scholarly journals Analysis of Local Control Rate and Toxicity of Radiotherapy Dose of Cervical Cancer.

2019 ◽  
Vol 105 (1) ◽  
pp. E343-E344
Author(s):  
H. Zhang ◽  
S. Lu ◽  
J. Lang
Keyword(s):  
Cervical Cancer ◽  
Local Control ◽  
Local Control Rate ◽  
Radiotherapy Dose

scholarly journals Analysis of local control rate and toxicity of radiotherapy dose of cervical cancer.

2019 ◽  
Vol 5 (suppl) ◽  
pp. 136-136
Author(s):  
Hanyi Zhang ◽  
Shun Lu ◽  
Chang Sun ◽  
Jin Yi Lang
Keyword(s):  
Cervical Cancer ◽  
Local Control ◽  
Univariate Analysis ◽  
Local Control Rate ◽  
External Beam Radiation ◽  
Youden Index ◽  
High Dose ◽  
Advanced Cervical Cancer ◽  
Beam Radiation ◽  
Radiotherapy Dose

136 Background: The standard of care for treatment of advanced cervical cancer is the combination of external beam radiation therapy (EBRT) and intracavitary brachytherapy with cisplatin based concurrent chemotherapy. Radiotherapy plays a crucial role in treatment of cervical cancer. Recent GEC-ESTRO guidelines recommend that the dose to 90% (D90) of the high-risk clinical target volume (HRCTV) in cervical cancer be at least 85Gy with higher doses for poor response to radiotherapy. This study was aim to analyze our institution’s patients with locally advanced cervical cancer in regards to whether higher brachytherapy dose delivery lead to a better outcome, and to investigate the proper dose to balance the local control rate and toxicity. Methods: A total of 262 patients with local advanced cervical cancer treated at a single institution were retrospectively analyzed for the association between dosimetry and outcomes. Youden index was used to identify the optimal cut-off point of continuous tumor parameters and divide patients into subgroups. Significance of radiotherapy dose parameters on OS, PFS, LRFS and DMFS and toxicity was evaluated. Results: In the univariate analysis, for both HR-CTV and LR-CTV, the high dose group (EQD2 D90 >75Gy, LR-CTV>68Gy, respectively) have a better LRFS than low-dose groups (P<0.05). LR-CTV remains significance after adjusted for age and FIGO stage. Moreover, in the high-dose LR-CTV group, there is no association between dose of LR-CTV and LRFS was found, however, higher dose of HR-CTV significant associated with higher ratio of side effect was found. In addition, no association of dose of HR-CTV or LR-CTV and OS were found for all patients. Conclusions: Our results showed that dose of LR-CTV may be a useful prognostic factor of LRFS of patients with cervical cancer. Moreover, after D90 of LR-CTV reaches 68Gy, increasing dose did not show a better LRFS but lead to higher ratio of toxicity, supporting that LR-CTV at 68Gy might be a safety and efficacy dose of radiotherapy to the patients with cervical cancer. However, further improved in dose had no significant benefit on local control rate, and it might increase the risks of toxicity.

scholarly journals Can MRI Predict Local Control Rate of Uterine Cervical Cancer Immediately after Radiation Therapy?

2010 ◽  
Vol 9 (3) ◽  
pp. 141-148 ◽  
Author(s):  
Tsukasa SAIDA ◽  
Yumiko OISHI TANAKA ◽  
Kiyoshi OHARA ◽  
Akinori OKI ◽  
Toyomi SATO ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Local Control ◽  
Uterine Cervical Cancer ◽  
Local Control Rate

THREE-DIMENSIONAL PLANNING OF BRACHYTHERAPY FOR LOCALLY ADVANCED CERVICAL CANCER BY CT/MRI IMAGES

2018 ◽  
Vol 64 (5) ◽  
pp. 645-650
Author(s):  
Olga Kravets ◽  
Yelena Romanova ◽  
Oleg Kozlov ◽  
Mikhail Nechushkin ◽  
A. Gavrilova ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Local Control ◽  
Control Volume ◽  
Locally Advanced ◽  
Three Dimensional ◽  
Advanced Cervical Cancer ◽  
3D Ct ◽  
Mri Imaging ◽  
Tumor Target ◽  
Locally Advanced Cervical Cancer

We present our results of 3D CT/MRI brachytherapy (BT) planning in 115 patients with locally advanced cervical cancer T2b-3bN0-1M0. The aim of this study was to assess the differences in the visualization of tumor target volumes and risk organs during the 3D CT/MRI BT. The results of the study revealed that the use of MRI imaging for dosimetric planning of dose distribution for a given volume of a cervical tumor target was the best method of visualization of the soft tissue component of the tumor process in comparison with CT images, it allowed to differentially visualize the cervix and uterine body, directly the tumor volume. Mean D90 HR-CTV for MRI was 32.9 cm3 versus 45.9 cm3 for CT at the time of first BT, p = 0.0002, which is important for local control of the tumor process. The contouring of the organs of risk (bladder and rectum) through MRI images allows for more clearly visualizing the contours, which statistically significantly reduces the dose load for individual dosimetric planning in the D2cc control volume, і.є. the minimum dose of 2 cm3 of the organ of risk: D2cc for the bladder was 24.3 Gy for MRI versus 34.8 Gy on CT (p = 0.045); D2cc for the rectum - 18.7 Gy for MRI versus 26.8 Gy for CT (p = 0.046). This is a prognostically important stage in promising local control, which allows preventing manifestation of radiation damage.

Surgical resection of locally recurrent cervical cancer: a single institutional 70 patient series

2004 ◽  
Vol 14 (5) ◽  
pp. 846-851 ◽  
Author(s):  
V. Moutardier ◽  
G. Houvenaeghel ◽  
M. Martino ◽  
B. Lelong ◽  
V. J. Bardou ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Local Control ◽  
Cancer Recurrence ◽  
Palliative Surgery ◽  
Morbidity Rate ◽  
Actuarial Survival ◽  
Recurrent Cervical Cancer ◽  
Actuarial Survival Rate ◽  
Life Threatening ◽  
Threatening Situation

Pelvic recurrence of cervical cancer is a life-threatening situation and only local control can provide hope for remission. The aim of this study was to evaluate the role of surgery in the treatment of cervical cancer recurrence. This retrospective study analyzed a series of 70 patients who underwent resection of cervix locoregional recurrence. Thirteen patients had palliative salvage surgery for pelvic complications. Twenty-nine resections were considered as curative. Fifty recurrences required pelvic exenterations. The hospital mortality rate was 9% and the morbidity rate was 44%. Overall 5-year actuarial survival rate was 23%. Survival was significantly higher: (a) after curative resection and (b) after centropelvic recurrence resection. Local control was obtained in 48% of the cases and 13 patients are alive with a median follow-up of 75 months. In conclusion, the results of this small and heterogen series seem to justify an attempt to resection for centropelvic recurrences whenever possible. Palliative surgery should be reserved to salvage therapy and highly selected patients.

scholarly journals Carbon Ion Radiotherapy for Oligo-Recurrence in the Lung

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Naoyoshi Yamamoto ◽  
Mio Nakajima ◽  
Hirohiko Tsujii ◽  
Tadashi Kamada
Keyword(s):  
Colorectal Cancer ◽  
Lung Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Local Control ◽  
Local Control Rate ◽  
Carbon Ion Radiotherapy ◽  
Overall Survival Rate ◽  
Carbon Ion ◽  
Metastatic Lung

The clinical results after carbon ion radiotherapy for the metastatic lung tumors believed to be in the state of oligo-recurrence were evaluated. One hundred and sixteen lesions in 91 patients with lung cancer metastasis were treated with carbon ion radiotherapy at our institute from April 1997 to February 2011. Regarding the prescribed dose, total dose ranged between 40 gray equivalents (GyE) and 80 GyE, and fraction size ranged from 1 to 16 fractions. After a median followup period of 2.3 years (range, 0.3–13.1 years), the statistical overall survival rate and local control rate were 71.2% and 91.9% at 2 years after treatment, respectively. Treatment-related side effects were not a clinical problem. When classified by the primary organ, there were 49 cases of lung cancer, 20 cases of colorectal cancer, and 22 cases of others. The overall survival rate and local control rate for lung metastasis cases from lung cancer at 2 years after treatment were 81.5% and 92.4%, respectively, and 65.0% and 92.0% regarding lung metastasis from colorectal cancer. Carbon ion beam therapy for the metastatic lung tumors is a safe therapy, and the therapeutic effect is comparable to the outcome obtained from reported surgical resections.

Preliminary results of linear accelerator radiosurgery for acoustic schwannomas

1996 ◽  
Vol 85 (6) ◽  
pp. 1013-1019 ◽  
Author(s):  
William M. Mendenhall ◽  
William A. Friedman ◽  
John M. Buatti ◽  
Francis J. Bova
Keyword(s):  
Stereotactic Radiosurgery ◽  
Local Control ◽  
Linear Accelerator ◽  
Local Control Rate ◽  
Magnetic Resonance Images ◽  
High Rate ◽  
Content Type ◽  
Treatment Volume ◽  
Fine Print

✓ In this paper the authors evaluate the results of linear accelerator (LINAC)—based stereotactic radiosurgery for acoustic schwannomas. Fifty-six patients underwent LINAC-based stereotactic radiosurgery for acoustic schwannomas at the University of Florida between July 1988 and November 1994. Each patient was followed for a minimum of 1 year or until death; no patient was lost to follow up. One or more follow-up magnetic resonance images or computerized tomography scans were obtained in 52 of the 56 patients. Doses ranged between 10 and 22.5 Gy with 69.6% of patients receiving 12.5 to 15 Gy. Thirty-eight patients (68%) were treated with one isocenter and the dose was specified to the 80% isodose line in 71% of patients. Fifty-five patients (98%) achieved local control after treatment. The 5-year actuarial local control rate was 95%. At the time of analysis, 48 patients were alive and free of disease, seven had died of intercurrent disease, and one was alive with disease. Complications developed in 13 patients (23%). The likelihood of complications was related to the dose and treatment volume: 10 to 12.5 Gy to all volumes, three (13%) of 23 patients; 15 to 17.5 Gy to 5.5 cm3 or less, two (9%) of 23 patients; 15 to 17.5 Gy to more than 5.5 cm3, five (71%) of seven patients; and 20 to 22.5 Gy to all volumes, three (100%) of three patients. Linear accelerator—based stereotactic radiosurgery results in a high rate of local control at 5 years. The risk of complications is related to the dose and treatment volume.

Carbon Dioxide Laser Microsurgery for Early Supraglottic Carcinoma

1998 ◽  
Vol 107 (8) ◽  
pp. 680-688 ◽  
Author(s):  
Petra Ambrosch ◽  
Martina Kron ◽  
Wolfgang Steiner
Keyword(s):  
Carbon Dioxide ◽  
Overall Survival ◽  
Survival Rate ◽  
Local Control ◽  
Carbon Dioxide Laser ◽  
Local Control Rate ◽  
Overall Survival Rate ◽  
Laser Microsurgery ◽  
Supraglottic Carcinoma ◽  
Free Rate

Forty-eight untreated patients with early supraglottic carcinoma (12 patients stage I and 36 patients stage II) had primary carbon dioxide laser microsurgery between 1979 and 1994 with the intent of complete tumor removal with preservation of functionally important structures of the larynx. Ninety-six percent of the patients were treated exclusively by surgery; 4% had laser microsurgery and postoperative radiotherapy. With a median follow-up of 55 months, the 5-year local control rate with the first treatment was 100% for pT1 cases and 89% for pT2 cases. The ultimate local control rate with voice preservation, including patients successfully salvaged after a local recurrence, was 97% for pT2 carcinomas. Five (10%) patients died of tumor (TNM)–related deaths. The 3-year recurrence-free rate and 3-year overall survival rate (Kaplan-Meier) were 87% and 85%; the 5-year recurrence-free rate and 5-year overall survival rate were 83% and 76%, respectively. The results achieved with transoral laser microsurgery in early supraglottic carcinoma are comparable to those of open supraglottic laryngectomy with respect to local control and survival. The functional results are superior, since clinically relevant aspiration did not occur.

Radiotherapy Combined with Other Treatments in Rectal Cancer

1998 ◽  
Vol 84 (2) ◽  
pp. 238-246 ◽  
Author(s):  
Vincenzo Valentini
Keyword(s):  
Rectal Cancer ◽  
Local Control ◽  
Local Control Rate ◽  
Bolus Administration ◽  
Conventional Fractionation ◽  
Fractionation Schedule ◽  
Group 5 ◽  
The Individual ◽  
Improvement In Survival ◽  
The Cost

Since the first reports in the late 1950's, a large amount of data have been collected. The analysis of the main evidence from the major randomized trials will be analyzed in this paper according to preoperative, postoperative and chemoradiation approaches. Fifteen randomized preoperative trials were reported; they have been grouped according to the fractionation schedule. In the hypofractionation group (5 Gy for fraction), all five studies that delivered 3-5 doses in one week had a significant improvement in local control and one of them also showed improvement in survival. Operative mortality was higher in the radiotherapy arm if inadequate techniques had been applied. In 3 out of 8 studies with conventional fractionation there was a significant improvement in local control, but no impact in survival was detected. No studies with total dose lower than 34 Gy had an improvement in local control. None of the six randomized postoperative studies showed an improvement in local control or survival. In all trials the local control rate was uniform; ranging from 76% to 84%. Toxicity was higher in the radiotherapy arm. One preoperative and five postoperative randomized studies that used chemoradiation were analyzed. One postoperative chemoradiation study showed a significant improvement in survival in comparison to the surgery arm, and another showed the same advantage compared to the postoperative arm. Protracted infusional administration of 5FU concomitant to radiotherapy showed better survival than bolus administration. No advantages were shown in using MeCCNU or Levamisole in two studies. Toxicity was high and related to the dose and the modality of administration of the drugs in order to adequately treat the different stages of rectal cancer, patients must be carefully selected in order to prescribe the most effective and the least toxic treatment for the individual stage; organ preservation should be an essential goal for its impact on quality of life, and the cost estimates should be taken into account.

scholarly journals EP-1147 Local control rate in patients with skull-base chondrosarcoma treated with particle therapy

2019 ◽  
Vol 133 ◽  
pp. S636-S637
Author(s):  
E. D’Ippolito ◽  
A. Iannalfi ◽  
B. Vischioni ◽  
V. Vitolo ◽  
M.R. Fiore ◽  
...  
Keyword(s):  
Skull Base ◽  
Local Control ◽  
Local Control Rate ◽  
Particle Therapy

Stereotactic radiotherapy in patients with oligometastatic or oligoprogressive gynecological malignancies: a multi-institutional analysis

2020 ◽  
Vol 30 (6) ◽  
pp. 865-872 ◽  
Author(s):  
Cem Onal ◽  
Melis Gultekin ◽  
Ezgi Oymak ◽  
Ozan Cem Guler ◽  
Melek Tugce Yilmaz ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Local Control ◽  
Stereotactic Body Radiotherapy ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Complete Response ◽  
Term Survival ◽  
Free Survival ◽  
Oligometastatic Disease

IntroductionData supporting stereotactic body radiotherapy for oligometastatic patients are increasing; however, the outcomes for gynecological cancer patients have yet to be fully explored. Our aim is to analyze the clinical outcomes of stereotactic body radiotherapy in the treatment of patients with recurrent or oligometastatic ovarian cancer or cervical cancer.MethodsThe clinical data of 29 patients (35 lesions) with oligometastatic cervical cancer (21 patients, 72%) and ovarian carcinoma (8 patients, 28%) who were treated with stereotactic body radiotherapy for metastatic sites were retrospectively evaluated. All patients had <5 metastases at diagnosis or during progression, and were treated with stereotactic body radiotherapy for oligometastatic disease. Patients with ≥5 metastases or with brain metastases and those who underwent re-irradiation for primary site were excluded. Age, progression time, mean biologically effective dose, and treatment response were compared for overall survival and progression-free survival.ResultsA total of 29 patients were included in the study. De novo oligometastatic disease was observed in 7 patients (24%), and 22 patients (76%) had oligoprogression. The median follow-up was 15.3 months (range 1.9–95.2). The 1 and 2 year overall survival rates were 85% and 62%, respectively, and the 1 and 2 year progression-free survival rates were 27% and 18%, respectively. The 1 and 2 year local control rates for all patients were 84% and 84%, respectively. All disease progressions were observed at a median time of 7.7 months (range 1.0–16.0) after the completion of stereotactic body radiotherapy. Patients with a complete response after stereotactic body radiotherapy for oligometastasis had a significantly higher 2 year overall survival and progression-free survival compared with their counterparts. In multivariate analysis, early progression (≤12 months) and complete response after stereotactic body radiotherapy for oligometastasis were the significant prognostic factors for improved overall survival. However, no significant factor was found for progression-free survival in the multivariable analysis. No patients experienced grade 3 or higher acute or late toxicities.ConclusionsPatients with early detection of oligometastasis (≤12 months) and with complete response observed at the stereotactic body radiotherapy site had a better survival compared with their counterparts. Stereotactic body radiotherapy at the oligometastatic site resulted in excellent local control rates with minimal toxicity, and can potentially contribute to long-term survival.

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