Psychophysiological Aspects in the Clinical Picture of Disease in Patients Who Received Local Radiation Injury

2021 ◽  
Vol 66 (3) ◽  
pp. 13-18
Author(s):  
Nelya Metlyaeva ◽  
M. Lartsev ◽  
A. Bushmanov ◽  
I. Galstyan ◽  
L. Ryabinina ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Radiation Damage ◽  
Clinical Picture ◽  
Radiation Injury ◽  
Specific Treatment ◽  
Stage I ◽  
External Irradiation ◽  
Main Diagnosis ◽  
Left Half ◽  
Local Radiation

Purpose: To evaluate in dynamics the psychophysiological adaptation of a patient who received local radiation damage to the tissues of the left half of the chest IV (extremely severe) severity (23 years of observation). Material and methods: Patient KTS, 66 years old, as the main diagnosis are the effects of local radiation damage to the skin and underlying tissues of the left half of the chest from external radiation (about 3 % of body surface area) IV extremely severe. Before receiving a radiation injury, she was able-bodied and socially adapted, worked as a nurse. In 1996, she was diagnosed with stage I left breast cancer T1N0M0 stage I, in connection with which she underwent a sectoral resection of the mammary gland. Then the patient underwent a course of radiation therapy. By retrospective assessment, the total dose of therapeutic effect before the incident was 10 Gy. At the time of the next session of radiation therapy in connection with the breakdown of the apparatus, a sharp uncontrolled increase in the dose of ionizing radiation (more than 100 Gy) occurred, causing serious injury. The patient was admitted to the Institute of Biophysics Clinic on the 5th day. Psychophysiological research was carried out with the use of automated software and methodic complex «Expert», designed to study the personal characteristics of a person, cognitive and intellectual personality characteristics in 2001 – 2017 years. Results: The effects of local radiation damage to the skin and underlying tissues of the left half of the chest from external irradiation of IV (extremely severe) degree in the form of cicatricial-atrophic changes of the soft tissues, with no bone skeleton remain. Disorders of mental adaptation are expressed in the form of senesto-hypochondria disorders, autism of perception, demonstrativeness, apathetic depression and introversion. The most profound contribution to the reduction of the adaptation of the victim is brought about by the features of deep internal disharmony caused by contradictory combinations of demonstrativeness, schizoid traits, anxious depression and affective rigidity. Conclusion: The data obtained indicate that impaired mental adaptation is an integral part of the clinical picture of local radiation injuries, and reveal the urgent need not only of specific treatment of radiation injury, but also of psychotropic pharmacotherapy and psychotherapy.

scholarly journals LATE RADIATION TOXICITY AFTER RADICAL RADIOTHERAPY FOR GENITAL CANCER

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.

Local radiation therapy for localized relapsed or refractory ovarian cancer patients with or without symptoms after chemotherapy

2002 ◽  
Vol 12 (3) ◽  
pp. 250-256 ◽  
Author(s):  
K Fujiwara ◽  
S Suzuki ◽  
E Yoden ◽  
H Ishikawa ◽  
Y Imajo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Median Number ◽  
Maximum Diameter ◽  
External Irradiation ◽  
Local Radiation

Abstract.Fujiwara K, Suzuki S, Yoden E, Ishikawa H, Imajo Y, Kohno I. Local radiation therapy for localized relapsed or refractory ovarian cancer patients with or without symptoms after chemotherapy.The purpose of this paper is to prospectively evaluate the effects of local radiation therapy upon localized ovarian cancer following chemotherapy. Patients with objective relapses or refractory disease but with localized epithelial ovarian cancers and who had undergone at least one regimen of chemotherapy were enrolled in this study. External irradiation was performed on all patients. Twenty patients, with a mean age of 53.8 ± 10.3 y, were enrolled in this study. The median number of previous chemotherapies was 2. The interval between previous chemotherapy and radiation therapy was 4.5 months. The maximum diameter of the lesions was 3.6 ± 1.8 cm. The irradiation dose was 52.3 ± 8.3 Gy. Neither hematologic nor intestinal toxicity >grade 3 was observed. Forty-four disease sites, including the lymph nodes, vaginal cuff, pelvis, abdomen, subcutaneous regions, and the brain were irradiated. Thirty of these sites were symptom-free before irradiation. In patients with symptoms, the symptomatic relief was obtained in approximately 50% of patients. Smaller lesions (P = 0.024) and lymph nodes (P = 0.042) demonstrated better responses than larger lesions or other sites, respectively. Regression rates correlated with longer survivals (P = 0.0195) after radiation therapy. Survival was significantly better when radiation therapy was given before patients had symptoms (P = 0.001). Survival was also better in patients with lymph node disease only (P = 0.0069). We conclude that local radiation therapy may be one of the treatment options for relapsed or refractory but localized ovarian cancer, particularly when the tumor is small and/or located in the lymph nodes, even when patients had no symptoms.

scholarly journals Principles of treatment of late rectal radiation damage in cancer patients

2021 ◽  
Vol 22 (1) ◽  
pp. 21-27
Author(s):  
V. V. Pasov ◽  
V. A. Korotkov ◽  
M. R. Kasymov ◽  
L. V. Aferkina ◽  
N. Р. Naumov ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radiation Damage ◽  
Malignant Neoplasms ◽  
Radiation Injuries ◽  
Pelvic Organs ◽  
Local Radiation ◽  
Rehabilitation Measures

Malignant neoplasms of the pelvic organs in the structure of cancer incidence make up about 30 % of the adult population of our country. The widespread use of radiation therapy, unfortunately, has also increased the frequency of radiation damage to the pelvic organs, which, as a rule, take a chronic course. Late radiation damage to the pelvic organs is a fairly common complication of radiation therapy for prostate cancer. According to various authors, the frequency of such iatrogenic pathological changes is up to 25 %. In fact, some patients who are cured of a malignant neoplasm acquire a new disease that significantly reduces the quality of life and requires treatment. During radiation therapy of prostate cancer, various anatomical formations can fall into the zone of radiation fields: the bladder, rectum, intra-pelvic tissue, neurovascular bundles and pelvic bones. It should be noted that isolated lesions of one organ are rare and in most cases they are combined. A special place in clinical practice is occupied by cases of local radiation injuries of the rectum, including severe complications of radiation and combined treatment associated with the formation of fistulas against the background of radiation-induced  intra-pelvic fibrosis in the absence of a relapse of the underlying disease. In addition, this situation is associated with a violation of the psycho-emotional status of patients, a sharp decrease in the quality of life, difficulties in social adaptation in society and family, pain syndrome, and problems of medical rehabilitation. Unfortunately, conservative measures for such local radiation injuries are not always effective, and the results of surgical interventions are far from ambiguous and require careful study of patients, search for an algorithm of indications and acceptable standardization of surgical manipulations.  This paper presents the basic principles of diagnosis, comprehensive treatment and rehabilitation of patients with late radiation rectitis, depending on the severity of the pathological process. Given the growth of malignant neoplasms  of the pelvic organs, we can assume a relative increase in the number of patients with complications associated with radiation therapy, which require rehabilitation measures. Such patients come to the attention of oncologists, radiologists, coloproctologists, gastroenterologists and therapists, etc. Currently, our country lacks a network of specialized regional departments that deal with this problem, as well as treatment standards, clinical recommendations, and  an algorithm for diagnostic and rehabilitation measures for local radiation injuries. In connection with the above, it became necessary to summarize the data of clinical studies based on their own experience. 

Radiation Sickness after Therapeutic Administration of 806 mCi of 131I for Thyroid Cancer

1967 ◽  
Vol 06 (02) ◽  
pp. 170-183
Author(s):  
K. Šilink ◽  
J. Němec ◽  
J. Kubal ◽  
S. Röhling ◽  
S. Vohnout
Keyword(s):  
Bone Marrow ◽  
Thyroid Cancer ◽  
Radiation Injury ◽  
Clinical Course ◽  
External Irradiation ◽  
Bone Marrow Depression ◽  
Erythroid Hyperplasia ◽  
Cytological Features ◽  
Haematological Changes ◽  
Therapeutic Administration

SummaryThe clinical course and the haematologic events in a patient suffering from metastatic thyroid cancer after administration of 806 mCi of 131I are described. A serious bone marrow depression developed and was treated successfully. The haematological changes during the early and late phases of the radiation injury were studied in detail and compared with those after external irradiation. The haematological events after internal irradiation with 131I are characterised by initial neutrophilic leukocytosis, protracted lymphopenia, slowly developing anaemia reaching lowest values about 3 months after administration, erythroid hyperplasia in the bone marrow after recovery from bone marrow depression and prominent cytological features of the bone marrow, especially pronounced erythropoietic polyploidy.

scholarly journals The impact of sociodemographic factors on the utilization of radiation therapy in breast cancer patients in Estonia: a register-based study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Fereshteh Shahrabi Farahani ◽  
Keiu Paapsi ◽  
Kaire Innos
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Registry ◽  
Psychosocial Support ◽  
Sociodemographic Factors ◽  
Stage I ◽  
Equal Access ◽  
Administrative Databases ◽  
The Impact ◽  
Over Time

Abstract Background Radiation therapy is an important part of multimodal breast cancer treatment. The aim was to examine the impact of sociodemographic factors on radiation therapy use in breast cancer (BC) patients in Estonia, linking cancer registry data to administrative databases. Methods Estonian Cancer Registry provided data on women diagnosed with BC in Estonia in 2007–2018, including TNM stage at diagnosis. Use of radiation therapy within 12 months of diagnosis was determined from Estonian Health Insurance Funds claims, and sociodemographic characteristics from population registry. Receipt of radiation therapy was evaluated over time and by clinical and sociodemographic factors. Poisson regression with robust variance was used to calculate univariate and multivariate prevalence rate ratios (PRR) with 95 % confidence intervals (CI) for receipt of radiation therapy among stage I–III BC patients age < 70 years who underwent primary surgery. Results Overall, of 8637 women included in the study, 4310 (50 %) received radiation therapy within 12 months of diagnosis. This proportion increased from 39 to 58 % from 2007 to 2009 to 2016–2018 (p < 0.001). Multivariate regression analysis showed that compared to women with stage I BC, those with more advanced stage were less likely to receive radiation therapy. Receipt of radiation therapy increased significantly over time and was nearly 40 % higher in 2016–2018 than in 2007–2009. Use of radiation therapy was significantly lower for women with the lowest level of education compared to those with a university degree (PRR 0.88, 95 % CI 0.80–0.97), and for divorced/widowed women (PRR 0.95, 95 % CI 0.91–0.99) and single women (PRR 0.92, 95 % CI 0.86–0.99), compared to married women. Age at diagnosis, nationality and place of residence were not associated with receipt of radiation therapy. Conclusions The study showed considerable increase in the use of radiation therapy in Estonia over the study period, which is in line with increases in available equipment. The lack of geographic variations suggests equal access to therapy for patients living in remote regions. However, educational level and marital status were significantly associated with receipt of radiation therapy, highlighting the importance of psychosocial support in ensuring equal access to care.

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