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External beam radiotherapy (EBRT) combined with brachytherapy (BT) is the standard mode of radical radiotherapy for locally advanced cervical cancer. The cumulative equivalent doses in 2 Gy per fraction (EQD
) is an important basis for estimating the probability of local control of tumors and monitoring the occurrence of side effects in normal tissues. The purpose of this study was to explore the predictive value of Excel forms based on an automatic calculation in radical adaptive BT for cervical cancer.
A retrospective analysis of 119 patients suffering from cervical cancer, treated with radical radiotherapy. All patients were treated with EBRT and adaptive BT. EBRT prescribed dose was 42.0-50.4 Gy in 21-28 fractions. BT nominal prescribed dose was 28 Gy in 4 fractions, separated by one week. Total EQD
prediction at nth (
= 1-3) BT (TEPB
) or actual cumulative EQD
(ACEQD
) can be calculated automatically by inputting the physical dose based on an in-house designed application. The relationship bm, which allows for balance between the total dose to target volumes and organs at risk (OARs). Excel forms based on EQD2 automatic calculation presents high predictive accuracy.
In this paper, excess dose is originally proposed to represent the dose outside the target volume that encompass only organs at risk (OARs), not the whole dose volume of isodose surface volume (ISV). By means of spatial consideration, excess dose-related parameters would also compensate inconsistent applicator positions and OARs motion, which may deviate the identical dose small-volume assumption of D
. Late toxicity correlations of these parameters were investigated.
A retrospective review was performed on cervical cancer high-dose-rate image-guided adaptive brachytherapy (HDR-IGABT). From ISVs of 60 to 100 Gy EQD
(a/β = 3), excess dose-related parameters were derived as following toxicity negligible volume (Vneg = V
of toxicity negligible organs; high-risk clinical target volume - HR-CTV, uterus, and vagina), excess dose volume (Vex = ISV - Vneg), Vneg normalized parameters of excess dose volume ratio (Rex = Vex/Vneg), and indirect excess dose volume ratio (iRex = ISV/Vneg). Relationships between tilization for spatial control of dose expansion, in addition to high-dose control with OAR small volumes. Further investigations are needed to define the optimum use of these predictors.
Excess dose-related parameters, including Vex, Rex, and iRex, showed significant mean differences and parameter-toxicity relationships for late GI but not for GU toxicities. Positive NRIs suggest iRex60 utilization for spatial control of dose expansion, in addition to high-dose control with OAR small volumes. Further investigations are needed to define the optimum use of these predictors.
Technological advances with commercial production of surface applicators allowed high-dose-rate (HDR) afterloading brachytherapy to overpass challenges associated with the delivery of superficial radiation when treating non-melanoma skin cancer (NMSC). selleck chemicals We reviewed our single institutional experience using HDR to treat basal (BCC) and squamous cell (SCC) carcinomas.
A retrospective review of all patients treated with HDR and Leipzig-style applicators for NMSC at the Radiation Oncology Department, AC Camargo Cancer Center, from March 2013 to December 2018 was performed.
Seventy-one patients with 101 lesions (BCCs, 69.3% or
= 70) and median age 80 (range, 51-102) years old were evaluated. The median follow-up was 42.8 (range, 12-82) months. The 3-year and 5-year actuarial local control (LC) rates were 97.9% and 87.2%, respectively. On univariate analysis, treatments with EQD
less than 50 Gy (
< 0.001) and dose per fraction smaller than 3 Gy (
< 0.001) were found to be statistically significant predictive factors of a worse outcome. On multivariate analysis, SCC had a worse prognosis over BCC (
= 0.007, HR = 2.3, CI 1.2-6.6). All patients developed some degree of acute side effects graded 1 to 2. Grade 3 acute side effects were observed in 9 (8.9%) patients. Moreover, severe late side effects (grade 3), hypopigmentation, and telangiectasia were observed in 4 (3.9%) patients. No grade 4 acute or late side effects were seen in this cohort.
HDR offers a convenient treatment schedule for patients and is associated with excellent LC. The most effective regimen, in terms of dose and fractionation, to treat superficial NMSC with HDR remains uncertain, but a moderate minimum EQD
dose of 50 Gy should be used.
HDR offers a convenient treatment schedule for patients and is associated with excellent LC. The most effective regimen, in terms of dose and fractionation, to treat superficial NMSC with HDR remains uncertain, but a moderate minimum EQD2 dose of 50 Gy should be used.
To investigate the safety and feasibility of endovascular brachytherapy using iodine-125 (
I) seed strand for locally advanced pancreatic ductal adenocarcinoma (PDAC) with vascular invasion.
From January 2010 to January 2015, 12 patients diagnosed with locally advanced, inoperable PDAC with splenic or superior mesenteric vein invasion were enrolled in the present study and received endovascular brachytherapy combined with regional intra-arterial infusion chemotherapy. Standardized software was used for dose calculation. Procedure-related and radiation complications were documented and assessed. Overall survival was calculated with the Kaplan-Meier approach.
The technical success rate of
I seed strand implantation and stent placement was 100%. During follow-up with a mean duration of 17.00 ±6.07 months (range, 6~24 months), the mean and median survival times were 12.0 ±2.4 months (95% CI 7.4~16.6 months) and 10.7 ±1.4 months (95% CI 8.0~13.5 months), respectively. One month after the treatment, the disease control and objective rates were 83.8% and 58.3%, respectively. The 6-, 12-, and 15-month cumulative survival rates were 66.7%, 47.6%, and 9.5%, respectively.
Endovascular brachytherapy using
I seed strand and stent placement may be a safe and effective treatment option for locally advanced pancreatic duct adenocarcinoma with vascular invasion.
Endovascular brachytherapy using 125I seed strand and stent placement may be a safe and effective treatment option for locally advanced pancreatic duct adenocarcinoma with vascular invasion.
The aim of this study was to compare short-term oncologic outcomes and toxicity of focal or partial low-dose-rate brachytherapy (focal/partial LDR-BT) with whole gland low-dose-rate brachytherapy (whole LDR-BT) in localized prostate cancer patients.
Medical records of eligible patients who underwent focal/partial LDR-BT and whole LDR-BT between 2015 and 2017 at our institution were reviewed retrospectively. Clinical characteristics and pathologic outcomes were compared between focal/partial LDR-BT group and whole LDR-BT group. Biochemical recurrence-free survival was analyzed using Kaplan-Meier method and difference between two groups was assessed with log-rank test. Genitourinary and rectal toxicity were also evaluated between the two groups.
Of the 60 patients analyzed, 30 focal/partial LDR-BT patients and 30 whole LDR-BT brachytherapy patients were included. Relative to the whole LDR-BT group, the focal/partial LDR-BT group had significantly higher initial PSA level (
= 0.002), smaller number of implanted seeds (
< 0.001), and shorter follow-up duration (
< 0.001). There was no significant difference between the two groups with regard to prostate volume, biopsy Gleason score, and risk group stratification. The 3-year biochemical recurrence-free survival estimates for focal/partial LDR-BT group and whole LDR-BT group were 91.8% and 89.6%, respectively, which was not significantly different (
= 0.554). Genitourinary symptoms were significantly worse in whole LDR-BT group than in focal/partial LDR-BT group. The incidence of rectal toxicity was similar between two groups.
Our findings indicate that the focal/partial LDR-BT is comparable to the whole LDR-BT with respect to short-term biochemical recurrence and toxicities.
Our findings indicate that the focal/partial LDR-BT is comparable to the whole LDR-BT with respect to short-term biochemical recurrence and toxicities.
The aim of this paper was to evaluate treatment outcomes following interventional radiotherapy (brachytherapy - BT) for nasal vestibule cancer.
Considering histological diagnosis and staging, a multidisciplinary tumor board indicated an exclusive interventional radiotherapy for all patients. Plastic tubes were placed mainly with interstitial approach. The total dose was 44 Gy in 14 fractions, 3 Gy/fraction (except for the first and last fractions, 4 Gy), 2 fractions per day (b.i.d.), 5 days a week. Inclusion criteria for this analysis were patients affected by squamous cell carcinoma with follow-up more than 6 months.
20 patients with primary nasal vestibule cancer were treated with IRT from May 2012 to June 2019. We excluded 4 patients due to follow-up less than 6 months and 2 patients affected by basal cell carcinoma. link2 In total, 14 consecutive previously untreated patients were considered for definitive analysis, median age was 67.5 (range, 51-83) years, median follow-up was 53 (range, 6-84) months. All patients followed the protocol except one, who received a total dose of 42 Gy in 12 fractions, 3 Gy per 6 fractions, and 4 Gy per 6 fractions. link3 Local control at 12, 24, and 36 months was 85.7%. Overall survival at 12 months was 92.3%, at 24 months was 76.9%, and at 36 months was 69.2%. Staging system proposed by Wang was statistically significant on local control (LC), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Excellent cosmetic results were observed.
This study confirms that interventional radiotherapy could be considered as a definitive treatment in nasal vestibule cancer with excellent oncological and cosmetic outcomes.
This study confirms that interventional radiotherapy could be considered as a definitive treatment in nasal vestibule cancer with excellent oncological and cosmetic outcomes.
Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care units (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions.
This is a retrospective cohort study using data from the COVID-19 Virtual Pediatric System (VPS) dashboard containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state-level data contained 13 different factors from population density, comorbid conditions, and social distancing score. The absolute CPA count was converted to frequency using the state's population. Univariate and multivariate regression analyses were performed to assess the association between CPA frequency and admission endpoints.
A total of 205 CPAs were reported by 167 PICUs across 48 states. The estiation. These factors should be included in future studies using patient-level data.
Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density. Type 1 DM appears to be associated with increased duration of HFNC and intubation. These factors should be included in future studies using patient-level data.
Homepage: https://www.selleckchem.com/products/avitinib-ac0010.html
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