Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add more filters










Database
Language
Publication year range
1.
Radiother Oncol ; 159: 161-167, 2021 06.
Article in English | MEDLINE | ID: mdl-33798613

ABSTRACT

BACKGROUND AND PURPOSE: Optimal treatment of extremity soft tissue sarcomas (ESTS) is controversial. The aim of this study was to evaluate neoadjuvant chemotherapy (ChT) plus concomitant hypofractionated RT (hypo-RT) in local and distant disease relapse. Here we report safety, feasibility and early outcomes. MATERIALS AND METHODS: This was a prospective, single arm study with a goal accrual of 70 patients. Between 2015 and 2018, 18 patients with histologically confirmed nonmetastatic ESTS were assigned to receive doxorubicin and ifosfamide for three neoadjuvant cycles, concomitant with hypo-RT (25 Gy in 5 fractions) followed by surgery. The primary endpoint was disease-free survival (DFS). Secondary outcomes were pathologic response, wound complications (WC), and morbidity rates. RESULTS: Median follow-up was 29 months. At last follow-up, 13/18 patients were alive without evidence of local or systemic disease (DFS 72%), 1 had died due to metastatic disease, and 3 were alive with distant metastasis. One patient presented with local relapse within the irradiated field. Mean DFS time was 48.6 months (95% CI: 37.3-59.9). Six patients (33%) had no residual viable tumor detected in pathologic specimens (3 of these myxoid liposarcomas). There was a significant difference in WC among patients with acute RT skin toxicity. Six patients (33%) developed major WC. No grade 3 or 4 ChT adverse events were reported. CONCLUSION: Despite the limited sample size, these early outcomes demonstrate that this treatment regimen is feasible and well tolerated with high rates of limb preservation, local control, and pathologic complete response, supporting further investigation in a multi-institutional setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT02812654; https://clinicaltrials.gov/ct2/show/NCT02812654.


Subject(s)
Neoadjuvant Therapy , Sarcoma , Antineoplastic Combined Chemotherapy Protocols , Extremities , Feasibility Studies , Humans , Neoplasm Recurrence, Local , Prospective Studies , Sarcoma/drug therapy , Treatment Outcome
2.
Sci Rep ; 6: 28074, 2016 06 14.
Article in English | MEDLINE | ID: mdl-27296459

ABSTRACT

There is no consensus on the use of computed tomography in vaginal cuff brachytherapy (VCB) planning. The purpose of this study was to prospectively determine the reproducibility of point bladder dose parameters (DICRU and maximum dose), compared with volumetric-based parameters. Twenty-two patients who were treated with high-dose-rate (HDR) VCB underwent simulation by computed tomography (CT-scan) with a Foley catheter at standard tension (position A) and extra tension (position B). CT-scan determined the bladder ICRU dose point in both positions and compared the displacement and recorded dose. Volumetric parameters (D0.1cc, D1.0cc, D2.0cc, D4.0cc and D50%) and point dose parameters were compared. The average spatial shift in ICRU dose point in the vertical, longitudinal and lateral directions was 2.91 mm (range: 0.10-9.00), 12.04 mm (range: 4.50-24.50) and 2.65 mm (range: 0.60-8.80), respectively. The DICRU ratio for positions A and B was 1.64 (p < 0.001). Moreover, a decrease in Dmax was observed (p = 0.016). Tension level of the urinary catheter did not affect the volumetric parameters. Our data suggest that point parameters (DICRU and Dmax) are not reproducible and are not the ideal choice for dose reporting.


Subject(s)
Brachytherapy/methods , Endometrial Neoplasms/radiotherapy , Radiotherapy Planning, Computer-Assisted/methods , Uterine Cervical Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Endometrial Neoplasms/surgery , Female , Humans , Middle Aged , Prospective Studies , Radiotherapy Dosage , Reproducibility of Results , Tomography, X-Ray Computed , Urinary Catheterization , Uterine Cervical Neoplasms/surgery , Young Adult
3.
Article in English | MEDLINE | ID: mdl-25442494

ABSTRACT

OBJECTIVE: To determine whether an intraoral stent may decrease radiation dose to health tissues during intensity-modulated radiotherapy (IMRT) and to evaluate the effect on mucositis. STUDY DESIGN: A total of 33 patients with tongue or floor of the mouth cancer were retrospectively evaluated and divided into 2 groups: group 1 (with stent, n = 19) and group 2 (without stent, n = 14). Data were collected on dosimetric and mucositis outcomes. RESULTS: The mean dose to the maxilla was significantly lower in group 1 (20.9 Gy) than in group 2 (35.8 Gy) (P = .05). The mean dose to the ipsilateral parotid was 35.0 Gy in group 1 vs 41.8 Gy in group 2 (P = .05). No difference was seen in the severity of mucositis between groups (P = .82). However, grade III mucositis was present in group 1 at 4 weeks after IMRT, 1 week after its occurrence in group 2. CONCLUSIONS: A stent was effective in decreasing doses to healthy structures and delaying the emergence of mucositis.


Subject(s)
Mouth Neoplasms/radiotherapy , Mucositis/etiology , Radiation Injuries/prevention & control , Radiation Protection/instrumentation , Radiotherapy, Intensity-Modulated , Stents , Adult , Aged , Aged, 80 and over , Dose-Response Relationship, Radiation , Female , Humans , Male , Maxilla/radiation effects , Middle Aged , Mouth Neoplasms/pathology , Neoplasm Staging , Parotid Gland/radiation effects , Radiation Dosage , Radiometry , Retrospective Studies , Severity of Illness Index , Tongue Neoplasms/pathology , Tongue Neoplasms/radiotherapy
SELECTION OF CITATIONS
SEARCH DETAIL
...