First Russian experience of the stereotactic radiotherapy on the prostate bed

2020 ◽  
Vol 10 (2) ◽  
pp. 133-142
Author(s):  
Roman V. Novikov ◽  
Julia S. Melnik ◽  
Olga I. Ponomareva ◽  
Sergey N. Novikov
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radiation Treatment ◽  
Medical Center ◽  
Clinical Signs ◽  
Early Period ◽  
Radiation Toxicity ◽  
Postoperative Radiation Therapy ◽  
Dose Hypofractionation ◽  
Prostate Bed

Purpose. Assess the safety of postoperative radiation therapy on the area of the prostate bed (PB) using extreme dose hypofractionation (5 fractions of 6.67 Gr). Materials and methods. from April 2019 to March 2020 at the National Medical Center of Oncology named after N.N. Petrov of the Ministry of Health of the Russian Federation in the first 15 patients of the prostate cancer carried out stereotactic radiation therapy (SRT) on the PB. Depending on the clinical situation, adjuvant and salvage SRT were distinguished. Linear electron accelerators with 6 MeV energy are used for treatment. Three factional regimes were evaluated: 5 factions of 6.6 Gr, 5 factions of 6.8 Gr and 5 factions of 7 Gr. The clinical target volume is defined by RTOG (2010). Results. The median of follow-up was 7.6 (1.3-11.6) months. Of the 15 patients, adjuvant SRT performed three observed, and the remaining 12 patients salvage SRT (4 early, 8 delayed). Acute radiation toxicity was estimated in 12 patients. Early impairment from the lower urinary tract 1 degree was observed in 8 (66.7%) 12 of them. Toxicity of 2 or more degree in the early period was not observed. Clinical signs of early 1st degree toxicity from the rectum were found in five (41.7%) of the bowel of the 12 observed. One patient (8.3%) there was a mixture of blood in the feces, which required a medical correction, which was considered as toxicity of the 2nd degree. Conclusions. Postoperative SRT of the PB region is a promising modern method of radiation treatment of patients with prostate cancer. The presented methods of adjuvant and salvage SRT are feasible in clinical practice and are characterized by an acceptable level of early radiation toxicity.

Association between travel distance and use of postoperative radiation therapy among men with organ-confined prostate cancer: Does geography influence treatment decisions?

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 24-24
Author(s):  
Melaku A Arega ◽  
David Yang ◽  
Trevor Joseph Royce ◽  
Brandon Arvin Virgil Mahal ◽  
Edward Christopher Dee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radiation Treatment ◽  
Travel Distance ◽  
Adjuvant Radiation ◽  
Postoperative Radiation ◽  
Treatment Facility ◽  
Postoperative Radiation Therapy ◽  
Pathologic Features ◽  
Treatment Facilities

24 Background: Following radical prostatectomy, men with adverse pathologic features or a persistent post-operative detectable PSA are candidates for postoperative radiation therapy (PORT). Previous data have suggested disparities in receipt of adjuvant radiation therapy for adverse pathologic features according to travel distance. Among patients without adverse pathologic features (pT2 disease and negative margins), the main indication for PORT is a persistent post-operative detectable PSA. However, it remains unknown whether the rate of receipt of PORT in this cohort of men with persistently detectable PSA is related to travel distance from the treating facility. Methods: Using the National Cancer Database, we identified 287,274 men with prostate cancer diagnosed in 2004-2015 managed with upfront surgery who were found to have pT2 disease with negative surgical margins. Multivariable logistic regression defined adjusted odds ratios (AORs) with 95% confidence intervals (95CI) of receiving PORT as the primary dependent variable and distance ( < 5, 5-10, 10-20, > 20 miles from the treatment facility) as the primary independent variable. Results: Within our cohort, progressively farther distance from the treatment facility was associated with lower rates of PORT. In patients living < 5 miles, 5-10 miles, 10-20 miles, and > 20 miles from the treating facility, rates of PORT were 1.52% (referent), 1.23% (AOR 0.86, 95CI 0.78-0.96), 1.11% (AOR 0.81, 95CI 0.73-0.90), and 0.65% (AOR 0.43, 95CI 0.38-0.47), respectively (p < 0.005 in pairwise comparisons). Conclusions: For men with localized prostate cancer without adverse pathologic features managed with surgery, increasing distance from treatment facility was associated with lower receipt of PORT. Given that the rate of a persistent post-operative detectable PSA is unlikely to depend on the distance to the treatment facility, these findings raise the possibility that the geographic availability of radiation treatment facilities influences the decision to undergo PORT for patients with persistent post-operative detectable PSA.

Toxicity Associated With Postoperative Radiation Therapy for Prostate Cancer

2011 ◽  
Vol 34 (6) ◽  
pp. 611-618 ◽  
Author(s):  
Puneeth Iyengar ◽  
Lawrence B. Levy ◽  
Seungtaek Choi ◽  
Andrew K. Lee ◽  
Deborah A. Kuban
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy

scholarly journals Rare Radiation Complications after Treatment of Cervical Cancer

2020 ◽  
Vol 5 (6) ◽  
pp. 176-181
Author(s):  
О. М. Sukhina ◽  
◽  
K. V. Nemaltsova ◽  
V. S. Sukhin ◽  
◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Radiation Damage ◽  
Locally Advanced ◽  
Clinical Signs ◽  
Long Term Results ◽  
Great Effort ◽  
Radiation Toxicity ◽  
Advanced Cervical Cancer ◽  
Locally Advanced Cervical Cancer

Currently, cervical cancer is one of the most common types of oncological pathology. Radiation therapy is the main treatment for patients with locally advanced cervical cancer. The main goal of radiation treatment for cervical cancer is to plan the amount of radiation in which the primary tumor and the areas of regional lymph outflow are subject to the maximum possible impact with minimal radiation exposure to critical organs (rectum and bladder). However, the program of combined radiation therapy according to a radical program in patients with locally advanced cervical cancer provides for irradiation of sufficiently large volumes with high therapeutic doses. Radiation therapy with radiomodifying cytostatics or with competitive polychemotherapy improves both immediate and long-term results of treatment, but increases the risk of radiation reactions. According to clinical signs, radiation toxicity is divided into general and local, which, in turn, can be early and late, depending on the time of occurrence. The risk of radiation damage naturally increases with an increase in the total absorbed dose. The presence of comorbidities also affects the likelihood of post-radiation complications. Chronic diseases of organs located in the irradiated zone significantly increase the risk of their radiation damage. Individual radiosensitivity plays a decisive role in the occurrence of radiation complications. The article describes a case of a urinary-small intestinal fistula in patient A., 80 years old. The patient has been observed in the clinic of the State Organization «Grigoriev Institute for Medical Radiology and Oncology National Academy of Medical Sciences of Ukraine» since 2016 for cervical cancer FIGO IVA stage (pathohistological conclusion was squamous cell non-keratinizing cancer), a course of combined radiation therapy with modification of 5-fluorouracil under a radical program was carried out. The relapse-free period for cervical cancer was 4 years, the patient regularly underwent control examinations at the Institute's clinic. Since March 2020 has had complaints about the presence of feces in the urine, which is why she came to the clinic. Conclusion. Treatment of this category of patients is a difficult task that requires time and great effort from both medical staff and patients

Dosimetric evaluation of whole-pelvis radiation therapy of prostate cancers: clinical experience

2020 ◽  
pp. 1-15
Author(s):  
Ernest Osei ◽  
Hafsa Mansoor ◽  
Johnson Darko ◽  
Beverley Osei ◽  
Katrina Fleming ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Cancer Patients ◽  
Seminal Vesicles ◽  
Conformity Index ◽  
Prostate Bed ◽  
Risk Patients ◽  
Treatment Plans ◽  
The Mean

Abstract Background: The standard treatment modalities for prostate cancer include surgery, chemotherapy, hormonal therapy and radiation therapy or any combination depending on the stage of the tumour. Radiation therapy is a common and effective treatment modality for low-intermediate-risk patients with localised prostate cancer, to treat the intact prostate and seminal vesicles or prostate bed post prostatectomy. However, for high-risk patients with lymph node involvement, treatment with radiation will usually include treatment of the whole pelvis to cover the prostate and seminal vesicles or prostate bed and the pelvic lymph nodes followed by a boost delivery dose to the prostate and seminal vesicles or prostate bed. Materials and Methods: We retrospectively analysed the treatment plans for 179 prostate cancer patients treated at the cancer centre with the volumetric-modulated arc therapy (VMAT) technique via RapidArc using 6 MV photon beam. Patients were either treated with a total prescription dose of 78 Gy in 39 fractions for patients with intact prostate or 66 Gy in 33 fractions for post prostatectomy patients. Results: There were 114 (64%) patients treated with 78 Gy/39 and 65 (36%) treated with 66 Gy/34. The mean homogeneity index (HI), conformity index (CI) and uniformity index (UI) for the PTV-primary of patients treated with 78 Gy are 0.06 ± 0.01, 1.04 ± 0.01 and 0.99 ± 0.01, respectively, and the corresponding mean values for patients treated with 66 Gy are 0.06 ± 0.02, 1.05 ± 0.01 and 0.99 ± 0.01, respectively. The mean PTV-primary V95%, V100% and V105% are 99.5 ± 0.5%, 78.8 ± 12.2% and 0.1 ± 0.5%, respectively, for patients treated with 78 Gy and 99.3 ± 0.9%, 78.1 ± 10.6% and 0.1 ± 0.4%, respectively, for patients treated with 66 Gy. The rectal V50Gy, V65Gy, V66.6Gy, V70Gy, V75Gy and V80Gy are 26.8 ± 9.1%, 14.2 ± 5.3%, 13.1 ± 5.0%, 10.8 ± 4.3%, 6.9 ± 3.1% and 0.1 ± 0.1%, respectively, for patients treated with 78 Gy and 33.7 ± 8.4%, 14.1 ± 4.5%, 6.7 ± 4.5%, 0.0 ± 0.2%, 0.0% and 0.0%, respectively, for patients treated with 66 Gy. Conclusion: The use of VMAT technique for radiation therapy of high-risk prostate cancer patients is an efficient and reliable method for achieving superior dose conformity, uniformity and homogeneity to the PTV and minimal doses to the organs at risk. Results from this study provide the basis for the development and implementation of consistent treatment criteria in radiotherapy programs, have the potential to establish an evaluation process to define a consistent, standardised and transparent treatment path for all patients that reduces significant variations in the acceptability of treatment plans and potentially improve patient standard of care.

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