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Pesquisa : E02.815.635.700.700 [Categoria DeCs]
Referências encontradas : 22 [refinar]
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  1 / 22 IBECS  
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Id: 173721
Autor: Li, H; Xu, D; Han, X; Ruan, Q; Zhang, X; Mi, Y; Dong, M; Guo, S; Lin, Y; Wang, B; Li, G.
Título: Dosimetry study of 18F-FMISO + PET/CT hypoxia imaging guidance on intensity-modulated radiation therapy for non-small cell lung cancer
Fonte: Clin. transl. oncol. (Print);20(10):1329-1336, oct. 2018. ilus, tab.
Idioma: en.
Resumo: Objectives: This study was to evaluate the feasibility of simultaneous integrated boost on tumor hypoxia area by studying the dosimetric change of hypoxia imaging guidance on intensity-modulated radiation therapy for non-small cell lung cancer (NSCLC). Methods: Five NSCLC patients with large hypoxic volume participated in this study. FDG PET/CT images were fused with CT localization images to delineate gross tumor volume. FMISO PET/CT images were fused with CT localization images to delineate hypoxic biological target volume (BTV) (tissue maximum ratio ≥ 1.3) by threshold. BTV was irradiated with 72, 78 and 84 Gy, respectively, 30 times. The dosimetry differences were compared in target volume and organ at risk between simultaneous integrated boost plans and conventional radiotherapy plans. Results: Dosages on BTV of NSCLC hypoxic area were increased to 72, 78 and 84 Gy, respectively, by simultaneous integrated boost intensity-modulated radiation therapy. There was no obvious difference in dosage distributions on original target volume compared with those in conventional radiotherapy. Dosages on main organ at risk in chest met the dosimetric constraint, and there was no significant difference compared with those in conventional radiotherapy. Conclusion: It is feasible in dosiology that the dosages in NSCLC hypoxic area were added to 72, 78 and 84 Gy by simultaneous integrated boost with the guidance of 18F-FMISO PET/CT

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  2 / 22 IBECS  
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Id: 173697
Autor: Correa, R; Gómez-Millán, J; Lobato, M; Fernández, A; Ordoñez, R; Castro, C; Lupiañez, Y; Medina, JA.
Título: Radiotherapy in soft-tissue sarcoma of the extremities
Fonte: Clin. transl. oncol. (Print);20(9):1127-1135, sept. 2018. tab.
Idioma: en.
Resumo: Sarcomas are an infrequent and heterogeneous group of neoplasia. Surgery with or without associated radiotherapy (RT) is the basic treatment for this type of tumour. To increase the therapeutic ratio (the index between cytotoxic effects in tumours and normal tissue complications with a certain dose of radiation), new advances are being investigated to increase local and distant control and to decrease the morbidity of the treatment. The aim of this review was to analyse the different strategies, based on technology and biology, which are being investigated to increase the therapeutic ratio of this disease

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  3 / 22 IBECS  
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Id: 170555
Autor: Chen, AM; Hsu, S; Lamb, J; Yang, Y; Agazaryan, N; Steinberg, ML; Low, DA; Cao, M.
Título: MRI-guided radiotherapy for head and neck cancer: initial clinical experience
Fonte: Clin. transl. oncol. (Print);20(2):160-168, feb. 2018. ilus, tab.
Idioma: en.
Resumo: Purpose. To report a single-institutional experience with the use of magnetic resonance imaging (MRI)-guided radiotherapy for cancers of the head and neck. Materials and methods. Between October 2014 and October 2016, 18 patients with newly diagnosed cancers of the head and neck were prospectively enrolled on an institutional registry trial investigating the feasibility and efficacy of external-beam radiotherapy delivered using on-board MRI. All patients had biopsy-proven evidence of malignancy, measurable disease, and the ability to provide consent. None had previously received any treatment. Median dose was 70 Gy (range 54-70 Gy). MRI scans were obtained as part of an image-guided registration protocol for alignment prior to and during each treatment. Concurrent chemotherapy was administered to 14 patients (78%). Patient-reported outcomes were assessed using the University of Washington quality of life instrument. Results. Seventeen of 18 patients completed the planned intensity-modulated radiotherapy (IMRT) treatment of which 15 (83%) had a complete response and 2 (11%) had a partial response based on initial post-therapy positron emission tomography (PET) at 3 months. The 1-year estimates of progression-free survival, overall survival, and local-regional control were 95, 96, and 95%, respectively. There were no treatment-related fatalities. The incidence of grade 3+ acute toxicity was 44%. The proportion of patients rating their health-related quality of life as "very good" or "outstanding" at 6 months and 1 year after completion of radiation therapy was 60 and 70%, respectively. Conclusions. MRI-guided radiotherapy achieves clinical outcomes comparable to contemporary series reporting on IMRT for head and neck cancer (AU)

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  4 / 22 IBECS  
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Id: 168909
Autor: Fondevilla Soler, A; López-Guerra, JL; Dzugashvili, M; Sempere Rincón, P; Sautbaet, A; Castañeda, P; Díaz, JM; Praena-Fernandez, JM; Rivin del Campo, E; Azinovic, I.
Título: Outcome and toxicity of intensity modulated radiotherapy with simultaneous integrated boost in locally advanced non-small cell lung cancer patients
Fonte: Clin. transl. oncol. (Print);19(12):1469-1477, dic. 2017. tab, graf.
Idioma: en.
Resumo: Purpose. The aim of this study was to assess the feasibility and treatment outcome of intensity modulated radiation therapy with simultaneous integrated boost (SIB-IMRT) in locally advanced non-small cell lung cancer (NSCLC) patients. Materials and methods. A total of 64 NSCLC patients with stage IIB (3%), IIIA (36%), and IIIB (61%) were treated with concomitant (N = 47; 73%) or sequential (N = 9; 14%) chemotherapy between February 2009 and January 2014. Eight patients (13%) received RT alone. All patients received the same irradiation scheme using IMRT: prophylactic dose for mediastinum was 56 Gy at 1.65 Gy/fraction and SIB to macroscopic disease up to 68 Gy at 2 Gy/fraction. Results. The median follow-up was 16 months (range, 1-70 months). The overall survival rate for all patients was 79% after 1 year and 46% after 2 years. Disease-free survival (DFS) was 81 and 45% after 1 and 2 years, respectively, resulting in a median DFS of 16 months. Multivariate analysis showed a statistically significant association between stage IIIB patients and a higher risk of mortality (HR 2.11; P = 0.019). In addition, T4 stage associated with higher risk of recurrence (HR 2.23; P = 0.024) while concomitant chemoradiation was associated with lower risk of any recurrence (HR 0.34; P = 0.004) No patient experienced grade ≥3 esophagitis and only 6 cases (9%) had grade 3 pneumonitis. Only having a higher lung volume was associated with higher risk of pneumonitis in the multivariate analysis (HR 16.21; P = 0.022). Conclusion. This study in advanced NSCLC patients shows that SIB-IMRT is an effective technique with acceptable toxicity, also when combined with chemotherapy (AU)

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  5 / 22 IBECS  
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Id: 165219
Autor: Zapatero, A; Roch, M; Büchser, D; Castro, P; Fernández-Banda, L; Pozo, G; Liñán, O; Martin de Vidales, C; Cruz-Conde, A; García-Vicente, F.
Título: Reduced late urinary toxicity with high-dose intensity-modulated radiotherapy using intra-prostate fiducial markers for localized prostate cancer
Fonte: Clin. transl. oncol. (Print);19(9):1161-1167, sept. 2017. tab, graf.
Idioma: en.
Resumo: Background/purpose. To evaluate the impact of intensity-modulated radiotherapy (IMRT) with intra-prostate fiducial markers image-guided radiotherapy (IGRT) on the incidence of late urinary toxicity compared to 3D conformal radiotherapy (3DCRT) for patients with prostate cancer (PC). Methods and materials. We selected 733 consecutive patients with localized PC treated with dose-escalation radiotherapy between 2001 and 2014. Eligibility criteria were radiation dose >72.0 Gy, no pelvic RT and minimum follow-up 24 months. 438 patients were treated with 3DCRT and 295 with IMRT. Acute and late urinary complications were assessed using the EORTC/RTOG and CTCAEs v3.0 definition. The Cox regression model was used to compare grade ≥2 urinary toxicity between both techniques. The median follow-up was 75 months (range 24-204). Results. The median isocenter radiation dose was 78.7 Gy for 3DCRT and 80.7 Gy for IMRT/IGRT (p < 0.001). The 5-year incidence of late grade ≥2 urinary toxicity was 6.4% for IMRT and 10.8% for 3DCRT [hazard ratio (HR) 0.575, p = 0.056]. The corresponding 5-year estimates of late grade ≥2 hematuria were 2% for IMRT and 5.3% for 3DCRT (HR 0.296, p = 0.024). On multivariate analysis, the antecedent of prior transurethral resection of the prostate was also a strong predictor of a higher risk of urinary complications (HR 2.464, p = 0.002) and of hematuria (HR 5.196, p < 0.001). Conclusion. Compared with 3DCRT, high-dose IMRT/IGRT is associated with a lower rate of late urinary complications in spite of higher radiation dose (AU)

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  6 / 22 IBECS  
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Id: 160897
Autor: Luo, Y; Qin, Y; Lang, J.
Título: Effect of adaptive replanning in patients with locally advanced nasopharyngeal carcinoma treated by intensity-modulated radiotherapy: a propensity score matched analysis
Fonte: Clin. transl. oncol. (Print);19(4):470-476, abr. 2017. tab, graf.
Idioma: en.
Resumo: Purpose. Limited data have been published regarding the effect of adaptive radiotherapy (ART) on clinical outcome in patients with nasopharyngeal carcinoma (NPC). We compared the long-term outcomes in patients with locally advanced NPC treated by adaptive intensity-modulated radiotherapy (IMRT) replanning versus IMRT. Methods. 200 NPC patients with stage T3/T4 were included between October 2004 and November 2010. Patients in both treatment groups were matched using propensity score matching method at the ratio of 1:1. Clinical outcomes were analyzed with Kaplan-Meier method, log-rank test and Cox regression. Results. After matching, 132 patients (66 patients in each group) were included for analysis. The median follow-up for the IMRT replanning group was 70 months, while the IMRT group was 69 months. The 5-year local-regional recurrence-free survival (LRFS) rate was higher in IMRT replanning group (96.7 vs. 88.1 %, P = 0.022). No significant differences in distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS) were observed between the two groups. 21.2 % patients in IMRT replanning group and 28.8 % patients in IMRT group had distant metastasis. In multivariable analysis, IMRT replanning was identified as an independent prognostic factor for LRFS (hazard ratio 0.229; 95 % CI 0.062-0.854; P = 0.028), but not for DMFS, PFS and OS. Conclusions. IMRT replanning provides an improved LRFS for stage T3/T4 NPC patients compared with IMRT. Distant metastasis remains the main pattern of treatment failure. No significant advantage was observed in DMFS, PFS and OS when adaptive replanning was used (AU)

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  7 / 22 IBECS  
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Texto completo SciELO Espanha
Id: 151216
Autor: Esco, R; Valencia, J; Polo, S.
Título: Radioterapia y citoprotección. Estado actual / No disponible
Fonte: Oncología (Barc.);27(7):40-46, jul. 2004. ilus, tab.
Idioma: es.
Resumo: No disponible
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  8 / 22 IBECS  
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Id: 151180
Autor: Srivastava, SP; Cheng, CW; Das, IJ.
Título: The effect of slice thickness on target and organs at risk volumes, dosimetric coverage and radiobiological impact in IMRT planning
Fonte: Clin. transl. oncol. (Print);18(5):469-479, mayo 2016. ilus, graf.
Idioma: en.
Resumo: Purpose: Dose-volume histogram (DVH) has become an important tool for evaluation of radiation outcome as reflected from many clinical protocols. While dosimetric accuracy in treatment planning system (TPS) is well quantified, the variability in volume estimation is uncertain due to reconstruction algorithm that is investigated in this study. In addition, the impact of dose distribution and tumor control probability (TCP) were also investigated with CT slice thickness for IMRT planning. Materials and methods: A water phantom containing various objects with accurately known volume ranging from 1 to 100 cm3 was scanned with 1, 2, 3, 5, and 10 mm slice thickness. The CT data sets were sent to Eclipse TPS for contour delineation and volume estimation. The data were compared with known volume for the estimation of error in the volume of each structure. IMRT Plans were generated on phantom containing four objects with different slice thickness (1û5 mm) to calculate TCP. ICRU-83- recommended dose points such as D2%, D50%, D98%, as well as homogeneity and conformity index were also calculated. Results: The variability of volumes with CT slice thickness was significant especially for small volume structures. A maximum error of 92 % was noticed for 1 cm3 volume of object with 10 mm slice thickness, whereas it was *19 % for 1 mm slice thickness. For 2 and 3 cm3 objects, the maximum error of 99 % was noticed with 10 mm slice thickness and *60 % with 5 mm. The differences are smaller for larger volumes with a cutoff at about 20 cm3. The calculated volume of the objects is a function of reconstruction algorithm and slice thickness. The PTV mean dose and TCP decreased with increasing slice thickness. Maximum variation of *5 % was noticed in mean dose and *2 % in TCP with change in slice thickness from 1 to 5 mm. The relative decrease in target volume receiving 95 % of the prescribed dose is *5 % with change in slice thickness from 1 to 5 mm. The homogeneity index increases up to 163 % and conformity index decreases by 4 % between 1 and 5 mm slice thickness, producing highly inhomogeneous and least conformal treatment plan. Conclusions: Estimation of a volume is dependent on CT slice thickness and the contouring algorithm in a TPS. During commissioning of TPS and for all clinical protocols, evaluation of volume should be included to provide the limit of accuracy in DVH from TPS, especially for small objects. A smaller slice thickness provides superior dosimetry with improved TCP. Thus, the smallest possible slice thickness should be used for IMRT planning, especially when smaller structures are present (AU)

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  9 / 22 IBECS  
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Texto completo
Id: 139041
Autor: Nagarajan, Karthika.
Título: Chemo-radiotherapy induced oral mucositis during IMRT for head and neck cancer - An assessment
Fonte: Med. oral patol. oral cir. bucal (Internet);20(3):e273-e277, mayo 2015. ilus, tab.
Idioma: en.
Resumo: BACKGROUND: This study is conducted mainly to evaluate the changes in quality and quantity of oral epithelial cells during the course of IMRT.MATERIAL AND METHODS:30 Patients undergoing chemo-radiotherapy were followed through course of treatment. They were compared with a group of age- and sex-matched healthy individuals. The procedure involved WHO clinical scoring, collection of oral washings and preparation of buccal smears from both study group and control group. The changes occurred were recorded as a way of assessing the severity of oral mucositis. RESULTS: revealed a significant occurrence of oral mucositis in almost all patients during weekly follow up. There was a significant increase in percentage of viable buccal epithelial cells in study group when compared to normal controls (P<0.005) during and at the end of chemo-radiotherapy. CONCLUSIONS: quantification of oral mucositis can be done at cellular level by determining the oral mucosal cell viability and their maturation during IMRT (AU)
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  10 / 22 IBECS  
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Id: 128642
Autor: Wang, Q; Jiang, Z; Qi, X; Lu, S; Wang, S; Leng, C; Lu, F; Liu, H; Liang, S; Shi, J.
Título: Whole brain radiation therapy followed by intensity-modulated boosting treatment combined with concomitant temozolomide for brain metastases from non-small-cell lung cancer
Fonte: Clin. transl. oncol. (Print);16(11):1000-1005, nov. 2014.
Idioma: en.
Resumo: BACKGROUND: Brain metastases (BMs) represent an important cause of morbidity in patients with non-small-cell lung cancer (NSCLC) and are associated with a mean survival of <1 year. Thus, new regimens improving the outcome of these patients are urgently needed. We have evaluated the response to treatment, overall survival, disease progression, and adverse effects of a concomitant treatment with whole brain radiation therapy (WBRT) followed by intensity-modulated boosting RT (IMBRT) and temozolomide (TMZ) in patients with BMs from NSCLC. METHODS: A total of 32 patients with no more than four BMs were enrolled in this retrospective study. Patients received 30 Gy of WBRT in 15 fractions and followed by 20 Gy of IMBRT in 10 fractions with concomitant TMZ of 75 mg/m(2)/day orally during RT and continued TMZ therapy (150-200 mg/m(2)/day for 5 days every 28 days for an additional 2-6 cycles after RT). RESULTS: Three patients had a complete response, 9 patients had a partial response, while 15 patients had stable disease; therefore, the objective responses achieved 37.5 %. Median overall survival was 8.0 months and median time to progression was 5.5 months. Common treatment-related adverse effects (Grade ≤2) included nausea, vomiting, and asthenia. Grade 3 or worse hematologic toxicities were rare. No patient presented with gross neurocognitive dysfunction. CONCLUSION: WBRT followed by IMBRT combined with concomitant TMZ is well tolerated, yielding an encouraging objective response rate; however, overall survival improves slightly comparing with RTOG 9508 randomized trial (AU)

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