vessels as well as ectatic vessels in the choroid. Histological evidence of radiation retinopathy and choroidopathy were seen in 69% of eyes enucleated after receiving radiation therapy, which, in some cases, also had vitreous hemorrhage. Polypoidal choroidal vasculopathy, choroidal neovascularization, and retinal choroidal anastomoses (RAP-type lesions) were seen in 12 of the 16 eyes (75%). Discussion/Conclusion Irradiation of malignant tumors of the eye causes not only radiation retinopathy but also radiation choroidopathy. The role of radiation choroidopathy in the subsequent visual loss following radiotherapy and the role of anti-VEGF therapy needs to be recognized and distinguished from radiation retinopathy. Our data adds to the prior limited knowledge that radiation affects the choroid and can induce specific phenotypes similar to the clinical spectrum of CNV, PCV, and RAP.

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MET-05 Clinical investigation of treatment results and recurrence patterns of metastatic brain tumors from the viewpoint of postoperative irradiation

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa143.083 ◽

2020 ◽

Vol 2 (Supplement_3) ◽

pp. ii19-ii19

Author(s):

Tetsuo Hashiba ◽

Haruka Kawano ◽

Katsuya Ueno ◽

Qiang Lee ◽

Haruna Isozaki ◽

...

Keyword(s):

Radiation Therapy ◽

Brain Tumors ◽

Clinical Investigation ◽

Postoperative Radiotherapy ◽

En Bloc Resection ◽

Metastatic Brain Tumors ◽

Treatment Results ◽

En Bloc ◽

Postoperative Radiation Therapy ◽

Observation Period

Abstract While whole brain radiation therapy (WBRT) had been the standard postoperative radiation therapy for metastatic brain tumors for long time, recently local radiation therapy (LRT) has be become to be a new standard due to the accumulation of clinical evidences. Treatment results and pattern of recurrence were retrospectively analyzed from view point of postoperative radiotherapy. In this study, totally 69 patients were included and they were divided into WBRT group or LRT group. We analyzed the number of lesions, treated era, overall survival after diagnosis of metastasis (OS), recurrence free survival after RT (RFS), and patterns of recurrences. The subjects consisted of 37males and 32 females and average age was 61.7 years old. There were 49 cases in the WBRT group and 20 cases in the LRT group. While all cases before November 2017 had WBRT performed, LRT was adopted mainly in cases with a small number of metastases since December 2017. Although there was a difference in the observation period between the two groups, OS tended to be longer in the LRT group (P=0.08), while RFS tended to be shorter in the LRT group (P=0.08). Radiological recurrence after RT was observed in 7 cases in both groups, and in WBRT group, all cases were local recurrence, whereas in LRT group, all cases were new lesions or disseminated recurrence. Although there are biases such as the difference in observation period between the two groups and the tendency to adopt WBRT in cases with a large number of metastases, there is a possibility that postoperative LRT is not inferior to WBRT, especially for cases with a small number of metastases. However, we have experienced some cases of disseminated recurrence, and so it is necessary to consider the resection fashion such as whether en-bloc resection or piece meal resection when selecting postoperative RT.

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Systemic Therapy for Head and Neck Skin Cancers

FACE ◽

10.1177/27325016211013880 ◽

2021 ◽

pp. 273250162110138

Author(s):

Rebecca Knackstedt ◽

Peter Taub ◽

Gary Rogers ◽

Brian Gastman

Keyword(s):

Radiation Therapy ◽

High Risk ◽

Head And Neck ◽

Systemic Therapy ◽

Malignant Tumors ◽

Curative Therapy ◽

Recurrent Tumors ◽

Skin Cancers ◽

Systemic Therapies ◽

Melanoma Skin

The mainstay of curative therapy for head and neck skin cancers relies upon surgery and/or radiation therapy. However, for some aggressive, non-resectable or recurrent tumors, systemic therapy is necessary. Recent emerging classes of drugs have shown to improve survival for high-risk, recurrent, and unresectable variants of these tumors. The goal of this paper is to review options for systemic therapies for head and neck skin cancers including melanoma, non-melanoma skin cancers and other rare and non-malignant tumors.

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Long-term treatment results of postoperative radiation therapy for advanced stage oropharyngeal carcinoma

American Journal of Otolaryngology ◽

10.1016/0196-0709(93)90060-k ◽

1993 ◽

Vol 14 (2) ◽

pp. 140

Keyword(s):

Radiation Therapy ◽

Term Treatment ◽

Oropharyngeal Carcinoma ◽

Advanced Stage ◽

Postoperative Radiation ◽

Treatment Results ◽

Postoperative Radiation Therapy ◽

Long Term Treatment

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LATE RADIATION TOXICITY AFTER RADICAL RADIOTHERAPY FOR GENITAL CANCER

Проблеми радіаційної медицини та радіобіології = Problems of Radiation Medicine and Radiobiology ◽

10.33145/2304-8336-2020-25-130-147 ◽

2020 ◽

Vol 25 ◽

pp. 130-147

Author(s):

O. Sukhina ◽

◽

K. Nemaltsova ◽

O. Panov ◽

◽

...

Keyword(s):

Radiation Therapy ◽

Radiation Damage ◽

Malignant Tumors ◽

Practical Experience ◽

Radiation Toxicity ◽

Long Term Effects ◽

Radiation Cystitis ◽

Local Radiation ◽

Effects Of Radiation ◽

Female Genital

Radiation therapy for malignant tumors of the female genital area, even with the use of modern radiotherapy equipment and dosimetric planning, causes the development of local radiation changes. An approach involving methods of general and local exposure is used in their treatment. One of the most promising directions is the creation of optimal combinations of medicines (in the form of ointments, gels, aerosols, suppositories, etc.), which have a therapeutic effect on the inflammatory process. The article reflects the clinical course and stage of occurrence of late radiation reactions of the skin, vaginal/cervix mucosa, bladder, and intestines, as well as the features of their treatment. Literary data and own practical experience in the treatment of radiation complications are presented. When reviewing the topic under study, it could be concluded that the leading cause of the development of local radiation damage is the errors in the planning and implementation of radiation therapy, when high absorbed doses that exceed the tolerance of healthy tissues are used. Another reason for this is the poor accounting for dose distribution of ionizing radiation in tissues, the presence of concomitant diseases in patients, and the underestimation of the long-term effects of radiation. Key words: female genital organs, radiation damage, radiodermatitis, radioepitheliitis, radiation rectitis, radiation cystitis.

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Тhe effect of cancer patients’ positioning accuracy during radiation therapy sessions using medical linear electron accelerators on the parameters of their individual 3D dose distribution

Doklady BGUIR ◽

10.35596/1729-7648-2020-18-7-31-39 ◽

2020 ◽

Vol 18 (7) ◽

pp. 31-39

Author(s):

M. N. Piatkevich ◽

E. V. Titovich ◽

G. V. Belkov

Keyword(s):

Radiation Therapy ◽

Radiation Treatment ◽

Malignant Tumors ◽

Rapid Development ◽

Treatment Session ◽

Malignant Neoplasms ◽

Horizontal Position ◽

Individual Dose ◽

Dose Distributions ◽

The Impact

Due to the rapid development and further improvement of radiation treatment technologies oncologists have an opportunity to precisely deliver individual dose distributions to the tumor, minimizing the doses obtained by critical organs and healthy structures. For the correct and successful application of these complex methods of radiation therapy, it was necessary to enforce the requirements for the technical and dosimetric parameters of the radiotherapy equipment. The purpose of the research is to determine the magnitude of the possible error for patients’ positioning during their radiotherapy treatments using medical linear accelerators by modeling the impact of the patient’s body on the treatment couch. To determine the values of a possible error, the authors have considered the design and characteristics of a typical treatment couch, developed a model of the “average” patient’s body (phantom), which allowed changing the load to the treatment couch with a step of 1 kg. The position parameters of treatment couches were determined for the main types of localization of radiation therapy for malignant tumors: head and neck tumors, breast tumors and pelvic tumors. Numerical values of the treatment coach deviations from prescribed horizontal position were experimentally established for a load from 40 to 180 kg for a treatment couch used at the N.N. Alexandrov National Cancer Centre of Belarus. Based on the obtained experimental data, the necessity to correct the patient's treatment conditions at the stage of treatment planning were confirmed in order to ensure the delivery accuracy of individual dose distributions as required by the radiation therapy protocols. Authors stated that an analysis of the dependence of the deviations in the dose delivered to the patients on the deviation of the radiotherapy table from its horizontal position should be carried out for each radiotherapy table used in clinical practice. The development and implementation of a mechanism that will allow considering this information when choosing the parameters of the patient’s treatment session and prescribing the dose for any localization of malignant neoplasms is needed.

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OTHR-02. MULTIMODALITY TREATMENT FOR CHILDREN WITH CENTRAL NERVOUS SYSTEM (CNS) TUMOR IN OUR INSTITUTE

Neuro-Oncology ◽

10.1093/neuonc/noaa222.632 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii423-iii423

Author(s):

Mari Sasano ◽

Koichiro Sumi ◽

Nobuhiro Moro ◽

Hideki Oshima ◽

Maiko Hirai ◽

...

Keyword(s):

Radiation Therapy ◽

Brain Tumor ◽

Malignant Tumors ◽

Treatment Plan ◽

Pediatric Brain Tumor ◽

Multimodality Treatment ◽

Whole Body ◽

Cell Transplant ◽

Treatment Team ◽

Cns Tumor

Abstract BACKGROUND The brain tumor has a highest mortality rate among childhood malignant tumors. Development of peripheral blood stem cell transplant combined chemotherapy and radiation therapy improved the survival rate of patients with pediatric brain tumor drastically late years. Because of its complicated treatment plan, neurosurgeons cannot readily manage these aggressive therapies which require minute whole body control including prevention of lethal infection due to bone marrow suppression. Even if such treatment is effective and patient survives, the aftereffects may reduce patient’s QOL. PURPOSE We report outcomes of the patients with CNS tumor after multimodality treatment. In addition, we introduce the activity contents by the in-hospital children brain tumor multi-disciplinary medical treatment team organized in March 2016. METHODS We retrospectively reviewed 29 patients (under 15 years old) diagnosed as CNS tumors with total of 43 tumor surgeries between January 2001 and December 2019. RESULTS The histopathological diagnoses were 7 germ cell tumor, 7 astrocytic tumor, 4 ependymal tumor, 4 medulloblastoma, 2 craniopharyngioma, 2 AT/RT and 3 others. The mean age at first surgery was 7.4 y.o. (range: 0.3–14.8). Both chemotherapy and radiation therapy were performed in 22 cases out of 29. There were 15 survivors (11 ambulant, 3 W/C, 1 bedridden), 12 deaths, 2 lost follow-ups. Mean follow-up period was 66 months (range: 1–206). CONCLUSION To improve outcomes, we hold on a regular basis of team meeting, discuss treatment plan, and share information. Recently, we also care issues of the patients, such as fertility and palliative medicine.

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