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Clin Lung Cancer ; 22(3): 225-233.e7, 2021 05.
Article in English | MEDLINE | ID: covidwho-1592247


BACKGROUND: To examine the effect of radiotherapy field size on survival outcomes and patterns of recurrence in patients treated with postoperative radiotherapy (PORT) for non-small-cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the records of 216 patients with T1-4 N1-2 NSCLC following surgery and PORT using whole mediastinum (WM) or high-risk (HR) nodal fields from 1998 to 2015. Survival rates were calculated using the Kaplan-Meier method. Univariate and multivariable analyses were conducted using Cox proportional hazards modeling for outcomes and logistic regression analysis for treatment toxicities. RESULTS: Median follow-up was 28 months (interquartile range [IQR] 13-75 months) and 38 months (IQR 19-73 months) for WM (n = 131) and HR (n = 84) groups, respectively. Overall survival (OS) was not significantly different between groups (median OS: HR 49 vs. WM 32 months; P = .08). There was no difference in progression-free survival (PFS), freedom from locoregional recurrence (LRR), or freedom from distant metastasis (P > .2 for all). Field size was not associated with OS, PFS, or LRR (P > .40 for all). LRR rates were 20% for HR and 26% for WM groups (P = .30). There was no significant difference in patterns of initial site of LRR between groups (P > .1). WM fields (OR 3.73, P = .001) and concurrent chemotherapy (odds ratio 3.62, P = .001) were associated with grade ≥2 toxicity. CONCLUSIONS: Locoregional control and survival rates were similar between PORT groups; an improved toxicity profile was observed in the HR group. Results from an ongoing prospective randomized clinical trial will provide further insight into the consequences of HR PORT fields.

Carcinoma, Non-Small-Cell Lung/therapy , Lung Neoplasms/therapy , Radiotherapy, Conformal/methods , Aged , COVID-19/drug therapy , Carcinoma, Non-Small-Cell Lung/pathology , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Lung Neoplasms/pathology , Male , Middle Aged , Progression-Free Survival , Radiotherapy, Adjuvant/methods , Retrospective Studies , Survival Rate
Anticancer Res ; 41(9): 4407-4410, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1395530


BACKGROUND/AIM: Many patients with gynecological malignancies receive postoperative radiotherapy, which can lead to fear and sleep disorders. We aimed to identify the prevalence of and risk factors for sleep disorders. PATIENTS AND METHODS: Sixty-two patients assigned to radiotherapy for gynecological malignancies were retrospectively evaluated. Seventeen characteristics were analyzed for associations with pre-radiotherapy sleep disorders including age, Karnofsky performance score, Charlson comorbidity index, history of additional malignancy, family history of gynecological cancer, distress score, emotional, physical or practical problems, tumor site/stage; chemotherapy, treatment volume, brachytherapy, and the COVID-19 pandemic. RESULTS: The prevalence of pre-radiotherapy sleep disorders was 46.8%. Sleep disorders were significantly associated with Charlson comorbidity index ≥3 (p=0.012), greater number of physical problems (p<0.0001), and advanced primary tumor stage (p=0.005). A trend was found for greater number of emotional problems (p=0.075). CONCLUSION: Pre-radiotherapy sleep disorders are common in patients with gynecological malignancies, particularly in those with specific risk factors. Patients should be offered early psychological support.

Genital Neoplasms, Female/radiotherapy , Genital Neoplasms, Female/surgery , Radiotherapy, Adjuvant/methods , Sleep Wake Disorders/epidemiology , Adult , Brachytherapy , COVID-19/epidemiology , Female , Genital Neoplasms, Female/pathology , Genital Neoplasms, Female/psychology , Humans , Middle Aged , Neoplasm Staging , Prevalence , Retrospective Studies , Risk Factors , Sleep Wake Disorders/etiology , Treatment Outcome
Cancer Rep (Hoboken) ; 4(2): e1320, 2021 04.
Article in English | MEDLINE | ID: covidwho-967725


BACKGROUND: COVID-19 outbreak was declared as a pandemic by the World Health Organization in March 2020. Over the last 3 months, the pandemic has challenged the diagnosis and treatment of all cancer, including rectal cancer. Constraints in resources call for a change in the treatment strategy without compromising efficacy. RECENT FINDINGS: Delivery of shorter treatment schedules for radiotherapy offers advantages like short overall treatment time, improved throughput on the machine, improved compliance and reduced risk of transmission of COVID 19. Other strategies include delaying surgery, reducing the intensity of chemotherapy and adoption of organ preservation approach. CONCLUSION: The curative treatment of rectal cancer should not be hindered during the COVID pandemic, and modifications in the multi-modality treatment will help achieve quality care.

COVID-19/prevention & control , Communicable Disease Control/standards , Pandemics/prevention & control , Radiation Oncology/organization & administration , Rectal Neoplasms/therapy , COVID-19/epidemiology , COVID-19/transmission , Chemoradiotherapy, Adjuvant/methods , Chemoradiotherapy, Adjuvant/standards , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Neoadjuvant Therapy/methods , Neoadjuvant Therapy/standards , Organ Sparing Treatments/methods , Organ Sparing Treatments/standards , Personal Protective Equipment/standards , Radiation Oncology/methods , Radiation Oncology/standards , Radiotherapy, Adjuvant/methods , Radiotherapy, Adjuvant/standards , Rectal Neoplasms/diagnosis , Telemedicine/methods , Telemedicine/organization & administration , Telemedicine/standards , Time Factors , Time-to-Treatment/standards , Treatment Outcome