RESUMEN
AIM: This communication reviews results and toxicity of image-guided high-dose-rate endorectal brachytherapy (HDREBT) boost after external beam radiotherapy (ERT) in medically inoperable patients with rectal cancer. MATERIALS AND METHODS: A total of 18 patients with rectal cancer and clinical stage T2-4N02 treated with HDREBT boost after ERT were retrospectively reviewed. RESULTS: Following treatment with a median total dose (EQD2, α/ßâ¯= 10) of 66â¯Gy (range 48-92â¯Gy), the incidence of early and late rectal grade 3 toxicity was 11% and 19%, respectively. There was no correlation between the occurrence of acute and late toxicity. CONCLUSION: With proper technique, a combined approach using EBRT and HDREBT was associated with acceptable toxicity in medically inoperable rectal cancer patients.
Asunto(s)
Adenocarcinoma/radioterapia , Braquiterapia/efectos adversos , Incontinencia Fecal/etiología , Hemorragia/etiología , Proctitis/etiología , Traumatismos por Radiación/etiología , Enfermedades del Recto/etiología , Neoplasias del Recto/radioterapia , Adenocarcinoma/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Braquiterapia/métodos , Relación Dosis-Respuesta en la Radiación , Femenino , Estudios de Seguimiento , Humanos , Dosificación Radioterapéutica , Neoplasias del Recto/diagnóstico por imagen , Estudios RetrospectivosRESUMEN
BACKGROUND: This study compared outcomes of nonresectable hepatocellular carcinoma (HCC) who had transarterial chemoembolization (TACE) vs. stereotactic body radiation therapy (SBRT) after TACE (TACE + SBRT). METHODS: This was a retrospective study of 2 centers in Hong Kong. There were 49 patients who had TACE + SBRT and 202 patients who had TACE alone. Propensity score matching was used to adjust for differences in patients' demographics and tumor characteristics between the 2 groups. The primary outcome was overall survival (OS) and secondary outcomes were progression-free survival (PFS) and treatment-related toxicity. RESULTS: After matching, 49 patients were in the TACE + SBRT group and 98 patients in the TACE group with similar baseline characteristics. The 1-&3-year OS were better in TACE + SBRT group (67.2 vs. 43.9% and 36.5 vs. 13.3%, p = 0.003). The 1-&3-year PFS was also better in TACE + SBRT group (32.5 vs. 21.4% and 15.1 vs. 5.1%, p = 0.012). Radiological disease control was better in the TACE + SBRT group (98 vs. 56.7%). Risk of severe toxicity was uncommon in both treatment arms. TACE + SBRT was an independent good prognostic factor for OS and PFS in multivariate analysis, whereas AFP>200 ng/ml, large tumor and multiple tumors predicted worse OS. CONCLUSION: TACE + SBRT is safe and results in better survivals in nonresectable HCC patients.