Repopulation of Tumour Cells during Radiotherapy Is Doubled during Treatment Gaps

Tarnawski, R.; Składowski, Krzysztof; Wygoda, A.; Mucha, Anna

doi:10.1080/10273660008833056

Cited by 9 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Así, uno de los motivos descritos para explicar los abandonos del tratamiento radioterápico es la incapacidad de soportar los efectos adversos de la radioterapia (14,15). Se ha notificado que esta falta de control del dolor puede por tanto reducir los posibles beneficios de la radioterapia (15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionunclassified

“…Este fenómeno se encuentra bien documentado en pacientes con carcinoma de células escamosas de cabeza y cuello, así como en otros tipos de cáncer (16)(17)(18)(19)24). Así, se ha estimado que la tasa de repoblación durante un cese del tratamiento es casi cuatro veces más rápida que durante los días de irradiación (20,21). Asimismo, se ha estimado que al alargar el tiempo de radioterapia en un día el control local se reduce en un 1,4-1,7% cada día (16,22).…”

Section: Discussionunclassified

See 1 more Smart Citation

Dolor irruptivo oncológico inducido por radioterapia: ¿es posible optimizar su tratamiento?

Gayoso

Rijo

Sánchez³

et al. 2015

Rev. Soc. Esp. Dolor

View full text Add to dashboard Cite

Introduction: In the context of radiotherapy, control of breakthrough cancer pain (BTPc) is particularly challenging. BTPc has been defined by the Spanish Society of Pain (SED), the Spanish Society of Medical Oncology (SEOM) and the Spanish Society for Palliative Care (SECPAL) as a sudden and transient exacerbation of pain of great intensity (VAS > 7) and short (less than 20-30 minutes), which appears on the basis of a stable persistent pain when it is reduced to a tolerable level (VAS < 5) by using major opioids. Objectives: The main objective of this study was to assess the intensity of BTPc induced by cancer treatments that included radiotherapy (RT), both exclusive and associated with che-motherapy (RT/CT). Secondly, the efficacy of treatment was evaluated with fentanyl sublingual scheduled for BTPc control. Material and methods: Retrospective, observational study in 110 patients recruited in 19 Spanish Radiotherapy Services. Patients must have BTPc induced by RT or RT/CT, with or without medication prescribed and with an intensity outside a VAS > 6 in the last 24-48 h. Controls were established at baseline and at 3, 7, 15 and 30 days. Results: There was a decrease in mean values on the VAS scale as the study progressed (VAS = 6 in the control 0 to VAS = 3 in the control 3) and the differences were significant (p < 0.0001). Treatment satisfaction was rated as good or excellent by 85.3% of patients and 92.7% of researches. Conclusions: The results of this study demonstrate the efficacy of BTPc treatment with sublingual fentanyl in the context of the radiotherapy cancer treatment, with a significant decrease in VAS from baseline values. The high satisfaction among physicians and patients with this treatment reflects the efficacy and convenience of sublingual fentanyl in controlling BTPc.

show abstract

Section: Discussionunclassified

Dolor irruptivo oncológico inducido por radioterapia: ¿es posible optimizar su tratamiento?

Gayoso

Rijo

Sánchez³

et al. 2015

Rev. Soc. Esp. Dolor

View full text Add to dashboard Cite

show abstract

“…treatment gaps) in radiotherapy delivery can significantly compromise treatment success, local tumour control and overall survival. 91,[93][94][95][96] According to Nagar and Formenti, 91 delaying the start of adjuvant radiotherapy over 8 weeks after surgery will double the risk of local recurrence in breast cancer patients and every week of radiotherapy delay beyond 2 weeks after surgery for high-grade gliomas patients increases the risk of death by 8•9%. Several studies have reported a significant impact of the COVID-19 pandemic on radiotherapy delivery in several cancer centres.…”

Section: Radiation Therapymentioning

confidence: 99%

Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

et al. 2021

View full text Add to dashboard Cite

Background: Globally, cancer is the second leading cause of death, and it is estimated that over 18·1 million new cases are diagnosed annually. The COVID-19 pandemic has significantly impacted almost every aspect of the provision and management of cancer care worldwide. The time-critical nature of COVID-19 diagnosis and the large number of patients requiring hospitalisation necessitated the rerouting of already limited resources available for cancer services and programmes to the care of COVID-19 patients. Furthermore, the stringent social distancing, restricted in-hospital visits and lockdown measures instituted by various governments resulted in the disruption of the oncologic continuum including screening, diagnostic and prevention programmes, treatments and follow-up services as well as research and clinical trial programmes. Materials and Methods: We searched several databases from October 2020 to January 2021 for relevant studies published in English between 2020 and 2021 and reporting on the impact of COVID-19 on the cancer care continuum. This narrative review paper describes the impact of the COVID-19 pandemic on the cancer patient care continuum from screening and prevention to treatments and ongoing management of patients. Conclusions: The COVID-19 pandemic has profoundly impacted cancer care and the management of cancer services and patients. Nevertheless, the oncology healthcare communities worldwide have done phenomenal work with joint and collaborative efforts, utilising best available evidence-based guidelines to continue to give safe and effective treatments for cancer patients while maintaining the safety of patients, healthcare professionals and the general population. Nevertheless, several healthcare centres are now faced with significant challenges with the management of the backlog of screening, diagnosis and treatment cases. It is imperative that governments, leaders of healthcare centres and healthcare professionals take all necessary actions and policies focused on minimising further system-level delays to cancer screening, diagnosis, treatment initiation and clearing of all backlogs cases from the COVID-19 pandemic in order to mitigate the negative impact on cancer outcomes.

show abstract

“… 6 , 7 Such poor pain control has been reported to impact a patient’s willingness to attend treatment and to affect their ability to complete a course of treatment without interruptions, which in turn would impact the potential benefits of radiotherapy. 8 , 10 – 13 , 15 – 17 , 27 …”

Section: Conclusion and Potential Implicationsmentioning

confidence: 99%

“… 8 , 11 – 14 The repopulation rate during a treatment gap was estimated to be nearly four times faster than that during irradiation days. 15 , 16 One extra day of prolonged treatment of radiotherapy was estimated to reduce local control by 1.4% to 1.7% each day. 8 , 17 In another study, each day of interruption of radiotherapy was estimated to increase the hazard rate by 3.3% for local and regional tumor control, and by 2.9% for disease-free survival.…”

Section: Introductionmentioning

confidence: 99%

Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy

Bell¹,

Butler²

2013

JPR

View full text Add to dashboard Cite

BackgroundStudies report the need for improved pain management in the radiation oncology setting. Many patients with well controlled background pain experience breakthrough pain in cancer (BTPc) that can interrupt their treatment schedule with a potentially negative impact on outcomes. BTPc can be unpredictable and predictable; both types of pain can be managed with fast-acting analgesics, but predictable pain lends itself to anticipatory management.MethodsFive consecutive cases are described in which fentanyl pectin nasal spray (FPNS) was used to manage BTPc, with an emphasis on the anticipatory management of predictable pain in cancer patients receiving radiotherapy.ResultsPatients (four men, one woman), age range 32–84 years, were diagnosed with various cancers. All patients were receiving opioid treatment for chronic pain, and experienced predictable pain with radiotherapy which included pain associated with lying on a treatment table for a sustained time during an average of 29 radiotherapy treatments; pain associated with radiation simulation and radiotherapy; pain associated with odynophagia related to increasing mucositis during treatment, resulting in decreased nutritional intake; pain associated with the customized immobilization mask for head and neck cancer patients; and pain associated with defecation. Some patients also reported pain awakening them randomly at night (eg, sleep interruption). All patients attained lower pain intensity scores (2/10 to 3/10), reduced from approximately 7/10, when they were treated with FPNS 20 minutes before a predictable pain event. No patient experienced any pain-related interruptions to their course of radiotherapy. The average number of radiotherapy sessions was 29 per patient, excluding one short-course treatment for one patient.ConclusionFPNS offers a good solution to the management of BTPc because its fast onset of action makes it very suitable for the anticipatory treatment of predictable pain, which is likely to minimize interruptions to the radiotherapy schedule.

show abstract

Repopulation of Tumour Cells during Radiotherapy Is Doubled during Treatment Gaps

Cited by 9 publications

References 6 publications

Dolor irruptivo oncológico inducido por radioterapia: ¿es posible optimizar su tratamiento?

Dolor irruptivo oncológico inducido por radioterapia: ¿es posible optimizar su tratamiento?

Impact of COVID-19 pandemic on the oncologic care continuum: urgent need to restore patients care to pre-COVID-19 era

Management of predictable pain using fentanyl pectin nasal spray in patients undergoing radiotherapy

Contact Info

Product

Resources

About