scholarly journals Therapeutic irradiation in the management of gynecological cancer and predictability of radiation-induced complications

2021 ◽  
Vol 29 (2) ◽  
pp. 34-51
Author(s):  
V. S. Ivankova ◽  
V. M. Mikhailenko ◽  
E. A. Domina ◽  
T. V. Khrulenko ◽  
L. M. Baranovska ◽  
...  
Keyword(s):  
Clinical Study ◽  
Cancer Patients ◽  
Comparison Group ◽  
Gynecological Cancer ◽  
High Energy ◽  
Vaginal Cancer ◽  
Study Group ◽  
Sh Groups ◽  
Group I ◽  
Radiation Induced

Background. Today, applying radiotherapy (RT) in management of both primary and secondary vaginal cancer (SVC) take pride of place in the spectrum of specialized treatments for cancer patients. Secondary vaginal tumors are more common (6% to 33%) in cervical cancer (CC) patients, while in uterine cancer (UC) occur in 8–10% of cases treated either surgically, or by means of radiotherapy, otherwise via a combination approach. Therefore, RT is administered in about 80% of primary vaginal cancer and particularly SVC patients. When using even the most advanced radiotherapy equipment implying the cutting-edge technologies, there is a risk of radiation-induced complications in healthy organs and tissues that fall under the irradiation area. Keeping in mind the key radiobiological paradigms makes it possible not only to predict the probability of tumor resorption upon   radiation exposure, but also to assess the biological effectiveness of absorbed dose, as well as the risk of late radiation complications. Purpose – to enhance the effectiveness and assess the toxicity of SVC RT via ascertaining BT (brachytherapy) most suitable techniques depending on the type of ionizing radiation and exploring predictability of radiation-induced complications in terms of biomolecular cell properties. Materials and methods. Clinical study was performed at the National Cancer Institute Clinic (Radiation Oncology Department), using a high-energy BT unit with a HDR 192Ir source. The SVC patients (n = 106) were treated according to the developed BT methods. They had been pretreated for the CC (n = 65) with squamous cell carcinoma histologically diagnosed in the most cases or UC (n = 41) with histologically prevalent adenocarcinoma of a variable grade. Patients had a locally advanced pelvic tumor process with tumor staging II–III, T2-3N0-1M0. Along with clinical study the radiobiological research was conducted to count the apoptotic cells in both intact and irradiated peripheral blood lymphocytes (PBL), as well as the level of SH-groups of plasma proteins and peptides in gynecological cancer patients and healthy donors to predict the risk of radiation-induced complications. Results and discussion. Given the delayed effect of RT, the treatment effective- ness was analyzed immediately after RT session and also 3 months upon completion of the conservative therapy. Thus, positive tumor response upon three months of observation over time was registered in 67.9 ± 5.2% of patients in study group I, in 72.5 ± 6.9% in study group II, and in 51.3 ± 6.8% in comparison group. Hence the values in study groups were higher than in comparison group by 16.6% and 21.2% respectively. All patients tolerated BT satisfactorily. Neither general nor local rectum or bladder severe (above grade II) toxicities were noted both during treatment and over the next 3 months upon its completion in all the patients regardless of study group. Results obtained in radiobiological studies correlated with clinical and literature data. Conclusions. Decrease in manifestations of RT toxicity, namely of the ear- ly radiation reactions from interfacing critical organs was established in groups I and II vs comparison group I, especially in group I where a high- energy 192Ir source was used in the SBD irradiation mode of 3 Gy twice a week. The obtained results of the experimental study suggest that the content of SH-groups in blood plasma and the level of PBL apoptosis can be considered as additional predictive measures of radiosensitivity of non-malignant cells from the irradiated tumor environment.

scholarly journals Transition from conformal to advanced radiotherapy techniques in treatment planning of gynecological cancer patients

2021 ◽  
pp. 77-77
Author(s):  
Borislava Petrovic ◽  
Olivera Ivanov ◽  
Milana Marjanovic ◽  
Jelena Licina ◽  
Ivan Gencel ◽  
...  
Keyword(s):  
At Risk ◽  
Cancer Patients ◽  
Maximum Dose ◽  
Organs At Risk ◽  
Gynecological Cancer ◽  
Conformal Radiation Therapy ◽  
Significant Difference ◽  
Treatment Plans ◽  
Radiation Induced ◽  
Risk Treatment

Background/ Aim. Transition from standard to highly conformal radiation therapy techniques, requires implementation of complex advanced dosimetry. The aim of the work was comparison of dosimetric parameters of 3DCRT and VMAT plan, as well as complications after treatment in relation to dosimetric parameters at gynecological cancer patients. Methods. Forty-nine gynecological cancer patients were included in the study. All patients were planned for 3D CRT, but due to unacceptable doses to organs at risk, treatment plans for IMRT or VMAT were generated for 21 patients. The patients were prescribed 50.4 Gy/28 fractions (4) and 45 Gy/25 fractions (45 patients). The coverage of PTV and doses to organs at risk were recorded. PTV margins were evaluated for both techniques according to the Van Herk formula. Results. ICRU 83 criteria were fulfilled in all 3DCRT /VMAT/IMRT plans providing optimal coverage of PTV. Doses to OARS: in average, the V45Gy in small bowel in IMRT/VMAT plans was four times smaller than the same of 3DCRT plans. The V45Gy of small bowels was in average 49.4cm3 in IMRT/VMAT plans, while in 3DCRT plans it was 211.6 cm3. In case of femoral head, significant reduction in V30Gy (10.8 % vs. 33.1%) and mean dose in case of IMRT/VMAT plans was recorded (30.4 Gy in 3DCRT vs 23.6 Gy). Rectum was planned with significantly lower dose in terms of V30Gy (79.5% vs 95.2%) in IMRT/VMAT plans. Bladder was better spared in VMAT plans in terms of V40Gy (51% vs. 91%), but maximum dose was higher in VMAT plans than in 3DCRT (50.1 Gy to 48.1 Gy in average). For all OARs there is statistically significant difference registered at p>0.05. Toxicities recorded in VMAT and 3DCRT patients include mainly radiation induced cystitis and enteritis. Patients treated with 3DCRT generally have longer recovery time. Homogeneity index was 0.11 for VMAT plans and 0.09 for 3DCRT plans. Conclusions. Analysis of dosimetric parameters revealed significant differences in normal tissue doses for same 3DCRT and VMAT patient, which confirmed necessity for implementation of advanced techniques for as many patients as possible.

scholarly journals Psychological Distress in Cancer Patients with Underage Children

2016 ◽  
Vol 24 (2) ◽  
pp. 146-151
Author(s):  
Jamila Akter ◽  
Jaglul Gaffer Khan ◽  
Manzurul Haque Khan ◽  
Mohammad Zaid Hossain
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Comparison Group ◽  
Anxiety And Depression ◽  
Study Group ◽  
College Hospital ◽  
Medical College ◽  
Depression Status ◽  
Female Cancer Patients ◽  
Minor Children

Context: A cross-sectional comparative study was designed to compare psychological distress in cancer patients with and without minor children.Materials and methods: This study was done to compare anxiety and depression status among the cancer patients attending at National Institute of Cancer Research Hospital, Oncology department in Dhaka Medical College Hospital and in Uttara Adhunik Medical College Hospital. The study was conducted from September, 2012 to June, 2013. Respondents had been divided into two groups. In study group 123 cancer patients having underage children were included and in comparison group 116 cancer patients without having underage children were selected. Purposive sampling was applied. All the married cancer patients in both groups were selected randomly each between the age from 20 to 60 years with minimal or no physical difficulties. They did not have any history of prior psychiatric illness or co morbidities or substance abuse related to development of secondary psychiatric disorders. Distress among the patients were measured with the Hospital Anxiety and Depression Scale (Two sub scales – A – Anxiety subscale and D – Depression subscale).Result: In the study group, 60.2% respondents were male and 39.8% female. And in comparison group male and female were 42.2% and 57.8%. Mean age of the participants in study group was 36.97±4.37 and in comparison group was 42.98±11.74 years. The mean duration since diagnosis was 12.85±13.11 months in study group and 11.53±6.72 months in comparison group. Majority of the respondents in study group were suffering from guynaecological cancer (25.2%) and gastro intestinal cancer (25.2%). Majority cancer in comparison group were guynaecological cancer (31%) and haematolymphoid cancer (20.7%) as well. Metastasis was present in 42.3% patients in study sample and 35.3% patients in comparison group. In study group 99.2% patients were suffering from both anxiety and depression. Majority (79.3%) patients in comparison group had been found depressed and 70.7% of them were anxious also. In study group 48.8% had moderate anxiety, 39% had severe and 11.4% had mild anxiety. Only 0.8% cancer patient had normal anxiety in this group. In comparison group 29.3% patients were normal in this regard. Majority (64.7%) had mild anxiety, 6% had moderate and no one had severe anxiety. Anxiety status was significantly different between the groups ( p < 0.001 ). Majority of the cancer patients in study group were suffering from depression. In this group 45.5% had moderate, 37.4% had severe, 16.3% had mild depression. In comparison group 62.1% had mild, 20.7% normal, 16.4% moderate and 0.9% had severe depression. The groups were significantly different ( p < 0.001 ) in depression status. In study group mean anxiety score in male was 15.72±2.314 and in female was 12.06±2.802, i.e. father with minor children were suffering from more anxiety than the mother (t = 7.878, p < 0.001). Mean depression score in male in study group was 11.91±2.489 and in female was 17.55±2.542, i.e. female cancer patients with minor children were found more depressed than male (t = 12.211; and p < 0.001).Conclusion: Almost all of the cancer patients with minor children had been found psychologically distressed. Cancer father with minor children were more prone to development of higher anxiety than the mothers in the same group. Female cancer patients with minor children were found more depressed than male.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 146-151

scholarly journals Sandalwood Oil and Turmeric-Based Cream Prevents Ionizing Radiation-Induced Dermatitis in Breast Cancer Patients: Clinical Study

Medicines ◽  
2017 ◽  
Vol 4 (3) ◽  
pp. 43 ◽  
Author(s):  
Suresh Rao ◽  
Sanath Hegde ◽  
Manjeshwar Baliga-Rao ◽  
Jyothi Lobo ◽  
Princy Palatty ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Study ◽  
Ionizing Radiation ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Radiation Induced ◽  
Sandalwood Oil

scholarly journals IRIDIUM-192 RADIOTHERAPY BENEFITS IN THE MANAGEMENT OF GYNECOLOGICAL TUMORS

2020 ◽  
Vol 25 ◽  
pp. 569-578
Author(s):  
V. Ivankova ◽  
◽  
E. Domina ◽  
T. Khrulenko ◽  
L. Baranovska ◽  
...  
Keyword(s):  
Dose Rate ◽  
Cancer Patients ◽  
Radiation Oncology ◽  
Biological Effects ◽  
Gynecological Cancer ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Radiation Sources ◽  
Radiation Induced

Background. Application of the most advanced radiation technologies of brachytherapy featuring the high dose rate sources i.e. 60Co and 192Ir within contemporary management protocols for gynecological cancer provides maximum dose distribution in the clinical target along with minimal radiation exposure on surrounding organs and tissues. It involves irradiation of large spaces with delivery of high therapeutic doses at the tolerance bound of «critical» organs (bladder, rectum) and tissues. Thus minimization of the early and late radiation complications, life span extent and quality of life increase remain just the issues in contemporary radiation oncology requiring therefore the elaboration of radiobiological criteria along with substantiation of physiсо-engineering properties of the radiation sources. Taking into account the basic radiobiological patterns will ensure a definitive further progress in the field of radiation oncology. Objective: to study and compare the biological effects of 192Ir with the effects of the reference gamma radiation 60Co and increase the effectiveness of brachytherapy using a 192Ir source. Materials and methods. Radiobiological dosimetry on the basis of a test system of peripheral blood lymphocytes from the gynecological cancer patients with subsequent cytogenetic analysis of radiation-induced chromosome aberrations was performed to study and compare the biological effects of 192Ir and reference 60Со γ-radiation, and to enhance the efficiency of 192Ir brachytherapy. Results. Radiation markers, i.e. dicentric chromosomes with an accompanying paired fragment prevailed in the spectrum of radiation-induced damage. Variability of individual cytogenetic parameters of peripheral lymphocytes upon the first fraction of irradiation at the same dose of 5 Gy indicated an individual sensitivity of patients to the 192Ir γ-irradiation. Comprehensive conservative treatment with adjuvant radiotherapy was applied to the patients (n = 98) having got secondary vaginal cancer stage II–III, T2-3N0-1M0. The high dose-rate (HDR) brachytherapy using 192Ir radiation sources was applied in the main study group (n = 37), HDR brachytherapy using 60Co radiation sources was applied in the control group (n = 35). Conclusion. The HDR brachytherapy with 192Ir and 60Co sources on the up-to-date technology intensive devices provides a high accuracy of dose distributions when irradiating the malignant neoplasms with minimized radiation exposure to the «critical» tissues. Treatment results are improved therefore. The use of 192Ir radiation sources compared with 60Co ones resulted in an increased throughput of treatment, enhanced tumor regression, and reduced incidence of radiation effects on the critical organs. Currently we perform the radiobiological studies on somatic cells from cancer patients at the genetic, biochemical, biophysical, and cytological levels in order to receive a biological indication of radiation damage under the impact of 192Ir isotope. Continuation of clinical trials with radiobiological support will provide an opportunity to predict the early and late radiation complications and thus to provide a personalized approach in brachytherapy of cancer patients using the 192Ir sources of γ-rays. Key words: HDR brachytherapy, 192Ir and 60Co high dose rate sources.

scholarly journals Gender Specific Psychological Distress in Cancer Patients with Underage Children

2016 ◽  
Vol 6 (1) ◽  
pp. 10-15
Author(s):  
Jamila Akter ◽  
Manzurul Haque Khan ◽  
Jaglul Gaffer Khan
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Comparison Group ◽  
Depression Score ◽  
Anxiety Score ◽  
Anxiety And Depression ◽  
Study Group ◽  
College Hospital ◽  
Medical College ◽  
Minor Children

Background: Psychological distress has become an epidemic among cancer patients. Less is known about the pattern of anxiety and depression in cancer patients with minor children. Gender issue is also important in this regard. Psychological distress is an important predictor of quality of life in cancer patients. A majority of these disorders are eminently treatable.Materials and methods: A cross-sectional comparative study was done to compare anxiety and depression status between cancer patients having and not having minor children, attending at National Institute of Cancer Research Hospital, Oncology department in Dhaka Medical College Hospital and in Uttara Adhunik Medical College Hospital. The study was conducted for the time period from September, 2012 to June, 2013. In study group, having underage children, 123 cancer patients were included. Whereas in comparison group without having underage children, 116 patients were selected. Purposive sampling was applied. Cancer patients in both groups were selected randomly, each between the age from 20 to 60 years, corresponding to Karnofsky Performance Scale Score > 79. All The included cancer patients were married and did not have history of substance use or any prior psychiatric illness or co morbidities related to development of secondary psychiatric disorders. Distress among the patients were measured with the Hospital Anxiety and Depression Scale (Two sub scales – A – Anxiety subscale and D – Depression subscale).Result: In the study group, 60.2% respondents was male and 39.8% was female. And in comparison group male and female ratio was 42.2% and 57.8%. Mean age of the participants in study group was 36.97±4.37 and in comparison group was 42.98±11.74 years respectively. The mean duration since diagnosis was 12.85±13.11 months in study group and 11.53±6.72 months in comparison group. Majority of the respondents in study group were suffering from guynaecological cancer (25.2%) and gastro intestinal cancer (25.2%). Whereas majority cancer patients in comparison group were guynaecological cancer (31%) and haematolymphoid cancer (20.7) as well. Metastasis was present in 42.3% patients in study sample and 64.7% patients in comparison group. It was noticed that, both male and female in study group were found significantly more distressed than the comparison group (p < 0.001). In study group mean anxiety score in male (n=74) was 15.72±2.314 and in female (n=49) was 12.06±2.802, i.e. father with minor children were suffering from more anxiety than the mother (t = 7.878, p < 0.001). Mean depression score in male (study group) was 11.91±2.489, whereas in female it was 17.55±2.542, i.e. female cancer patients with minor children were found more depressed than male (t = 12.211; and p < 0.001). In comparison group, mean anxiety score among male (n=49) was 7.27±1.630 and in female (n=67) mean anxiety score was 8.84±1.592. Female were more anxious than male in comparison group (t = 5.196; p < 0.001). In this group, mean depression score in male was 9.671±1.651 and in female it was 8.58±2.161. Male without minor children were found more depressed than female in this group (t = 2.958; p = 0.004).But among all the cancer patients majority of female were found anxious (93.1%) i.e prevalence of anxiety was more in female. And majority of the male respondents (95.1%) were depressed; (odds ratio; depression in male: female = 3.120; CI at 95% level – from 1.176 to 8.276).Conclusion: Cancer father with minor children were more prone to development of higher anxiety. And anxiety was more prevalent in female among all the cancer patients with and without minor children.J. Paediatr. Surg. Bangladesh 6(1): 10-15, 2015 (Jan)

In situ TEM studies of irradiation effects for materials improvement

1991 ◽  
Vol 49 ◽  
pp. 452-453
Author(s):  
Charles W. Allen
Keyword(s):  
Nuclear Reactor ◽  
Austenitic Stainless Steels ◽  
High Energy ◽  
Point Of View ◽  
In Situ Tem ◽  
Irradiation Effects ◽  
Tem Analysis ◽  
Radiation Induced ◽  
Analytical Tools

Irradiation effects studies employing TEMs as analytical tools have been conducted for almost as many years as materials people have done TEM, motivated largely by materials needs for nuclear reactor development. Such studies have focussed on the behavior both of nuclear fuels and of materials for other reactor components which are subjected to radiation-induced degradation. Especially in the 1950s and 60s, post-irradiation TEM analysis may have been coupled to in situ (in reactor or in pile) experiments (e.g., irradiation-induced creep experiments of austenitic stainless steels). Although necessary from a technological point of view, such experiments are difficult to instrument (measure strain dynamically, e.g.) and control (temperature, e.g.) and require months or even years to perform in a nuclear reactor or in a spallation neutron source. Consequently, methods were sought for simulation of neutroninduced radiation damage of materials, the simulations employing other forms of radiation; in the case of metals and alloys, high energy electrons and high energy ions.

ROLE OF LIPID PROFILE IN OVARIAN CARCINOMA PATIENTS

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Dr. Manisha ◽  
Dr. Ruchi Jindal
Keyword(s):  
Ovarian Cancer ◽  
Lipid Profile ◽  
Cancer Patients ◽  
Ovarian Tumor ◽  
Ovarian Cancer Risk ◽  
Low Level ◽  
Medical College ◽  
Group I ◽  
History Of

Background: The term "ovarian cancer" includes several different types of cancer that  arise from cells of the ovary, most commonly, tumors arise from the epithelium or lining cells of the ovary.  Ovarian cancer risk is positively associated with higher consumption of dietary cholesterol and eggs, and inversely associated with a higher intake of vegetables. High consumption of fats may increase circulating estrogen levels, thus increasing the possibility of cell damage and proliferation that is responsible for cancerous growth. Material & Methods: The present study was conducted at Geetanjali Medical College and Hospital, Udaipur (Rajasthan). Total  100 cases (females) attending the obstetrics and gynecology department for some gynecological and other problem  were selected for this study between the age of 40-60 years, who were attending cancer centre at GEETANJALI MEDICAL COLLEGE AND  HOSPITAL, Udaipur (Rajasthan).                GROUP I: - It consisted of healthy females control subjects (n=50) .By routine examination and tests, we ensured that all the subjects were healthy and there were no signs and symptoms or history of ovarian tumor and diseases GROUP II: - It consisted of ovarian cancer females subjects (n=50) with a history of ovarian tumor. Results:   Higher level of cholesterol, LDL, VLDL and low level of HDL are found in ovarian cancer patients. Conclusion: The present study we highlights the importance and role of serum lipid profile in diagnosis, prognosis and recurrence of the disease. The study shows that serum level of cholesterol, LDL, VLDL was elevated in  patients of ovarian cancer while low level of HDL are found in ovarian cancer patients. Key words: lipid profile, ovarian cancer.

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