Диагностика и лечение опухолей мочеполовой системы. Рак мочевого пузыряПаллиативная лучевая терапия рака мочевого пузыря
Purpose: To define efficiency and safety of use of the active scanning proton beam in reirradiation of recurrent malignant gliomas. Material and methods: Researched group included 26 patients who were treated on a complex of proton therapy Prometeus. 57.7 % of tumors were glioblastoma, 26.9 % – gliomas of GII and 15.4 % GIII gliomas. Proton therapy was carried out with use of the active scanning beam, image-guiding system and use of the individual fixing devices. To all patients PET/CT with 11C-methionine and MRI were carried out, target volume delineation was carried out by results of coregistration of both images. Results: Terms of observation were from 1 to 32 months. The assessment of direct efficiency is carried out at 19 patients in 3 months after completion of treatment. From the group 52.7 % of patients (n = 10) had disease stabilization. At 11.5 % (n = 3) – partial response. Tumor regression volume varied from 50 to 90 %. Progressing of a disease developed in 31.5 % of the considered cases (n = 6). Other 7 patients expect control inspection. 15.4 % (n = 4) patients developed grade 2 radiodermatitis in the field of radiation fields, the remaining 84.6 % (n = 22) had grade 1 radiodermatitis. Of the entire group of patients, only one case of the development of a late radiation complication in the form of radionecrosis is observed at an observation period of 13 months. Conclusion: Preliminary results of a research showed that performing proton therapy by the active scanning beam is the effective method of treatment of patients with the diagnosed recurrent gliomas, allowing to increase life expectancy of patients with maintaining satisfactory general condition.
Цель исследования -оценка эффективности и токсичности одновременной химиолучевой терапии больных раком слизистой оболочки полости рта с использованием ускоренного гиперфракционирования дозы облучения. Материал и методы. Клинические наблюдения представлены 79 пациентами, проходившими лучевую терапию на облучательных установках «Терабалт» в режиме ускоренного гиперфракционирования с одновременным проведением 2 циклов полихимиотерапии по схеме pF. Дневная доза 2,5 Гр была разделена на две фракции: 1,0 Гр и 1,5 Гр, которые подводились с 5-6-часовым интервалом ежедневно 5 раз в нед до суммарной очаговой дозы 60,0 Гр и 50,0 Гр на зоны высокого и низкого риска соответственно. Результаты. Полная регрессия, частичная регрессия, стабилизация выявлены в 63,3 %, 35,4 %, 1,3 % случаев соответственно. Пятилетняя общая и безрецидивная выживаемость в целом в группе составила 54,5 % и 50,4 % соответственно. В подгруппе больных со стадиями опухоли T3-4 пятилетняя общая выживаемость составила 50,8 %, безрецидивная -47,2 %. Тяжелые мукозиты (III степени) выявлены у 36,7 % больных. В зоне облучения на кожных покровах у 85 % пациентов отмечались лучевые реакции, которые были оценены как кожная токсичность первой степени. Остеорадионекрозы нижней челюсти развились в 8,9 % случаев. Все пациенты, включенные в исследование, завершили запланированный курс химиолучевого лечения. Заключение. Одновременная химиолучевая терапия с ускоренным гиперфракционированием дозы облучения 1,0 Гр + 1,5 Гр может рассматриваться как эффективный вариант противоопухолевой терапии при выборе оптимальной тактики лечения больных раком органов полости рта при наличии противопоказаний к хирургическому вмешательству.Ключевые слова: химиолучевая терапия, рак полости рта, гиперфракционирование, выживаемость, токсичность.
The purpose of the study was to compare the efficacy and toxicity of hypofractionated versus hyperfractionated radiotherapy in patients with inoperable lung cancer.Material and Methods. Patients with inoperable lung cancer, who were treated between 2014 and 2017, were assigned to undergo radiotherapy in two arms: accelerated hypofractionated conformal radiotherapy arm with 70 patients (60 Gy in 25 fractions, with 2.4 Gy per fraction) and accelerated hyperfractionated radiotherapy with 49 patients (60–70 Gy with 1–1.5 Gy per fraction). At the same time, platinum-based chemotherapy was applied.Results. The rates of partial response, complete response, stable disease and progressive disease were 44.3, 7.2, 38.5 and 10.0 %, respectively in patients with hypofractionated conformal radiotherapy arm. The corresponding values were 71.4, 6.1, 16.4 and 6.1 %, respectively in patients with hyperfractionated radiotherapy arm. The 2-year overall survival rate was 62.8 % for the hypofractionated group and 58.1 % for the hyperfractionated group. Esophagitis III grade was observed in 4 (5.7 %) patients of the hypofractionated group and in 3 (6.5 %) patients of the hypofractionated group. Pneumonitis III grade was reported in 2 (2.9 %) patients in the hypofractionated radiotherapy arm and in 4 (8.7 %) patients in the hyperfractionated radiotherapy arm.Conclusion. Results of the study showed that 3D-conformal hypofractionated radiotherapy combined with concurrent chemotherapy resulted no in severe radiation-induced complications, and demonstrated satisfactory short-and long-term treatment outcomes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.