Subject(s)
Bone Marrow Transplantation/methods , Hematologic Neoplasms/radiotherapy , Hematologic Neoplasms/therapy , Whole-Body Irradiation/methods , Adolescent , Child , Child, Preschool , Cobalt Radioisotopes/therapeutic use , Humans , Particle Accelerators , Radiotherapy Dosage , Radiotherapy, High-EnergyABSTRACT
OBJECTIVES: The aim of this work was to compare the doses in critical organs, treatment duration, patient comfort and personnel workload during total body irradiation carried out alternatively with a Cobalt 60 and with 15 MeV photons at linear accelerator. PATIENTS AND METHODS: Twenty consecutive patients irradiated with a Cobalt unit and twenty irradiated with 15 MeV photons in a linear accelerator were used for comparison of the dose delivered. Each irradiation was repeated eight times during four consecutive days up to a total dose of 12.6 Gy in the whole body (below 10 Gy in the lungs). Lateral fields were used in six fractions, and anterior-posterior fields in two fractions. An electron boost to the thorax wall was added. Doses were calculated and measured in-vivo in ten transverse sections. RESULTS: For the patient taken as an example doses in the middle of the lungs were 10.7 Gy for Co-60 and 11.2 Gy for 15 MeV photons without compensators and 9.6 Gy, 9.6 Gy respectively when compensators were applied. Mean doses in the lungs in the group were 9.5 Gy for Co-60 and 9.7 Gy for X 15 MeV, respectively. Duration of the treatment was shorter with the use of the 15 MeV than that with Co-60 by about 20%. Repositioning of the patient during two fractions with the use of X 15 MeV could be eliminated and therefore the patient's comfort increased.
Subject(s)
Immunosuppression Therapy/methods , Whole-Body Irradiation/methods , Cobalt Radioisotopes , Humans , Lung/radiation effects , Particle Accelerators , Photons , Radiation Protection/methods , Radiotherapy DosageABSTRACT
In nowadays development in radiotherapy head and neck cancers has been achieved step by step in 3 main fields: technological, radiobiological and general strategy of oncological treatment. One of the most important technical changes are: the introducing of three dimensional treatment planning (3 DCRT) system and application of new radiological imaging methods (CT, MRI) in treatment planning with a computer technology calculation of dose distribution. From the radiobiological point of view a very important fact has been to distinguishing two kinds of tissue (acute and late reacting tissue) which response depends on change in fraction dose. It has given the theoretical basis to clinical trials of new methods of fractionation (hyper-, accelerated hyperfractionation). The dynamic development of surgery and chemotherapy have established a new place for radiation therapy in the complex treatment of tumours (adjuvant, elective, concomitant treatment). It has been established that in advanced tumours, the first modality of treatment is surgery in conjunction with postoperative radiotherapy. Routine application of chemotherapy in head and neck cancer is still controversial with exception of radiochemotherapy of nasopharyngeal cancer, particularly in cases of lymph nodes metastases.
Subject(s)
Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/diagnosis , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
In the present report, we serially measured the levels of interleukin-6 (IL-6) and some acute-phase proteins (APP) in 61 lung cancer patients undergoing radiotherapy in order to investigate the relationship between the response to the treatment and the changes in parameters of systemic inflammatory response. The patients were divided into two groups depending on the response to the treatment. The first group (referred to as responders) comprised 32 patients with stable disease, partial remission or total remission. Twenty-nine patients with progression of the disease were included to the second group (referred to as non-responders). Six patients died due to the lung cancer during the study. We showed a decrease in IL-6 serum level and C-reactive protein (CRP) level in responders but not in non-responders. However, the most interesting results were obtained after retrospective analysis of the data of six deceased patients. In these patients we observed an elevation of IL-6 and CRP before the patients' deaths. Following the changes in acute-phase response and interleukin-6 serum levels in lung cancer patients seems to be helpful in prognosis of the outcome of the disease. Based on our data, we conclude that an elevation in IL-6 and/or CRP level in patients with lung cancer may serve as an adverse prognostic factor.
