scholarly journals Effectiveness and toxicity of conventional radiotherapy treatment for painful spinal metastases: a detailed course of side effects after opposing fields versus a single posterior field technique

2017 ◽  
Vol 7 (1) ◽  
pp. 17-26 ◽  
Author(s):  
Paulien G. Westhoff ◽  
◽  
Alexander de Graeff ◽  
Evelyn M. Monninkhof ◽  
Ilse de Pree ◽  
...  
Keyword(s):  
Side Effects ◽  
Spinal Metastases ◽  
Conventional Radiotherapy ◽  
Field Technique ◽  
Posterior Field ◽  
Radiotherapy Treatment

scholarly journals Management of recurrent or progressive spinal metastases: reirradiation techniques and surgical principles

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. i45-i53
Author(s):  
Rupesh Kotecha ◽  
Nicolas Dea ◽  
Jay S Detsky ◽  
Arjun Sahgal
Keyword(s):  
Progressive Disease ◽  
Organs At Risk ◽  
Methodological Approach ◽  
Spinal Metastases ◽  
Multidisciplinary Care ◽  
Rehabilitation Medicine ◽  
Surgical Approaches ◽  
Mechanical Instability ◽  
Conventional Radiotherapy ◽  
Treated Site

Abstract With the growing incidence of new cases and the increasing prevalence of patients living longer with spine metastasis, a methodological approach to the management of patients with recurrent or progressive disease is increasing in relevance and importance in clinical practice. As a result, disease management has evolved in these patients using advanced surgical and radiotherapy technologies. Five key goals in the management of patients with spine metastases include providing pain relief, controlling metastatic disease at the treated site, improving neurologic deficits, maintaining or improving functional status, and minimizing further mechanical instability. The focus of this review is on advanced reirradiation techniques, given that the majority of patients will be treated with upfront conventional radiotherapy and further treatment on progression is often limited by the cumulative tolerance of nearby organs at risk. This review will also discuss novel surgical approaches such as separation surgery, minimally invasive percutaneous instrumentation, and laser interstitial thermal therapy, which is increasingly being coupled with spine reirradiation to maximize outcomes in this patient population. Lastly, given the complexities of managing recurrent spinal disease, this review emphasizes the importance of multidisciplinary care from neurosurgery, radiation oncology, medical oncology, neuro-oncology, rehabilitation medicine, and palliative care.

Cranberry in radiotherapy: dispelling the myths. A review of the literature

2013 ◽  
Vol 13 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Lynne Gordon
Keyword(s):  
Urinary Tract ◽  
Side Effects ◽  
Quality Data ◽  
Cochrane Library ◽  
High Quality Data ◽  
Radiation Cystitis ◽  
Radiation Induced ◽  
Randomised Controlled ◽  
Firm Evidence ◽  
Radiotherapy Treatment

AbstractBackgroundTherapeutic radiographers routinely offer advice to patients regarding treatment-related side effects. Cranberry has long been used as a natural remedy for several health complaints and has more recently been suggested as having a role in the treatment and prophylaxis of urinary tract infection (UTI) and symptoms.PurposeThe aim of this review was to investigate whether there is a place for cranberry as part of the management of radiation cystitis caused by radiotherapy treatment of pelvic cancers, in order to aid therapeutic radiographers in tailoring their advice regarding pelvic side effects.Materials and methodsA structured search was carried out using PubMed, CINAHL, Scopus and Cochrane Library databases. A total of 25 articles were selected for review.ResultsThemes of mechanism of action of cranberry, composition of cranberry products, cranberry and UTI, use of cranberry in radiotherapy and further issues to consider were identified and explored.ConclusionA lack of high-quality data was identified in the literature reviewed and no firm evidence was found to support the continued recommendation of cranberry as part of management of radiation induced urinary tract side effects. Well-designed randomised controlled trials are required before further recommendations regarding the use of cranberry in radiotherapy are made.

scholarly journals Conventional Radiotherapy and Stereotactic Radiosurgery in the Management of Metastatic Spine Disease

2020 ◽  
Vol 19 ◽  
pp. 153303382094579
Author(s):  
Hao-ran Zhang ◽  
Ji-kai Li ◽  
Xiong-gang Yang ◽  
Rui-qi Qiao ◽  
Yong-Cheng Hu
Keyword(s):  
Spinal Cord ◽  
Pain Relief ◽  
Life Expectancy ◽  
Stereotactic Radiosurgery ◽  
Spinal Cord Compression ◽  
Spinal Metastases ◽  
Scoring Systems ◽  
Cord Compression ◽  
Conventional Radiotherapy ◽  
Radiation Induced

Spinal metastases are a common manifestation of malignant tumors that can cause severe pain, spinal cord compression, pathological fractures, and hypercalcemia, and these clinical manifestations will ultimately reduce the health-related quality of life and even shorten life expectancy in patient with cancer. Effective management of spinal bone metastases requires multidisciplinary collaboration, including radiologists, surgeons, radiation oncologists, medical oncologists, and pain specialists. In the past few decades, conventional radiotherapy has been the most common form of radiotherapy, which can achieve favorable local control and pain relief; however, it lacks precise methods of delivering radiation and thus cannot provide sufficient tumoricidal dose. The advent of stereotactic radiosurgery has changed this situation by using highly focused radiation beams guided by 3-dimensional imaging to deliver a high biologic equivalent dose to the target region, and the spinal cord can be identified and excluded from the target volume to reduce the risk of radiation-induced myelopathy. Separation surgery can provide a 2- to 3-mm safe separation of tumor and spinal cord to avoid radiation-induced damage to the spinal cord. Targets for separation surgery include decompression of metastatic epidural spinal cord compression and spinal stabilization without partial or en bloc tumor resection. Combined with conventional radiotherapy, stereotactic radiosurgery can provide better local tumor control and pain relief. Several scoring systems have been developed to estimate the life expectancy of patients with spinal metastases treated with radiotherapy. Thorough understanding of radiotherapy-related knowledge including the dose-fractionation schedule, separation surgery, efficacy and safety, scoring systems, and feasibility of combination with other treatment methods is critical to providing optimal patient care.

Radiotherapy

2019 ◽  
pp. 193-204
Author(s):  
Richard Brown ◽  
Paula Horne
Keyword(s):  
Side Effects ◽  
Treatment Plan ◽  
Radiotherapy Planning ◽  
Optimum Treatment ◽  
Recent Advances ◽  
Palliative Setting ◽  
Radiotherapy Treatment

This chapter examines the manner in which radiotherapy is employed to treat cancers and the general principles which govern its use. Radiotherapy can be used in a curative or palliative setting and is frequently combined with surgery or chemotherapy to produce an optimum treatment plan. The underpining radiobiology to treatment fractionation is briefly explored, before the differing modalities by which radiotherapy can be delivered are outlined. The principles of radiotherapy planning are laid out, before recent advances in radiotherapy treatment are also covered. Radiotherapy toxicities and side effects and the management of these are analysed in some detail.

Radiotherapy

2007 ◽  
pp. 201-212
Keyword(s):  
Side Effects ◽  
Treatment Planning ◽  
Normal Tissue ◽  
Skin Toxicity ◽  
Tumour Cells ◽  
The Body ◽  
Treatment Modalities ◽  
Psychological Consequences ◽  
Radiotherapy Treatment

Principles and uses 202 Treatment modalities 204 Treatment planning and delivery 206 Management of radiotherapy treatment and its side effects 208 Skin toxicity 210 Radiotherapy works by destroying cells within the body. It is delivered in as uniform a dose as possible to an accurately defined target to minimize physiological and psychological consequences for the patient. The aim is to kill the tumour cells whilst avoiding as much normal tissue as possible...

Radiographer review clinics: breast cancer

2004 ◽  
Vol 4 (1) ◽  
pp. 33-38 ◽  
Author(s):  
J. Cameron
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
Clinical Review ◽  
Adjuvant Treatment ◽  
Hormonal Therapy ◽  
Well Being ◽  
Radical Radiotherapy ◽  
Skin Reactions ◽  
Acute Skin Reactions ◽  
Radiotherapy Treatment

Acute skin reactions are expected in patients receiving radical radiotherapy to the breast. Side effects of other adjuvant treatments such as chemotherapy and hormonal therapy can further impact upon patients' well being. As a result these patients are routinely monitored throughout their radiotherapy treatment at a review clinic. Previously the domain of doctors, radiographers are expanding their existing role and becoming more involved in review clinics.This paper highlights the key side effects reported by actual patients from their adjuvant treatment and strategies to alleviate these side effects. It also reflects upon the experience, both positive and negative, of undertaking clinical review and role expansion in general.

scholarly journals Changes in Spinal Instability After Combined Therapy of Conventional Radiotherapy and Bone Modifying Agents for Painful Vertebral Bone Metastases

2021 ◽  
Author(s):  
Eiji Nakata ◽  
Shinsuke Sugihara ◽  
Yoshifumi Sugawara ◽  
Ryuichi Nakahara ◽  
Shouta Takihira ◽  
...  
Keyword(s):  
Combined Therapy ◽  
Spinal Metastases ◽  
Spinal Instability ◽  
Vertebral Metastases ◽  
Conventional Radiotherapy ◽  
Potential Risk Factors ◽  
The Difference ◽  
Over Time ◽  
Selection Of

Abstract Precise assessment of spinal instability is critical at the beginning and after radiotherapy for selection of the treatment and evaluating the effectiveness of radiotherapy. We investigated changes of spinal instability after radiotherapy and examined potential risk factors for the difference of the outcome of spinal instability for painful spinal metastases. We evaluated 81 patients who received radiotherapy for painful vertebral metastases in our institution between 2012 and 2016. The pain at the vertebrae was assessed. Radiological responses of irradiated vertebrae were assessed by computed tomography. Spinal instability was assessed by Spinal Instability Neoplastic Score (SINS). Follow-up assessments were done at the start of radiotherapy and at 1, 2, 3, 4, and 6 months after radiotherapy. At each of one to six months, pain disappeared in 62%, 84%, 93%, 98%, and 100% of patients. The median SINS were 8, 7, 6, 5, 5, and 4 at the beginning of radiotherapy and after 1, 2, 3, 4, and 6 months, respectively, which significantly decreased over time (P < 0.001). Multivariate analysis revealed that PLISE was the only risk factor for spinal instability at one month. In conclusion, spinal instability significantly improved over time after radiotherapy. Clinicians should take attention to PLISE in the radiotherapy of vertebral metastases.

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