ABSTRACT
Background: this study was performed to assess patient survival and treatment toxicity after helical tomotherapy [HT] with simultaneous integrated boost [SIB] radiotherapy [RT] for cancer patients with one to eight brain metastases [BM] who have been treated with or without surgery
Materials and Methods: a total of 48 brain metastasis [BM] patients were included in this retrospective study between April 2015 and December 2016,. The patients were treated with image-guided intensity modulated radiation therapy [IMRT] on the helical tomotherapy [HT] machine. Whole brain HT as 25 Gy and SIB to metastasis sites as 35 Gy was delivered in 10 fractions. The patient were aged between 50 to 80 years old, volume of the BM was between 6 to 75 cc and the number of brain metastasis was between 1 to 8, Karnofsky Performance Score [KPS] ranged between 50-90 and RPA I-III. Surgery was performed to two patients before RT. The maximum patient follow -up _me was 20 months
Results: the primary neurotoxicity observed in patients was grade I- II brain edema related headache and lethargy. In patients who had survived 3- 12 months, KPS improved median score of 20 points and RPA was grade I after six months. Twelve patients had passed away at the end of a 20- month follow-up
Conclusion: HT utilizing SIB treatment for 1- 8 BM was achieved successfully with no significant toxicity. An improvement of performance status indicators of patients following RT was observed
ABSTRACT
Background: post-operative fibrosis related pains and functional anomalies can be serious problems for patients. Radiotherapy [RT] could inhibit fibrosis which may occurs post- operation especially following laminectomy. Therefore, this study was designed to investigate the effect of peri-operative RT on the prevention of post-operative fibrosis and scar formation on rats
Materials and Methods: twenty three male Wistar albino rats, were divided into three experimental groups. Laminectomy was performed to L3 and L4 lomber vertebral regions of group L and L+R rats. The rats in L+R group in addition to this procedure also received peri-operative RT on the laminectomy area. A total dose of 700 cGy of RT was applied as a single fraction using electrons. Control rats received no treatment. A rotarod test was performed at 20, 30 and 40 rpm/min speed rates to determine the physical performances of the rats
Results: the results have indicated statistically significant [P<0.05] differences for the 30 rpm/min rotarod test between the L and L+R groups. Histopatologically, significant differences were observed in epidural fibrosis, fibroblast cell density and arachnoid adhesion between the L and L+R groups
Conclusion: it was concluded that peri-operative RT may provide a significant advantage for prevention post-laminectomic of scar tissue formation