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1.
Journal of Korean Medical Science ; : 1248-1252, 2013.
Artículo en Inglés | WPRIM | ID: wpr-173127

RESUMEN

Imatinib, the first-line treatment in patients with advanced gastrointestinal stromal tumors (GIST), is generally well tolerated, although some patients have difficulty tolerating the standard dose of 400 mg/day. Adjusting imatinib dosage by plasma level monitoring may facilitate management of patients who experience intolerable toxicities due to overexposure to the drug. We present two cases of advanced GIST patients in whom we managed imatinib-related toxicities through dose modifications guided by imatinib plasma level monitoring. Imatinib blood level testing may be a promising approach for fine-tuning imatinib dosage for better tolerability and optimal clinical outcomes in patients with advanced GIST.


Asunto(s)
Anciano , Humanos , Masculino , Antineoplásicos/sangre , Benzamidas/sangre , Monitoreo de Drogas , Exones , Neoplasias Gastrointestinales/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Mutación , Piperazinas/sangre , Tomografía de Emisión de Positrones , Proteínas Proto-Oncogénicas c-kit/genética , Pirimidinas/sangre , Tomografía Computarizada por Rayos X
2.
Korean Journal of Medical Physics ; : 209-213, 2007.
Artículo en Coreano | WPRIM | ID: wpr-213244

RESUMEN

In this work we have measured the dose distribution and the percent depth dose of 20 MeV electron beam using the X-OMAT films in order to verify the effects of transverse magnetic field on high energy elecrtron beam in a phantom. The result shows about 30% increase of the percent depth dose at 4.5 cm depth under the transverse magnetic field of 1.5 Tesla at 7.5 cm depth. We have verified that these were in an agreement with other theoretical results.


Asunto(s)
Campos Magnéticos
3.
Cancer Research and Treatment ; : 157-164, 2005.
Artículo en Inglés | WPRIM | ID: wpr-201931

RESUMEN

PURPOSE: To assess tumor regression, as determined by pelvic magnetic resonance imaging (MRI), and evaluate the efficacies and toxicities of the interim brachytherapy (BT) modification method, according to tumor regression during multi-fractionated high-dose-rate (HDR) BT for uterine cervical cancer. MATERIALS AND METHODS: Consecutive MRI studies were performed pre-radiotherapy (RT), pre-BT and during interfraction of BT (inter-BT) in 69 patients with cervical cancer. External beam radiotherapy (EBRT) was performed, using a 10 MV X-ray, in daily fraction of 1.8 Gy with 4-fields, 5 d/wk. Radiation was delivered up to 50.4 Gy, with midline shielding at around 30.6 Gy. Of all 69 patients, 50 received modified interim BT after checking the inter-BT MRI. The BT was delivered in two sessions; the first was composed of several 5 Gy fractions to point A, twice weekly, using three channel applicators. According to the three measured orthogonal diameters of the regressed tumor, based on inter-BT MR images, the initial BT plan was modified, with the second session consisting of a few fractions of less than 5 Gy to point A, using a cervical cylinder applicator. RESULTS: The numbers of patients in FIGO stages Ib, IIa, IIb and IIIb+IVa were 19 (27.5%), 18 (26.1%), 27 (39.2%) and 5 (7.2%), respectively. Our treatment characteristics were comparable to those from the literatures with respect to the biologically effective dose (BED) to point A, rectum and bladder as reference points. In the regression analysis a significant correlation was observed between tumor regression and the cumulative dose to point A on the follow-up MRI. Nearly 80% regression of the initial tumor volume occurred after 30.6 Gy of EBRT, and this increased to 90% after an additional 25 Gy in 5 fractions of BT, which corresponds to 73.6 Gy of cumulative BED10 to point A. The median total fraction number, and those at the first and second sessions of BT were 8 (5~10), 5 (3~7) and 3 (1~5), respectively. The median follow-up time was 53 months (range, 9~66 months). The 4-year disease-free survival rate of all patients was 86.8%. Six (8.7%) patients developed pelvic failures, but major late complications developed in only two (2.9%). CONCLUSION: Our study shows that effective tumor control, equivalent survival and low rates of major complications can be achieved by modifying the fraction size during BT according to tumor regression, as determined by consecutive MR images. We recommend checking the follow-up MRI at a cumulative BED10 of around 65 Gy to point A, with the initial BT modified at a final booster BT session.


Asunto(s)
Femenino , Humanos , Braquiterapia , Cuello del Útero , Supervivencia sin Enfermedad , Estudios de Seguimiento , Imagen por Resonancia Magnética , Radioterapia , Recto , Análisis de Regresión , Carga Tumoral , Vejiga Urinaria , Neoplasias del Cuello Uterino
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