scholarly journals Evaluation of acute/late toxicity and local recurrence in Τ1-Τ2 glottic carcinoma treated with accelerated hypofractionated 3D-conformal external beam radiotherapy (3D-CRT)

2013 ◽  
Vol 47 (2) ◽  
pp. 185-191 ◽  
Author(s):  
Vassilis E. Kouloulias ◽  
Anna Zygogianni ◽  
Eftychia Mosa ◽  
Kalliopi Platoni ◽  
John Georgakopoulos ◽  
...  
Keyword(s):  
Local Recurrence ◽  
External Beam Radiotherapy ◽  
Late Toxicity ◽  
Glottic Cancer ◽  
Primary Study ◽  
Radiation Toxicity ◽  
Glottic Carcinoma ◽  
Conventional Fractionation ◽  
Effects Of Radiation ◽  
Voice Preservation

Background.The aim of the study was to evaluate the efficacy, as well as the acute and late toxicity of an accelerated hypofractionated 3DCRT schedule as radical treatment in patients with organ confined glottic cancer cT1-2N0. Patients and methods. Between June of 2004 and September 2010, 47 retrospectively selected patients (29 males, 18 females) diagnosed with organ confined T1 or T2 glottic cancer, were treated with external 3DCRT in an accelerated hypofractionation schedule. The median age was 70 years. A dose of 64.4 Gy in 28 daily fractions was prescribed. The primary study endpoints were to assess the acute and late effects of radiation toxicity, according to the EORTC/ RTOG scale, as well as the therapeutic impact of this schedule in terms of local recurrence. Results. The median follow up was 36 months. At the end of radiotherapy, grade I, II and III acute toxicity was observed in 34, 9 and4 patients, respectively. Late grade I and II toxicity was observed in 25 and in 8 patients respectively. Only two local recurrences were observed, 15 and 24 months post 3DCRT respectively. Conclusions. Our radiotherapy schedule achieves a high locoregional control rate with the advantage of voice preservation. The proposed hypofractionated schedule can be recommended as a standard radiotherapy treatment, since these results are comparable with those of conventional fractionation schedules.

scholarly journals Randomized Trial of Hypofractionated External-Beam Radiotherapy for Prostate Cancer

2013 ◽  
Vol 31 (31) ◽  
pp. 3860-3868 ◽  
Author(s):  
Alan Pollack ◽  
Gail Walker ◽  
Eric M. Horwitz ◽  
Robert Price ◽  
Steven Feigenberg ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiation Therapy ◽  
Late Toxicity ◽  
Urinary Function ◽  
Conventional Fractionation ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer ◽  
Risk Patients

Purpose To determine if escalated radiation dose using hypofractionation significantly reduces biochemical and/or clinical disease failure (BCDF) in men treated primarily for prostate cancer. Patients and Methods Between June 2002 and May 2006, men with favorable- to high-risk prostate cancer were randomly allocated to receive 76 Gy in 38 fractions at 2.0 Gy per fraction (conventional fractionation intensity-modulated radiation therapy [CIMRT]) versus 70.2 Gy in 26 fractions at 2.7 Gy per fraction (hypofractionated IMRT [HIMRT]); the latter was estimated to be equivalent to 84.4 Gy in 2.0 Gy fractions. High-risk patients received long-term androgen deprivation therapy (ADT), and some intermediate-risk patients received short-term ADT. The primary end point was the cumulative incidence of BCDF. Secondarily, toxicity was assessed. Results There were 303 assessable patients with a median follow-up of 68.4 months. No significant differences were seen between the treatment arms in terms of the distribution of patients by clinicopathologic or treatment-related (ADT use and length) factors. The 5-year rates of BCDF were 21.4% (95% CI, 14.8% to 28.7%) for CIMRT and 23.3% (95% CI, 16.4% to 31.0%) for HIMRT (P = .745). There were no statistically significant differences in late toxicity between the arms; however, in subgroup analysis, patients with compromised urinary function before enrollment had significantly worse urinary function after HIMRT. Conclusion The hypofractionation regimen did not result in a significant reduction in BCDF; however, it is delivered in 2.5 fewer weeks. Men with compromised urinary function before treatment may not be ideal candidates for this approach.

Radiotherapy for T1 Carcinoma of the Glottis

1995 ◽  
Vol 81 (6) ◽  
pp. 414-418 ◽  
Author(s):  
Vincenzo Tombolini ◽  
Alfredo Zurlo ◽  
Paola Cavaceppi ◽  
Agatina Sarro ◽  
Carlo Guidi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Voice Quality ◽  
Field Size ◽  
Glottic Cancer ◽  
Surgical Approaches ◽  
Glottic Carcinoma ◽  
Laryngeal Function ◽  
Radiotherapy Alone ◽  
Voice Preservation ◽  
University Of Rome

Aims and background The management of patients with T1 carcinoma of the glottic larynx is controversial, because surgery and radiation therapy are reported to be effective treatments. Several studies have shown radiotherapy to be safe and effective, with a high percentage of voice preservation and minimal complications, but most Italian physicians prefer to surgically treat such patients. Methods From 1980 to 1990, 36 patients with stage I squamous cell glottic carcinoma were treated with radiotherapy alone at the Institute of Radiology of University of Rome “La Sapienza”. In all patients the irradiation fields were limited to the larynx, with field size ranging from 4 × 4 cm to 7 × 7 cm. Total tumor doses ranged between 51 and 70 Gy (median 60 Gy) with a mean number of 30 fractions of 2 to 3 Gy per fraction (3 or 5 fractions per week). Results After a median follow-up of 98 months, we observed an overall survival rate at 5 years of 91.4% and actuarial 10-year survival of 85.7%. Local control was achieved in 97.1% of cases, with an event-free survival of 94.2% at 5 and 10 years. No major complications like necrosis or persistent edema of the larynx were observed. Minor complications like dysphonia (8%) and dysphagia (5.5%) were temporary; laryngeal function was completely preserved at the end of therapy. Final voice quality ranged from good to excellent. Conclusions Our series confirms that radiation therapy has a major role in the management of early glottic cancer, with results comparable to surgical approaches and with better voice preservation.

Outcome of Open Surgical Therapy for Glottic Carcinoma

1993 ◽  
Vol 102 (10) ◽  
pp. 752-755 ◽  
Author(s):  
Jonas T. Johnson ◽  
Sheng-Po Hao ◽  
Eugene N. Myers ◽  
Robin L. Wagner
Keyword(s):  
Neck Dissection ◽  
Distant Metastasis ◽  
Medical Records ◽  
Glottic Cancer ◽  
Partial Laryngectomy ◽  
Glottic Carcinoma ◽  
Early Glottic Cancer ◽  
Regional Control ◽  
Open Surgical Therapy ◽  
Voice Preservation

A retrospective review was undertaken of the medical records of 270 patients with carcinoma of the glottic larynx. Patients were staged pathologically, and clinical pathologic correlates were made with outcome. In 92 patients with early glottic cancer, the 2-year rate of no evidence of disease for T1 was 98%, and for T2, 84%. Vertical partial laryngectomy resulted in voice preservation in 89%. Patients treated for advanced (T3 or T4) glottic carcinoma underwent total laryngectomy with or without neck dissection. Cervical nodes were involved in 22% of T3 and 41% of T4 patients at the time of treatment. Survival with no evidence of disease was chiefly determined by the development of regional recurrence, distant metastasis, and new primary cancer. Distant metastasis was associated with extracapsular spread (p = .003). Patients treated for T4 glottic carcinoma with neck dissection had improved survival compared with patients treated with laryngectomy alone (p = .006). Improved survival must be aimed at regional control, prevention, and management of distant metastasis and new primary carcinoma.

scholarly journals Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study

2020 ◽  
pp. bjophthalmol-2020-316293
Author(s):  
Puneet Jain ◽  
Paul T Finger ◽  
Maria Fili ◽  
Bertil Damato ◽  
Sarah E Coupland ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Local Excision ◽  
External Beam Radiotherapy ◽  
Staging System ◽  
Primary Treatment ◽  
Excision Biopsy ◽  
Conjunctival Melanoma ◽  
Recurrence Rates ◽  
Increased Risk ◽  
Eighth Edition

BackgroundTo relate conjunctival melanoma characteristics to local control.MethodsRetrospective, registry-based interventional study with data gathered from 10 ophthalmic oncology centres from 9 countries on 4 continents. Conjunctival melanoma patients diagnosed between January 2001 and December 2013 were enrolled in the study. Primary treatments included local excision, excision with cryotherapy and exenteration. Adjuvant treatments included topical chemotherapy, brachytherapy, proton and external beam radiotherapy (EBRT). Cumulative 5-year and 10-year Kaplan-Meier local recurrence rates were related to clinical and pathological T-categories of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.Results288 patients had a mean initial age of 59.7±16.8 years. Clinical T-categories (cT) were cT1 (n=218,75.7%), cT2 (n=34, 11.8%), cT3 (n=15, 5.2%), cTx (n=21,7.3%) with no cT4. Primary treatment included local excision (n=161/288, 55.9%) followed by excision biopsy with cryotherapy (n=108/288, 37.5%) and exenteration (n=5/288, 1.7%). Adjuvant therapies included topical mitomycin (n=107/288, 37.1%), plaque-brachytherapy (n=55/288, 19.1%), proton-beam (n=36/288, 13.5%), topical interferon (n=20/288, 6.9%) and EBRT (n=15/288, 5.2%). Secondary exenteration was performed (n=11/283, 3.9%). Local recurrence was noted in 19.1% (median=3.6 years). Cumulative local recurrence was 5.4% (3.2–8.9%), 19.3% (14.4–25.5%) and 36.9% (26.5–49.9%) at 1, 5 and 10 years, respectively. cT3 and cT2 tumors were twice as likely to recur than cT1 tumours, but only cT3 had statistically significantly greater risk of local recurrence than T1 (p=0.013). Factors such as tumour ulceration, plica or caruncle involvement and tumour thickness were not significantly associated with an increased risk of local recurrence.ConclusionThis multicentre international study showed that eighth edition of AJCC tumour staging was related to the risk of local recurrence of conjunctival melanoma after treatment. The 10-year cumulative local recurrence remains high despite current management.

Salvage brachytherapy for local recurrence after radical prostatectomy and subsequent external beam radiotherapy

Urology ◽  
2003 ◽  
Vol 62 (6) ◽  
pp. 1068-1072 ◽  
Author(s):  
Andrea Losa ◽  
Luciano Dante Nava ◽  
Nadia Di Muzio ◽  
Paola Mangili ◽  
Barbara Longobardi ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Local Recurrence ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Salvage Brachytherapy

External Beam Radiotherapy With Endocavitary Boost for Nasopharyngeal Cancer: Treatment Results and Late Toxicity After Extended Follow-Up

2010 ◽  
Vol 78 (3) ◽  
pp. 689-695 ◽  
Author(s):  
Dominic A.X. Schinagl ◽  
Henri A.M. Marres ◽  
Arnoud C. Kappelle ◽  
Matthias A.W. Merkx ◽  
Lucas A.M. Pop ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
External Beam Radiotherapy ◽  
Nasopharyngeal Cancer ◽  
Late Toxicity ◽  
External Beam ◽  
Treatment Results

T1/T2 glottic cancer managed by external beam radiotherapy—The influence of beam energy on local control

1998 ◽  
Vol 42 (1) ◽  
pp. 328 ◽  
Author(s):  
Padraig R. Warde ◽  
Brian O'Sullivan ◽  
Tony Panzarella ◽  
David G. Payne ◽  
Fei-Fei Liu ◽  
...  
Keyword(s):  
Local Control ◽  
Beam Energy ◽  
External Beam Radiotherapy ◽  
Glottic Cancer ◽  
External Beam

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.

S179 – Voice Self-evaluation after Treatment for T1 Glottic Cancer

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P136-P136
Author(s):  
Faustino Nunez ◽  
Maria Jesus Caminero ◽  
Jose-Luis Llorente-Pendas ◽  
Carlos Suarez-Nieto
Keyword(s):  
Laser Surgery ◽  
Voice Quality ◽  
Well Being ◽  
Voice Handicap Index ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Subjective Analysis ◽  
Maximum Phonation Time ◽  
Self Evaluation ◽  
The Voice

Objectives 1) To present the objective and subjective analysis of voice quality following treatment of an early epidermoid glottic carcinoma. 2) Results from the objective evaluation of the voice, along with the self-evaluation of voice quality quantified using the Voice Handicap Index of a group of patients treated with endoscopic laser surgery, are compared with patients treated with radiotherapy. Methods We performed an objective voice evaluation, as well as a physical, emotional, and functional well-being assessment of 19 patients treated with laser surgery and 18 patients treated with radiotherapy. The data obtained was gathered in the statistical database SPSS 12.0. The statistical analysis used was the “Student t test” in order to compare averages and the Chi-squared test for comparing proportions. The statistical differences were considered significant when p was lower than 0.05. Results Voice quality is affected both by surgery and radiotherapy. Voice parameters only show differences in the maximum phonation time between both treatments (p < 0,005). Patients Self-Perception Analysis (Voice Handicap Index) Upon completing the comparison between the two groups, the statistical difference is significant, in favor of the radiotherapy patients in functional and emotional ratings, as well as the global scores (p < 0,005). No significant differences were found in the physical scales. Conclusions There is a reduced impact in patient's perception of voice quality after radiotherapy, despite no significant differences in vocal quality between radiotherapy and laser cordectomy.

Sign in / Sign up

Export Citation Format

Share Document