RESUMEN
Patients with early stage high-risk prostate cancer (prostate specific antigen > 20, Gleason score > 7) are at high risk of recurrence following prostate cancer irradiation. Radiation dose escalation to the prostate may improve biochemical-free survival for these patients. However, high rectal and bladder dose with conventional three-dimensional conformal radiotherapy may lead to excessive gastrointestinal and genitourinary toxicity. Image-guided radiotherapy (IGRT), by virtue of combining the steep dose gradient of intensity-modulated radiotherapy and daily pretreatment imaging, may allow for radiation dose escalation and decreased treatment morbidity. Reduced treatment time is feasible with hypo-fractionated IGRT and it may improve patient quality of life.
RESUMEN
AIM: To assess the effectiveness of conventionally fractionated radiotherapy for local control and cosmesis in elderly patients (age 70 years or older) with non-melanoma skin cancer of the head. METHODS: A retrospective review of 15 patients undergoing definitive radiation (11 patients) or postoperative radiation (4 patients) for squamous cell carcinoma (9 patients) and basal cell carcinoma (6 patients) of the head was undertaken. At each follow-up visit, a radiation oncology resident and/or medical student was requested to examine the patient's head and neck, and determine the initial location of the cancer without reviewing their medical record. RESULTS: No patient developed a loco-regional recurrence. The residents and medical students were unable to determine the initial location of the cancer because of the skin normalcy. CONCLUSION: Conventionally fractionated radiotherapy is effective for local control and provides excellent cosmesis for elderly patients with skin cancer of the head.
Asunto(s)
Carcinoma Basocelular/radioterapia , Carcinoma de Células Escamosas/radioterapia , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias Cutáneas/radioterapia , Anciano , Anciano de 80 o más Años , Fraccionamiento de la Dosis de Radiación , Femenino , Humanos , Masculino , Melanoma , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
AIMS AND BACKGROUND: To evaluate the effectiveness of helical tomotherapy-based image-guided radiotherapy (IGRT) following surgery for lower extremity sarcoma. METHODS AND STUDY DESIGN: A retrospective review of three patients undergoing postoperative irradiation with tomotherapy for lower extremity sarcoma was conducted. Planning target volume (PTV) coverage, acute side effects, long-term complications and functional results were assessed. RESULTS: Tomotherapy allows adequate coverage of the PTV without an excessive radiation dose to the normal adjacent structures. Radiotherapy side effects were acceptable with no treatment breaks. All patients were disease free with no complications and no impairment of their daily activity at the last follow-up. CONCLUSION: IGRT delivered by tomotherapy may be ideally suited for sarcoma of the extremities because of its ability to achieve a high radiation dose along with excellent normal tissue sparing. Further prospective studies should be conducted to confirm this hypothesis.
Asunto(s)
Planificación de la Radioterapia Asistida por Computador , Radioterapia Guiada por Imagen , Radioterapia de Intensidad Modulada , Sarcoma/radioterapia , Sarcoma/cirugía , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Extremidad Inferior , Masculino , Tomografía de Emisión de Positrones , Dosificación Radioterapéutica , Radioterapia Adyuvante , Estudios Retrospectivos , Sarcoma/diagnóstico , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: In this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed. METHODS: A retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70 Gy (62.4-75 Gy). RESULTS: At a median follow-up of 14 months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications. CONCLUSIONS: IMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications.
Asunto(s)
Neoplasias Esofágicas/radioterapia , Recurrencia Local de Neoplasia/radioterapia , Radioterapia Guiada por Imagen/métodos , Anciano , Neoplasias Esofágicas/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Dosificación Radioterapéutica , Radioterapia Guiada por Imagen/efectos adversos , Radioterapia de Intensidad ModuladaRESUMEN
BACKGROUND: The aim of the study is to assess the effectiveness of intensity-modulated radiotherapy (IMRT) or image-guided radiotherapy (IGRT) for the prevention of retropharyngeal nodal recurrences in locally advanced head and neck cancer. METHODS: A retrospective review of 76 patients with head and neck cancer undergoing concurrent chemoradiation or postoperative radiotherapy with IMRT or IGRT who were at risk for retropharyngeal nodal recurrences because of anatomic site (hypopharynx, nasopharynx, oropharynx) and/or the presence of nodal metastases was undertaken.The prevalence of retropharyngeal nodal recurrences was assessed on follow-up positron emission tomography (PET)-CT scans. RESULTS: At a median follow-up of 22 months (4-53 months), no patient developed retropharyngeal nodal recurrences. CONCLUSION: Prophylactic irradiation of retropharyngeal lymph nodes with IMRT or IGRT provides effective regional control for individuals at risk for recurrence in these nodes.
