Inter-application displacement of brachytherapy dose received by the bladder and rectum of the patients with inoperable cervical cancer

AbstractBackground. The aim of the study was to examine on the CT basis the inter-application displacement of the positions D0.1cc, D1ccand D2ccof the brachytherapy dose applied to the bladder and rectum of the patients with inoperable cervical cancer.Patients and methods. This prospective study included 30 patients with cervical cancer who were treated by concomitant chemo-radiotherapy. HDR intracavitary brachytherapy was made by the applicators type Fletcher tandem and ovoids. For each brachytherapy application the position D0.1ccwas determined of the bladder and rectum that receive a brachytherapty dose. Then, based on the X, Y, and Z axis displacement, inter-application mean X, Y, and Z axis displacements were calculated as well as their displacement vectors (R). It has been analyzed whether there is statistically significant difference in inter-application displacement of the position of the brachytherapy dose D0.1cc, D1ccand D2ccof the bladder and rectum. The ANOVA test and post-hoc analysis by Tukey method were used for testing statistical importance of differences among the groups analyzed. The difference among the groups analyzed was considered significant if p < 0.05. Results. There are significant inter-application displacements of the position of the brachytherapy dose D0,1cc, D1ccand D2ccof the bladder and rectum. Conclusions. When we calculate the cumulative brachytherapy dose by summing up D0,1cc, D1ccand D2ccof the organs at risk for all the applications, we must bear in mind their inter-application displacement, and the fact that it is less likely that the worst scenario would indeed happen

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Clinical Investigations Evaluation of variation in dose of organs at risk in intracavitary brachytherapy of cervical cancer – a prospective study

Journal of Contemporary Brachytherapy ◽

10.5114/jcb.2011.21039 ◽

2011 ◽

Vol 1 ◽

pp. 23-25 ◽

Cited By ~ 1

Author(s):

Brahmacharimayum Arunkumar Sharma ◽

Tomcha Singh ◽

Jaichand Singh

Keyword(s):

Cervical Cancer ◽

At Risk ◽

Prospective Study ◽

Organs At Risk ◽

Intracavitary Brachytherapy ◽

Clinical Investigations ◽

A Prospective Study

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Impact of different treatment plans on EQD2 for intracavitary brachytherapy of cervical cancer

Journal of the Egyptian National Cancer Institute ◽

10.1186/s43046-021-00084-2 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Osman Vefa Gul ◽

Gokcen Inan ◽

Hamit Basaran

Keyword(s):

Cervical Cancer ◽

Small Intestine ◽

Organs At Risk ◽

External Beam Radiotherapy ◽

High Dose Rate ◽

Intracavitary Brachytherapy ◽

High Dose ◽

Dose Volume Histograms ◽

Significant Difference ◽

Treatment Plans

Abstract Background Cancer is one of the leading causes of death worldwide. According to GLOBOCAN estimates, there were 341,831 deaths from cervical cancer in 185 countries in 2020. The aim of this study was to compare equieffective dose (EQD2) at 2 Gy per fraction by using dose volume histograms (DVHs) derived from external beam radiotherapy (EBRT) and high-dose rate brachytherapy (HDR-BRT) treatment plans used in cervical cancer radiotherapy. Methods Fifteen patients with stage IIB-IIIB cervical cancer were included in this retrospective study. Treatment with three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) was planned for all patients in 28 fractions, with a total of 50.4 Gy to be delivered to the whole pelvic region. After EBRT, manual optimization (MO) or inverse optimization (IO) HDR-BRT plans were created in 4 fractions with a total of 28 Gy. The plans obtained were grouped as IMRT + IO, IMRT + MO, 3DCRT + IO, and 3DCRT + MO by calculating EQD2s among these plans. D90, D95, and D98 values were compared in all plans for CTVHR total EQD2. In addition, EQD2 values for critical organs at risk (OARs) such as rectum, bladder, small intestine, and sigmoid were compared in all plans for volumes of 2 cm3, 1 cm3, and 0.1 cm3, respectively. Results There was no significant difference between the treatment groups in terms of CTVHR D90 and CTVIR D90 values; However, CTVHR D95 (p = 0.000) and CTVHR D98 (p = 0.000) values were found to be better in IMRT + IO technique. The IMRT + IO technique provided better protection for 2 cm3, 1 cm3, and 0.1 cm3 volumes of OARs compared to other techniques. Conclusions Considering all parameters such as CTVHR, CTVIR, rectum, bladder, small intestine, and sigmoid, combination of IMRT + IO treatment option was found to be significantly superior in total EQD2 calculations compared to other plans.

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Using Wearable Cameras to Assess Foods and Beverages Omitted in 24 Hour Dietary Recalls and a Text Entry Food Record App

Nutrients ◽

10.3390/nu13061806 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1806

Author(s):

Virginia Chan ◽

Alyse Davies ◽

Lyndal Wellard-Cole ◽

Silvia Lu ◽

Hoi Ng ◽

...

Keyword(s):

Dietary Assessment ◽

Fats And Oils ◽

Point Of View ◽

Self Report ◽

Smartphone App ◽

Food Record ◽

Post Hoc Analysis ◽

Significant Difference ◽

Post Hoc ◽

Paired T Test

Technology-enhanced methods of dietary assessment may still face common limitations of self-report. This study aimed to assess foods and beverages omitted when both a 24 h recall and a smartphone app were used to assess dietary intake compared with camera images. For three consecutive days, young adults (18–30 years) wore an Autographer camera that took point-of-view images every 30 seconds. Over the same period, participants reported their diet in the app and completed daily 24 h recalls. Camera images were reviewed for food and beverages, then matched to the items reported in the 24 h recall and app. ANOVA (with post hoc analysis using Tukey Honest Significant Difference) and paired t-test were conducted. Discretionary snacks were frequently omitted by both methods (p < 0.001). Water was omitted more frequently in the app than in the camera images (p < 0.001) and 24 h recall (p < 0.001). Dairy and alternatives (p = 0.001), sugar-based products (p = 0.007), savoury sauces and condiments (p < 0.001), fats and oils (p < 0.001) and alcohol (p = 0.002) were more frequently omitted in the app than in the 24 h recall. The use of traditional self-report methods of assessing diet remains problematic even with the addition of technology and finding new objective methods that are not intrusive and are of low burden to participants remains a challenge.

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The effect of liraglutide and sitagliptin on oxidative stress in persons with type 2 diabetes

Scientific Reports ◽

10.1038/s41598-021-90191-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Suvanjaa Sivalingam ◽

Emil List Larsen ◽

Daniel H. van Raalte ◽

Marcel H. A. Muskiet ◽

Mark M. Smits ◽

...

Keyword(s):

Oxidative Stress ◽

Type 2 Diabetes ◽

Nucleic Acid ◽

Urinary Excretion ◽

Post Hoc Analysis ◽

Significant Difference ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Post Hoc

AbstractGlucagon-like peptide 1 receptor agonists have shown cardioprotective effects which have been suggested to be mediated through inhibition of oxidative stress. We investigated the effect of treatment with a glucagon-like peptide 1 receptor agonist (liraglutide) on oxidative stress measured as urinary nucleic acid oxidation in persons with type 2 diabetes. Post-hoc analysis of two independent, randomised, placebo-controlled and double-blinded clinical trials. In a cross-over study where persons with type 2 diabetes and microalbuminuria (LIRALBU, n = 32) received liraglutide (1.8 mg/day) or placebo for 12 weeks in random order, separated by 4 weeks of wash-out. In a parallel-grouped study where obese persons with type 2 diabetes (SAFEGUARD, n = 56) received liraglutide (1.8 mg/day), sitagliptin (100 mg/day) or placebo for 12 weeks. Endpoints were changes in the urinary markers of DNA oxidation (8-oxo-7,8-dihydro-2′-deoxyguanosine (8-oxodG)) and RNA oxidation [8-oxo-7,8-dihydroguanosine (8-oxoGuo)]. In LIRALBU, we observed no significant differences between treatment periods in urinary excretion of 8-oxodG [0.028 (standard error (SE): 0.17] nmol/mmol creatinine, p = 0.87) or of 8-oxoGuo [0.12 (0.12) nmol/mmol creatinine, p = 0.31]. In SAFEGUARD, excretion of 8-oxodG was not changed in the liraglutide group [2.8 (− 8.51; 15.49) %, p = 0.62] but a significant decline was demonstrated in the placebo group [12.6 (− 21.3; 3.1) %, p = 0.02], resulting in a relative increase in the liraglutide group compared to placebo (0.16 nmol/mmol creatinine, SE 0.07, p = 0.02). Treatment with sitagliptin compared to placebo demonstrated no significant difference (0.07 (0.07) nmol/mmol creatinine, p = 0.34). Nor were any significant differences for urinary excretion of 8-oxoGuo liraglutide vs placebo [0.09 (SE: 0.07) nmol/mmol creatinine, p = 0.19] or sitagliptin vs placebo [0.07 (SE: 0.07) nmol/mmol creatinine, p = 0.35] observed. This post-hoc analysis could not demonstrate a beneficial effect of 12 weeks of treatment with liraglutide or sitagliptin on oxidatively generated modifications of nucleic acid in persons with type 2 diabetes.

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Investigation of whether in-room CT-based adaptive intracavitary brachytherapy for uterine cervical cancer is robust against interfractional location variations of organs and/or applicators

Journal of Radiation Research ◽

10.1093/jrr/rrw043 ◽

2016 ◽

Vol 57 (6) ◽

pp. 677-683 ◽

Cited By ~ 1

Author(s):

Yoshifumi Oku ◽

Hidetaka Arimura ◽

Tran Thi Thao Nguyen ◽

Yoshiyuki Hiraki ◽

Masahiko Toyota ◽

...

Keyword(s):

Cervical Cancer ◽

Radiation Treatment ◽

Organs At Risk ◽

Normal Tissue Complication Probability ◽

Uterine Cervical Cancer ◽

Intracavitary Brachytherapy ◽

Conformity Index ◽

Tumor Control ◽

Tumor Control Probability ◽

Target Volumes

Abstract This study investigates whether in-room computed tomography (CT)-based adaptive treatment planning (ATP) is robust against interfractional location variations, namely, interfractional organ motions and/or applicator displacements, in 3D intracavitary brachytherapy (ICBT) for uterine cervical cancer. In ATP, the radiation treatment plans, which have been designed based on planning CT images (and/or MR images) acquired just before the treatments, are adaptively applied for each fraction, taking into account the interfractional location variations. 2D and 3D plans with ATP for 14 patients were simulated for 56 fractions at a prescribed dose of 600 cGy per fraction. The standard deviations (SDs) of location displacements (interfractional location variations) of the target and organs at risk (OARs) with 3D ATP were significantly smaller than those with 2D ATP (P < 0.05). The homogeneity index (HI), conformity index (CI) and tumor control probability (TCP) in 3D ATP were significantly higher for high-risk clinical target volumes than those in 2D ATP. The SDs of the HI, CI, TCP, bladder and rectum D2cc, and the bladder and rectum normal tissue complication probability (NTCP) in 3D ATP were significantly smaller than those in 2D ATP. The results of this study suggest that the interfractional location variations give smaller impacts on the planning evaluation indices in 3D ATP than in 2D ATP. Therefore, the 3D plans with ATP are expected to be robust against interfractional location variations in each treatment fraction.

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Diastolic function in patients with preeclampsia during pre- and post-partum period using tissue doppler imaging

Medical Journal of Indonesia ◽

10.13181/mji.v25i2.1410 ◽

2016 ◽

Vol 25 (2) ◽

pp. 93-7 ◽

Cited By ~ 1

Author(s):

I B Rangga Wibhuti ◽

Amiliana M. Soesanto ◽

Fahmi Shahab

Keyword(s):

Diastolic Function ◽

Tissue Doppler Imaging ◽

Pregnancy Termination ◽

Post Partum ◽

Tissue Doppler ◽

Doppler Imaging ◽

Post Hoc Analysis ◽

Significant Difference ◽

Post Partum Period ◽

Post Hoc

Background: Prior studies have compared the E/e’ elevation in preeclampsia patients to normal patients, however there are no data whether this elevation persists after birth. The aim of this study is to analyze diastolic function in preeclampsia patients during pre- and post-partum period using E/e’ parameter measurement.Methods: This is a prospective cohort study of pregnant women with preeclampsia who were hospitalized and planned for pregnancy termination. Basic clinical characteristics were obtained from all samples. Echocardiography was done prepartum, 48-72 hours after termination, and 40-60 days postpartum. Post hoc analysis using least significant difference method was used to compare the results between measurements.Results: 30 subjects were enrolled in the study. Analysis on E/e’ characteristics showed statistical difference between prepartum E/e’ and 40 days postpartum E/e’ (11.87±3.184 vs 9.43±2.529, p=0.001, CI=1.123-3.751), as well as between 48 hours post-partum and 40 days post-partum period (12.12±2.754 vs 9.43±2.529, p<0.001, CI=1.615-3.771). There were no statistical differences between pre-partum E/e’ and 48 hours post-partum E/e’ (11.87±3.184 vs 12.12±2.754, p=0.633, CI=-1.345-0.832).Conclusion: This study showed diastolic dysfunction in preeclampsia patients persists up until a few days after birth, but resolves in time (40 days after birth) as measured by tissue doppler imaging.

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Postoperative adjuvant chemotherapy combined with intracavitary brachytherapy achieved the equivalent survival compared with concurrent chemoradiotherapy in cervical cancer patients with intermediate-risk

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyz057 ◽

2019 ◽

Vol 49 (8) ◽

pp. 714-718

Author(s):

Hao Yu ◽

Linlin Zhang ◽

Dapeng Li ◽

Naifu Liu ◽

Yueju Yin ◽

...

Keyword(s):

Cervical Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Early Stage ◽

Disease Free Survival ◽

Intracavitary Brachytherapy ◽

Intermediate Risk ◽

Postoperative Adjuvant Chemotherapy ◽

Significant Difference ◽

Grade Iii

Abstract Objectives The current study was aimed to evaluate the efficacy and toxicity of postoperative adjuvant chemotherapy (CT) combined with intracavitary brachytherapy (ICRT) in cervical cancer patients with intermediate-risk. Methods We analyzed the medical records of 558 patients who were submitted to radical surgery for Stage IB-IIA cervical cancer. A total of 172 of those 558 patients were considered intermediate-risk according to the GOG criteria. Among those 172 patients, 102 were subjected to CT combined with ICRT (CT+ICRT) and the remaining 70 patients were treated with concurrent chemoradiation (CCRT). The 3-year disease free survival (DFS), overall survival (OS), and complications of each group were evaluated and analyzed. Results No significant difference was observed in 3-year DFS or OS of the patients submitted to CT+ICRT and CCRT. Importantly, the frequencies of grade III to IV acute complications were significantly higher in patients submitted to CCRT than in those treated with CT+ICRT (Hematologic, P = 0.016; Gastrointestinal, P = 0.041; Genitourinary, P = 0.019). Moreover, the frequencies of grade III–IV late complications in patients treated with CCRT were significantly higher compared with CT+ICRT-treated patients (Gastrointestinal, P = 0.026; Genitourinary, P = 0.026; Lower extremity edema, P = 0.008). Conclusions Postoperative adjuvant CT+ICRT treatment achieved equivalent 3-year DFS and OS but low complication rate compared to CCRT treatment in early stage cervical cancer patients with intermediate-risk.

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The influence of overall treatment time to the efficiency of chemo-radiotherapy for locally advanced cervical cancer

Journal of Radiotherapy in Practice ◽

10.1017/s1460396917000371 ◽

2017 ◽

Vol 17 (1) ◽

pp. 124-130

Author(s):

Ekkasit Tharavichitkul ◽

Panupat Rugpong ◽

Nisa Chawapun ◽

Razvan M. Galalae

Keyword(s):

Cervical Cancer ◽

Treatment Time ◽

Locally Advanced ◽

Disease Free Survival ◽

Intracavitary Brachytherapy ◽

Treatment Results ◽

Overall Treatment Time ◽

Free Survival ◽

Significant Difference ◽

The Mean

AbstractPurposeThis study aims to clarify the influence of overall treatment time (OTT) on the efficiency of combined chemo-radiotherapy in cervical cancer.Material and methodsThis retrospective study enrolled 122 cervical cancer patients who had squamous cell carcinoma and had undergone definitive chemo-radiotherapy from 2009 to 2013. All patients received whole pelvic radiotherapy (WPRT) with the dose of 50 Gy in 25 fractions (with central shielding after 44 Gy) plus intracavitary brachytherapy with the dose of 28 Gy in four fractions. During WPRT, all patients received concurrent chemotherapy with weekly platinum-based regimen. The data of patient characteristics, OTT, treatment results and toxicities were collected and evaluated.ResultsThe mean follow-up time was 36 months. The mean age of patients was 52 years old; 68% of patients were stage IIB related to International Federation of Gynaecology and Obstetrics staging. Pelvic control (PC), distant metastasis-free survival (DMFS), disease-free survival (DFS) and overall survival (OS) rates did not differ significantly in the data-derived cut points of 55·8 and 53 days. No statistically significant difference in treatment results between the two groups of OTT<49 and OTT≥62 days was observed.ConclusionsIn our data-derived cut point, OTT did not influence to PC, DMFS, DFS and OS. The influence of OTT on treatment results may be found in longer periods.

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