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Treatment outcomes after definitive radio(chemo)therapy for 17 lacrimal sac squamous cell carcinoma.

OBJECTIVES: Tumors of the lacrimal sac are rare and life-threatening. Because of their rarity, no extensive clinical data on their management and prognosis exist. We investigated the application of definitive radiation therapy and its outcome in patients with lacrimal sac squamous cell carcinoma (LSSCC). METHODS: We retrospectively studied 17 patients with LSSCC at a single institution between 2003 and 2017. All the patients were treated with definitive radiotherapy, and 11 patients were delivered with cisplatin-based chemotherapy. The patients' clinical records were reviewed for symptoms, pa

Immune Checkpoint Inhibitor Therapy-related Pneumonitis: Patterns and Management.

In recent years, the use of immune checkpoint inhibitor (ICI) therapy has rapidly grown, with increasing U.S. Food and Drug Administration approvals of a variety of agents used as first- and second-line treatments of various malignancies. ICIs act through a unique mechanism of action when compared with those of conventional chemotherapeutic agents. ICIs target the cell surface receptors cytotoxic T-lymphocyte antigen-4, programmed cell death protein 1, or programmed cell death ligand 1, which result in immune system-mediated destruction of tumor cells. Immune-related adverse events are an incr

Proton Beam Therapy for Histologically or Clinically Diagnosed Stage I Non-Small Cell Lung Cancer (NSCLC): The First Nationwide Retrospective Study in Japan.

PURPOSE: To investigate the efficacy and safety of proton beam therapy (PBT) for the treatment of stage I non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Six hundred sixty-nine patients with 682 tumors histologically or clinically diagnosed stage I NSCLC according to the seventh edition of Union for International Cancer Control who received passive-scattering PBT from April 2004 and December 2013 in Japan were retrospectively reviewed to analyze survival, local control, and toxicities. RESULTS: Of 669 patients, 486 (72.6%) were men, with a median age of 76 years (range, 42-94 year

Treatment-associated toxicities reported by patients with early-stage invasive breast cancer.

BACKGROUND: Patient-reported toxicities help to appraise the breast cancer treatment experience. Yet extant data come from clinical trials and health care claims, which may be biased. Using patient surveys, the authors sought to quantify the frequency, severity, and burden of treatment-associated toxicities. METHODS: Between 2013 and 2014, the iCanCare study surveyed a population-based sample of women residing in Los Angeles County and Georgia with early-stage, invasive breast cancer. The authors assessed the frequency and severity of toxicities; correlated toxicity severity with unscheduled

Genetic Variants in CD44 and MAT1A Confer Susceptibility to Acute Skin Reaction in Breast Cancer Patients Undergoing Radiation Therapy.

PURPOSE: Heterogeneity in radiation therapy (RT)-induced normal tissue toxicity is observed in 10% of cancer patients, limiting the therapeutic outcomes. In addition to treatment-related factors, normal tissue adverse reactions also manifest from genetic alterations in distinct pathways majorly involving DNA damage-repair genes, inflammatory cytokine genes, cell cycle regulation, and antioxidant response. Therefore, the common sequence variants in these radioresponsive genes might modify the severity of normal tissue toxicity, and the identification of the same could have clinical relevance as

A potent steroid cream is superior to emollients in reducing acute radiation dermatitis in breast cancer patients treated with adjuvant radiotherapy. A randomised study of betamethasone versus two moisturizing creams.

BACKGROUND AND PURPOSE: The aim was to investigate whether treatment with potent local steroids can reduce signs and symptoms of acute radiation dermatitis in breast cancer patients undergoing adjuvant radiotherapy (RT) compared to emollient creams. MATERIAL AND METHODS: The study was randomised and double-blinded. Patients with breast cancer who had undergone mastectomy or breast-conserving surgery were included when they started adjuvant 3-D planned RT. In all, 104 patients were randomised 2:1:1 to three treatment groups, i.e. betamethasone+Essex® cream, Essex® cream or Canoderm® cream. The

Predictive factors for early and late local toxicities in anal cancer treated by radiotherapy in combination with or without chemotherapy.

BACKGROUND: The treatment of anal cancer is based on concomitant radiotherapy and chemotherapy and is associated with a nonnegligible rate of local severe toxicities that can strongly impair the quality of life. OBJECTIVE: A retrospective analysis was performed to screen the following factors as potential predictive factors for local skin and digestive toxicities, and as potential prognostic factors for cumulative colostomy incidence: sex, age, tumor size, clinical T and N stage, circumferential extension, invasion of anal margin, HIV status, type of chemotherapy, and type of radiotherapy and

Cetuximab, paclitaxel, carboplatin, and radiation for head and neck cancer: a toxicity analysis.

OBJECTIVE: To determine the feasibility and toxicity of the addition of cetuximab to paclitaxel, carboplatin, and concurrent radiation for patients with head and neck cancer. MATERIALS AND METHODS: Patients with stage III or IV locally advanced squamous cell cancer of the head and neck, without distant organ metastases, were eligible. Patients received 4 weeks of induction cetuximab followed by weekly cetuximab, paclitaxel, carboplatin, and concurrent radiation. RESULTS: Thirty-two patients were assessable for chemoradiation toxicities. Grade 3 and grade 4 mucositis occurred in 53% and 16% o

[Early-onset radiation complications and tissue damage in the treatment of head and neck tumors].

The report discusses the results of an evaluation of the effectiveness of combined radiotherapy in 1,192 cases of head and neck tumors divided into 4 groups: distant radiotherapy in standard fractions of 1.8-2.3 Gy, 5 times a week, TTD of 60 Gy (group 1 - 486 40.8%); radiotherapy + local UHF hyperthermia + regional intraarterial chemotherapy + hyper glycemia + administrations of regional intraarterial chemotherapy + hyperglycemia + local UHF hyperthermia (group 2 - 244 20.5%); accelerated superfractition radiotherapy with variable STD of 1 and 1.5/2 Gy, TTD of 60 Gy, plus neoadjuvant polychemo

Pravastatin limits radiation-induced vascular dysfunction in the skin.

About half of people with cancer are treated with radiation therapy; however, normal tissue toxicity still remains a dose-limiting factor for this treatment. The skin response to ionizing radiation may involve multiple inflammatory outbreaks. The endothelium is known to play a critical role in radiation-induced vascular injury. Furthermore, endothelial dysfunction reflects a decreased availability of nitric oxide. Statins have been reported to preserve endothelial function through their antioxidant and anti-inflammatory activities. In this study, wild type and endothelial nitric oxide synthase

Management of skin reactions during radiotherapy in Flanders (Belgium): a study of nursing practice before and after the introduction of a skin care protocol.

PURPOSE OF THE RESEARCH: To evaluate nursing practice in Flanders (Belgium) regarding skin care during radiotherapy and the effect of the introduction of an evidence based protocol on daily nursing practice. METHODS AND SAMPLE: Nurses working at radiotherapy departments in Flanders were invited to complete a 58-item questionnaire. The survey was undertaken in 2001 (n=67) and end of 2006 (n=89). Following the survey in 2001 an evidence based skin care protocol was made available for radiotherapy nurses and presented at their respective radiotherapy services. The questionnaire asked to what ext

A multicenter randomized trial of breast intensity-modulated radiation therapy to reduce acute radiation dermatitis.

PURPOSE: Dermatitis is a frequent adverse effect of adjuvant breast radiotherapy. It is more likely in full-breasted women and when the radiation is distributed nonhomogeneously in the breast. Breast intensity-modulated radiation therapy (IMRT) is a technique that ensures a more homogeneous dose distribution. PATIENTS AND METHODS: A multicenter, double-blind, randomized clinical trial was performed to test if breast IMRT would reduce the rate of acute skin reaction (notably moist desquamation), decrease pain, and improve quality of life compared with standard radiotherapy using wedges. Patien

Expression of HIF-1 alpha in irradiated tissue is altered by topical negative-pressure therapy.

BACKGROUND AND PURPOSE: Despite the enormous therapeutic potential of modern radiotherapy, common side effects such as radiation-induced wound healing disorders remain a well-known clinical phenomenon. Topical negative pressure therapy (TNP) is a novel tool to alleviate intraoperative, percutaneous irradiation or brachytherapy. Since TNP has been shown to positively influence the perfusion of chronic, poorly vascularized wounds, the authors applied this therapeutic method to irradiated wounds and investigated the effect on tissue oxygenation in irradiated tissue in five patients. MATERIAL AND

Induction of p53 expression in skin by radiotherapy and UV radiation: a randomized study.

BACKGROUND: p53 protein plays an important role in the response to DNA damage, and radiotherapy can cause radiation dermatitis. p53 and p21 levels increase in vitro when DNA is damaged by UVA, UVB, or gamma-radiation. To determine whether this response occurs in human skin and predicts the level of radiation dermatitis, we investigated levels of p53 and p21 in skin exposed to different types of radiation as part of a randomized study of women with breast cancer to evaluate topical steroid or emollient cream treatments for radiation dermatitis of their irradiated breast. METHODS: After surgery

Radiotherapy and "new" drugs-new side effects?

Background and purposeTargeted drugs have augmented the cancer treatment armamentarium. Based on the molecular specificity, it was initially believed that these drugs had significantly less side effects. However, currently it is accepted that all of these agents have their specific side effects. Based on the given multimodal approach, special emphasis has to be placed on putative interactions of conventional cytostatic drugs, targeted agents and other modalities. The interaction of targeted drugs with radiation harbours special risks, since the awareness for interactions and even synergistic t

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… Merlano et al. [ 128 ] | 2010 | Phase II | 45 | HNSCC | Up to 70 Gy, three cycles Cis/5-FU, split course RT, RT + cetux | 2% grade IV leukopenia (38% grade III), 7% grade IV neutropenia (33% grade III), 2% grade IV thrombopenia (13% grade III), 36% grade IV stomatitis (29% grade III), 73% grade III radiodermatitis … infection 5% | Hofheinz et al. [ 137 ] | 2006 | Phase I | 20 | Rectal cancer | Capecitabine + Irinotecan + 50.4 Gy | No grade IV, no rash, 20% grade III diarrhea | Kuhnt et al. [ 138 ] | 2010 | Phase I | 18 (16 eligible) | LA-HNSCC | HART (70.6 Gy) + Cis | 56% grade III mucositis, 38% ≥ grade III radiodermatitis …

[Какие хронические условия подходят для оказания специализированной медицинской помощи в рамках системы первичной медико-санитарной помощи?

СПРАВОЧНАЯ ИНФОРМАЦИЯ: С введением в действие ворот общего профиля (ВП) специалисты могли бы также брать на себя первичную медико-санитарную помощь пациентам с тяжелыми хроническими заболеваниями. Цель этого исследования заключалась в разработке основанного на данных метода выявления потенциально подходящих условий и демонстрации актуальности индивидуальных медицинских специальностей для ухода за пациентами. СТАТИСТИЧЕСКИЕ МЕТОДЫ: Использование общенациональных данных о требованиях врачей системы обязательного медицинского страхования 2024, доля случаев и дней лечения на одного пациента, лечащ

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… Zusammenhang mit Zwischenfällen bei diagnostischer und therapeutischer Anwendung 1648 33 C38 Bösartige Neubildung des Herzens, des Mediastinums und der Pleura 6694 32 C39 Bösartige Neubildung sonstiger und ungenau bezeichneter Lokalisationen des Atmungssystems und sonstiger intrathorakaler Organe 1579 32 L58 Radiodermatitis … Zwischenfällen bei diagnostischer und therapeutischer Anwendung | 1648 | 33 C38 | Bösartige Neubildung des Herzens, des Mediastinums und der Pleura | 6694 | 32 C39 | Bösartige Neubildung sonstiger und ungenau bezeichneter Lokalisationen des Atmungssystems und sonstiger intrathorakaler Organe | 1579 | 32 L58 | Radiodermatitis …

High-dose-rate brachytherapy using molds for lip and oral cavity tumors.

BACKGROUND: High-dose-rate (HDR) brachytherapy using the mold technique is a less invasive treatment for early lip and oral cavity cancer. However, limited reports exist regarding the feasibility of this method. In this retrospective study, we evaluated the outcome of this therapy and investigated its feasibility for lip and oral cavity tumors. METHODS: Between May 2002 and December 2010, 17 patients (median age, 80.0 years) with histologically confirmed squamous cell carcinoma of the lip or oral cavity were treated by means of HDR brachytherapy using the mold technique after external beam ra

Factors modifying the risk for developing acute skin toxicity after whole-breast intensity modulated radiotherapy.

BACKGROUND: After breast-conserving radiation therapy most patients experience acute skin toxicity to some degree. This may impair patients' quality of life, cause pain and discomfort. In this study, we investigated treatment and patient-related factors, including genetic polymorphisms, that can modify the risk for severe radiation-induced skin toxicity in breast cancer patients. METHODS: We studied 377 patients treated at Ghent University Hospital and at ST.-Elisabeth Clinic and Maternity in Namur, with adjuvant intensity modulated radiotherapy (IMRT) after breast-conserving surgery for brea

Dose-painted intensity-modulated radiation therapy for anal cancer: a multi-institutional report of acute toxicity and response to therapy.

PURPOSE: Chemoradiation for anal cancer yields effective tumor control, but is associated with significant acute toxicity. We report our multi-institutional experience using dose-painted IMRT (DP-IMRT). PATIENTS AND METHODS: Between August 2005 and May 2009, 43 patients were treated with DP-IMRT and concurrent chemotherapy for biopsy-proven, squamous cell carcinoma of the anal canal at two academic medical centers. DP-IMRT was prescribed as follows: T2N0: 42 Gy, 1.5 Gy/fraction (fx) to elective nodal planning target volume (PTV) and 50.4 Gy, 1.8 Gy/fx to anal tumor PTV; T3-4N0-3: 45 Gy, 1.5 G