scholarly journals Single fraction radiotherapy is more acceptable than multi-fraction radiotherapy to palliate the metastatic bone pain

2017 ◽  
Vol 45 (3) ◽  
pp. 151-155
Author(s):  
Sadia Sharmin ◽  
Md Zillur Rahman Bhuiyan ◽  
Atiar Rahman ◽  
Sarwar Alam
Keyword(s):  
Pain Relief ◽  
Bone Pain ◽  
Radiation Treatment ◽  
Symptom Relief ◽  
Complete Response ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Single Fraction ◽  
Significant Difference ◽  
Metastatic Bone Pain

One of the main goals of palliative radiation treatment is the relief of pain or dysfunction caused by the bone metastasis. Most patients achieve pain relief after irradiation. The striking clinical observation is that some patients experience symptom relief within 24hrs after the irradiation. This quasi experimental study was carried out in the department of Oncology, BSMMU from January 2014 to June 2014 with the intention to compare the role of single fraction and multiple fraction radiotherapy in the management of bone secondaries as regard as potency for pain relief. A total of 100 patients with age up to 70 years and of any sex having cytologically or histologically proven malignant diseases with the painful bone metastases in single or multiple sites without pathological fracture were selected for the study. They had no history of previous radiotherapy on the treatment site. Patients were divided in to two Arm A and Arm B with 50 patients in each arm. Arm A was treated with single (8 Gy) fraction radiotherapy and Arm B was treated with multiple fraction (30 Gy) radiotherapy i.e. 300 cGy per fraction in 10 fractions, 5 days a week for two weeks by telecobalt or orthovoltage machine. 44 patients in Arm A & 46 patients in Arm B completed the study. Onset of pain relief after completion of 4th week radiation were 68% in Arm A and 67.4% in Arm B . It was observed that, after 8th week of radiation 81.8% in Arm A and 86% in Arm B were relieved from pain. According to histological typing, 45% in Arm A & 52% patients in Arm B had complete response; 40% in Arm A & 37% patients in Arm B had partial response and overall distribution of no response of patient in Arm A was 18% and in Arm B was 7%. Metastatic bone pain represents one of the major indications in the external beam radiation therapy today.The disease can be efficiently treated by the use of either single fraction or multifraction radiotherapy without any significant difference in response to rate and early toxicities.Bangladesh Med J. 2016 Sep; 45 (3): 151-155

scholarly journals Changes in the cervical microbiota of cervical cancer patients after primary radio-chemotherapy

2020 ◽  
Vol 30 (9) ◽  
pp. 1326-1330
Author(s):  
Anastasia Tsakmaklis ◽  
Maria Vehreschild ◽  
Fedja Farowski ◽  
Maike Trommer ◽  
Christhardt Kohler ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Beta Diversity ◽  
Radiation Treatment ◽  
Diversity Index ◽  
Locally Advanced ◽  
Post Treatment ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Significant Difference ◽  
Pre Treatment

ObjectiveSeveral recent studies have identified a potential interaction between the vaginal microbiota and gynecological cancers, but little is known about the cervical microbiota and its changes during cancer treatment. Therefore, the aim of the study was to evaluate the quantitative and qualitative changes of cervical microbiota in patients undergoing concurrent chemotherapy and radiation treatment for locally advanced cervical cancer.MethodsCervical cytobrush samples of 15 cervical patients undergoing chemoradiation treatment were collected 1 day before starting external beam radiation therapy and on the day of the last fraction of brachytherapy. After DNA extraction, 16S rRNA amplicon sequencing of the V3–V4 region was performed on the MiSeq platform, followed by data processing and statistical analyses concerning the alpha and beta diversity of 16 samples (7 samples were excluded because of incomplete sample sets).ResultsThe amount of amplicon yield after polymerase chain reaction analysis in post-radiation samples was significantly lower compared with the baseline samples (pre 31.49±24.07 ng/µl; post 1.33±1.94 ng/µl; p=0.007). A comparison of pre-treatment and post-treatment samples did not show significant differences regarding beta diversity (weighted UniFrac). There was no significant difference in alpha diversity, which is used to characterize species diversity within a particular community and takes into account both number and abundance (Shannon Diversity Index pre-treatment samples: 2.167±0.7504 (95% CI 1.54 to 2.79); post-treatment samples: 1.97±0.43 (95% CI 1.61 to 2.33); p=0.38). Interindividual differences in patients could partly explain some variation of the samples (permutational multivariate analysis of variance).ConclusionThere was a strong reduction in cervical bacterial loads after chemoradiation. Neither alpha nor beta diversity varied significantly when baseline samples were compared with post-treatment samples.

scholarly journals Comparative study to evaluate dosimetric differences in patients of locally advanced carcinoma cervix undergoing intracavitary brachytherapy under two different anaesthesia techniques: an audit from a tertiary cancer centre in India

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Divyesh Kumar ◽  
G. Y. Srinivasa ◽  
Ankita Gupta ◽  
Bhavana Rai ◽  
Arun S. Oinam ◽  
...  
Keyword(s):  
Day Care ◽  
Treatment Time ◽  
Locally Advanced ◽  
Effective Alternative ◽  
External Beam Radiation ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Carcinoma Cervix ◽  
Beam Radiation ◽  
Significant Difference

Abstract Background Carcinoma cervix is amongst the leading causes of mortality and morbidity in women population worldwide. High-dose-rate intracavitary brachytherapy (HDR-ICBT) post external beam radiation therapy (EBRT) is the standard of care in managing locally advanced stage cervical cancer patients. HDR-ICBT is generally performed under general anaesthesia (GA) in operation theatre (OT), but due to logistic reasons, sometimes, it becomes difficult to accommodate all patients under GA. Since prolonged overall treatment time (OTT) makes the results inferior, taking patients in day care setup under procedural sedation (PS) can be an effective alternative. In this audit, we tried to retrospectively analyse the dosimetric difference, if any, in patients who underwent ICBT at our centre, under either GA in OT or PS in day care. Results Thirty five patients were analysed 16/35 (45.71%) patients underwent HDR-ICBT under GA while 19/35 (54.28%) patients under PS. In both groups, a statistically significant difference was observed between the dose received by 0.1 cc as well as 2 cc of rectum (p < 0.05), while the bladder and sigmoid colon had comparable dosages. Conclusion Though our dosimetric analysis highlighted better rectal sparing in patients undergoing HDR-ICBT under GA when compared to patients under PS, PS can still be considered an effective alternative, especially in centres dealing with significant patient load. Further studies are required for firm conclusion.

Age and Radiation Response in Glioblastoma Multiforme

Neurosurgery ◽  
2001 ◽  
Vol 49 (6) ◽  
pp. 1288-1298 ◽  
Author(s):  
Fred G. Barker ◽  
Susan M. Chang ◽  
David A. Larson ◽  
Penny K. Sneed ◽  
William M. Wara ◽  
...  
Keyword(s):  
Scale Score ◽  
Radiation Treatment ◽  
External Beam Radiation Therapy ◽  
Radiation Response ◽  
External Beam Radiation ◽  
Karnofsky Performance Scale ◽  
External Beam ◽  
Beam Radiation ◽  
Karnofsky Performance Scale Score ◽  
Performance Scale

ABSTRACT OBJECTIVE Advanced age is a strong predictor of shorter survival in patients with glioblastoma multiforme (GM), especially for those who receive multimodality treatment. Radiographically assessed tumor response to external beam radiation therapy is an important prognostic factor in GM. We hypothesized that older GM patients might have more radioresistant tumors. METHODS We studied radiographically assessed response to external beam radiation treatment (five-level scale) in relation to age and other prognostic factors in a cohort of 301 GM patients treated on two prospective clinical protocols. A total of 223 patients (74%) were assessable for radiographically assessed radiation response. A proportional odds ordinal regression model was used for univariate and multivariate analysis. RESULTS Younger age (P = 0.006), higher Karnofsky Performance Scale score before radiotherapy (P = 0.027), and more extensive surgical resection (P = 0.028) predicted better radiation response in univariate analyses. Results were similar when clinical criteria were used to classify an additional 61 patients without radiographically assessed radiation response (stable versus progressive disease). In multivariate analyses, age and extent of resection were significant independent predictors of radiation response (P &lt; 0.05); Karnofsky Performance Scale score was of borderline significance (P = 0.07). CONCLUSION Older GM patients are less likely to have good responses to postoperative external beam radiation therapy. Karnofsky Performance Scale score before radiation treatment and extent of surgical resection are additional predictors of radiographically assessed radiation response in GM.

scholarly journals Prevention and correction of radiation dermatitis with basic skin care: doctor and patient consensus

2021 ◽  
pp. 167-172
Author(s):  
D. A. Khlanta ◽  
D. S. Romanov
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Radiation Treatment ◽  
Negative Impact ◽  
Clinical Manifestations ◽  
External Beam Radiation ◽  
Radiation Dermatitis ◽  
Beam Radiation ◽  
Post Radiation

External beam radiation therapy is widely used by doctors around the world as one of the most common form of cancer treatment. The radiotherapy can help reduce the treatment aggression as compared with the surgical intervention in a large number of clinical situations, which ensures that the patient's quality of life will be decreased to a lesser extent in the after-treatment period. However, like the vast majority of anticancer treatments, the radiation therapy has a number of side effects, which are classified into acute radiation reactions and post-radiation injuries. Among them is radiation dermatitis, which is one of the most common adverse reactions to the radiotherapy. This complication manifests as erythema, as well as hyperpigmentation, dry and itchy skin, hair loss. In addition to the obvious negative impact on the patient's quality of life, some of the above factors can result in the development of a secondary skin infection. As one of the most frequent post-radiation complications, radiation dermatitis places radiotherapists before a challenge to reduce the incidence rates of this side effect, as well as to decrease the intensity of its clinical manifestations if it occurs. This challenge suggests the search for targeted drugs aimed to prevent and treat clinical symptoms. To date, dermatocosmetic products that are used to relieve skin manifestations of radiation treatment complications is an alternate option of the effective solution to the problem of radiation dermatitis. In the described clinical case, we assess the experience of using some of the dermatocosmetic products in a patient with a florid form of radiation dermatitis. 

OC-26 PROSTATE CANCER: SINGLE FRACTION HDR BOOST – 12.5GY OR 15GY -WITH EXTERNAL BEAM RADIATION. A COMPARISON OF TOXICITY

2012 ◽  
Vol 103 ◽  
pp. S11
Author(s):  
C. Arthur ◽  
J. Malik ◽  
R. Swindell ◽  
P. Mandali ◽  
A. Choudhury ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Single Fraction

Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer

2020 ◽  
pp. 030089162094002
Author(s):  
Florian Arend ◽  
Markus Oechsner ◽  
Clara B. Weidenbächer ◽  
Stephanie E. Combs ◽  
Kai J. Borm ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Lymph Node ◽  
Primary Tumor ◽  
Radiation Treatment ◽  
External Beam Radiation ◽  
Lymph Node Status ◽  
Beam Radiation ◽  
Pelvic Magnetic Resonance Imaging ◽  
Tumor Stages ◽  
Mri Sequences

Background: The purpose of this study is to detect a correlation between the preradiation tumor staging and the relative volumetric regression of the primary tumor through external beam radiation therapy (EBRT). Methods: Clinical data of 32 patients with a mean age of 60±12 years treated with primary radiation therapy (RT) of cervical carcinoma were analyzed. Union Internationale Contre le Cancer (UICC) stages were T1 = 4 patients, T2 = 15 patients, T3 = 8 patients, T4 = 5 patients; N1 = 26 patients, N0 = 6 patients; and M0 = 25 patients, M1 = 7 patients. All patients received pelvic magnetic resonance imaging (MRI) before RT as well as during RT. The cervical primary tumor was delineated as gross tumor volume (ptGTV) in T2-weighted MRI sequences. We compared ptGTV reduction by stage, lymph node status, metastatic status, and grading. Results: Mean ptGTV reduction during RT was 61.4±28.9%. T1 tumors shrank by 88.2±13.4%, T2 by 67.6±28.7%, T3 by 50.8±23.6%, and T4 by 38.7±27.2%. The difference in tumor shrinkage was statistically significant between the lower T stages and the higher T stages ( p < 0.05). There was no statistical difference in the mean ptGTV before treatment in the group with lymph node metastases (LNM) (54.1±47.7 cm3) as compared to the group without LNM (76.6±52.2 cm3). Nonetheless, ptGTV shrank significantly differently: by 68.9±25.7% (N1 patients) and by 29.0±17.7% (N0 patients). No significant differences in ptGTV shrinkage were observed in M0 versus M1 and G2 versus G3 tumors. Conclusion: There is a correlation between mean ptGTV reduction during EBRT and tumor stages. Tumors with higher T stages shrank less under radiation treatment, and the ptGTV of N1 patients responded better than that of N0 patients.

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