ABSTRACT
INTRODUCTION: All adult medulloblastoma (AMB) patients should be treated with craniospinal irradiation (CSI) postoperatively. Because of the long irradiation range, multiple radiation fields must be designed for conventional radiotherapy technology. CSI can be completed in only one session with helical tomotherapy (HT). We evaluated the dose of HT, volumetric intensity modulated arc therapy (VMAT), and three-dimensional conformal radiotherapy (3D-CRT) of AMB and the results of 5 cases of AMB treated with HT. METHODS: Complete craniospinal and posterior cranial fossa irradiation with HT, VMAT, and 3D-CRT and dose evaluation were performed. And results of 5 cases of AMB treated with HT were evaluated. RESULTS: A large volume of tissue was exposed to low dose radiation in the organs at risk (OAR), while a small volume was exposed to high dose radiation with HT. The conformity and uniformity of the targets were good with HT and VMAT, and the volume of targets exposed to high dose with VMAT was larger than that of HT. The uniformity of 3D-CRT was also good, but the dose conformity was poor. The main toxicity was hematologic toxicity, without 4th-degree bone marrow suppression. There was 3rd-degree inhibition in the white blood cells, hemoglobin, and platelets. The three female patients suffered menstrual disorders during the course of radiation. Two female patients with heavy menstruation suffered 3rd-degree anemia inhibition, and 2 patients suffered amenorrhea after radiotherapy. Although menstrual cycle was normal, the third patient was not pregnant. CONCLUSION: CSI with HT is convenient for clinical practice, and the side effects are mild. With good conformity and uniformity, VMAT can also be used for selection in CSI. For poor conformity, 3D-CRT should not be the priority selection for CSI. In female patients, the ovaries should be protected.
Subject(s)
Cerebellar Neoplasms/radiotherapy , Medulloblastoma/radiotherapy , Radiotherapy, Conformal/methods , Radiotherapy, Intensity-Modulated/methods , Adolescent , Adult , Female , Humans , Male , Organs at Risk/radiation effects , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted/methods , Retrospective Studies , Young AdultABSTRACT
This study is to analyze the radiation dose of head, body and tail of hippocampus (HC) of nasopharyngeal carcinoma (NPC) patients treated with intensity modulated radiotherapy (IMRT). Evaluate cognitive function of patients with Wechsler adult intelligence scale-Chinese revised (WAIS-CR). HC were segmented into HC head (HH), HC body (HB) and HC tail (HT) and the indexes were then analyzed. WAIS-CR was tested before and 3months after radiotherapy. The mean radiation dose of left and right HC was (1147 ± 976)cGy, (1011 ± 602)cGy respectively. The radiation dose and the volume exposed in different dose of HH, HB and HT decreased in turn. For 5 patients, before and after radiotherapy, the regular-order score was 8.60 ± 1.34, 8.0 ± 1.00 (P = 0.43), while the reverse-order score was 5.80 ± 0.84, 5.20 ± 0.84 (P = 0.07). The radiation dose of HH, HB and HT was different, and the radiation dose of HH was the highest, which should be emphasized especially.
Subject(s)
Hippocampus/radiation effects , Nasopharyngeal Carcinoma/radiotherapy , Nasopharyngeal Neoplasms/radiotherapy , Adult , Antineoplastic Agents/therapeutic use , Female , Gamma Rays , Hippocampus/diagnostic imaging , Humans , Male , Middle Aged , Nasopharyngeal Carcinoma/drug therapy , Nasopharyngeal Carcinoma/mortality , Nasopharyngeal Carcinoma/pathology , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/mortality , Nasopharyngeal Neoplasms/pathology , Neoplasm Staging , Radiation Dosage , Radiotherapy, Intensity-Modulated , Survival Rate , Young AdultABSTRACT
<p><b>OBJECTIVE</b>To study the clinicopathological characteristics and the prognostic factors in patients with hypopharyngeal cancer.</p><p><b>METHODS</b>Clinical and pathological data of 178 cases with hypopharyngeal cancer from January 2000 to December 2006 were studied.</p><p><b>RESULTS</b>Of the 178 hypopharyngeal cancer, the median survival time was 42.8 months (1 - 127 months). Total 3- and 5-year survival rates were 47% and 35%, respectively. The 5-year survival rates of stage I + II, stage III and stage IV were 76.2%, 46.7% and 29.6%, respectively. The second primary carcinoma occurred in 14.0% patients (25/178), of them 18 patients with synchronous carcinoma and 7 patients with metachronous carcinoma. The independent risk factors associated with the prognosis of these patients were T staging, N staging, clinical staging, performance status (PS), smoking index and treatment model (all P < 0.01). Multivariate Cox analysis showed that smoking index, staging of tumor and treatment were independent risk factors of prognosis. The rate of larynx function preservation was increasing with years from 2000 to 2006.</p><p><b>CONCLUSIONS</b>Surgery plus radiotherapy is the most important treatment for the patients with hypopharyngeal cancer. Tumor stage and treatment model are important predictors of survival in patients with hypopharyngeal cancer.</p>
