Empowering caregivers in the radiotherapy process: the results of a randomized controlled trial.

PURPOSE: The present study aims to evaluate the effectiveness of a mobile-assisted empowerment program developed specifically for caregivers of cancer patients undergoing radiotherapy. METHODS: In this study, seventy-four individuals who gave care for cancer patients that received radiotherapy between September 2019 and May 2020 were randomized to receive a mobile-assisted empowerment program or standard care. The mobile-assisted empowerment program comprised of education and information related to the radiotherapy process, videos, activities, and question-and-answer modules to support caregivers during the radiotherapy process. Outcome measures were collected at baseline (day 1 of radiotherapy) and on day 21 and included caregiver demographics, distress, quality of life, and coping style using validated questionnaires. RESULTS: Compared with baseline, individuals' mean scores of distress were lower in the empowerment group than the control group (p < 0.001). General quality of life and sub-dimension mean scores were higher in the empowerment group than the control group (p ≤ 0.05). There was no difference in the coping style average scores (p ≥ 0.05) between the two groups. CONCLUSIONS: This study supports the findings that a mobile-supported empowerment program reduced the level of caregiver distress and increased quality of life during their loved one's treatment with radiotherapy.

Intracranial meningioma: Experience with stereotactic radiotherapy.

PURPOSE: Definitive radiotherapy is a treatment option for patients with inoperable meningiomas. The purpose of this study was to evaluate the results of stereotactic radiotherapy as first-line treatment for intracranial meningiomas that were diagnosed radiologically. METHODS: Between January 2010 and June 2016, 56 patients with intracranial meningioma treated with Cyberknife- based Stereotactic Radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (hFSRT) were included. The median prescribed radiation dose was 16 Gy (range 13-18) for SRS and 25 Gy (range 18-33) for hFSRT. hFSRT doses were delivered in 3 to 5 fractions. RESULTS: Median follow-up was 58 months (range 6-97). Overall survival (OS) for the whole group was 89.2%; for SRS group it was 100% and for hFSRT group 87.5% (p=0.29). Progression free survival (PFS) for the whole group was 89.3%; for SRS group it was 87.5% and for hFSRT 89.5% at 5 years (p=0.93). CONCLUSION: SRS and hFSRT were effective with excellent local control rates and they can be an alternative treatment option for patients with inoperable meningiomas.

Demonstration of Response to Androgen Deprivation Therapy by 68Ga-PSMA PET/CT.

We present pretreatment and posttreatment Ga-PSMA PET/CT images of a 68-year-old man with metastatic prostate cancer who is a responder to androgen deprivation therapy.

Long-term effects of parotidectomy.

The present study investigated the long-term complications of parotidectomy, the differences in these complications in regard to the pathological diagnosis and type of surgery. The patients were questioned regarding the presence of facial paresis-paralysis, pain, loss of sensation, scarring, collapse, and mouth dryness in the area of operation. Complaints of pain (p = 0.287), scarring (p = 0.456), and mouth dryness (p = 0.136) did not show statistically significant differences between the cases with benign or malignant pathological outcomes. However, complaints of loss of sensation (p < 0.001), collapse in the area of operation (p = 0.025), paresis-paralysis (p < 0.001), and fear of repeated surgery (p = 0.032) were present at significantly higher rates. Complaints of pain (p = 0.258), scarring (p = 0.665), mouth dryness (p = 0.113) and fear of repeated surgery (p = 0.053) did not show statistically significant differences between the cases who underwent superficial or total parotidectomy. However, complaints of loss of sensation (p = 0.002), paresis (p < 0.001), and collapse in the area of operation (p = 0.019) were present at significantly higher rates. The type of tumor and surgical approach significantly affect the quality of life; however, parotidectomy generally does not lead to serious long-term complications that would disturb the patients.

The effect of radiotherapy on mucociliary clearance in patients with laryngeal and nasopharyngeal cancer.

The present study aimed to demonstrate how the nasal mucociliary transport times are affected in the patients receiving radiotherapy for head-neck tumor in two different anatomic localizations. The study included 44 patients receiving radiotherapy under the diagnoses of the nasopharyngeal and laryngeal cancer. The mucociliary transport times of both groups were measured via saccharine tablets before radiotherapy, and at months 3 and 6 after radiotherapy. The difference between the groups was statistically evaluated. The pre-irradiation (pre-RT) mean transport times of NPC and LC patients were 9.7 and 9.1 min, respectively. The difference in the mucociliary transport times between these two groups was not statistically significant (p = 0.49). The mean transport time was 26.1 min at post-RT month 3, 23.9 min, at month 6; the change from pre-RT to month 3 was significant (p < 0.05) and the change from month 3 to 6 was not statistically significant (p = 0.182). The mean transport time of the LC patients was 16.8 min. At post-RT month 3, 12.4 min. at month 6; the change from pre-RT to month 3 (p < 0.05) and the change from month 3 to 6 were statistically significant (p = 0.007). It was found that radiotherapy affected the physiological conditions of the patients with nasopharyngeal cancer in a more severe and sustained way compared to the LC patients, which negatively affects the patient's response to the treatment by the resulting organic and psychological effects.

The results of hypofractionated radiotherapy in 31 patients with high-grade gliomas.

In this prospective study, we investigated the effects of hypofractionated radiotherapy for patients with high-grade gliomas. About 31 patients with glioblastoma multiforme or anaplastic astrocytoma were studied between October 2003 and December 2004. Hypofractionated radiotherapy (3 Gy/fraction/day) was delivered to a total dose of 45 Gy in 15 fractions in 10 patients (32%) who had total excision before radiotherapy and to a total dose of 54 Gy in 18 fractions in 21 patients (68%) who had subtotal excision or biopsy alone. Sex, age, type of surgery, tumor grade, Karnofsky performance status, time between surgery and initiation of radiotherapy, and total radiotherapy dose were analyzed as potential prognostic factors for survival using the univariate log-rank method. The median follow-up was 15 months (4-16 months). A total of 15 patients (48%) died of their illness; 16 patients (52%) were still alive at the last follow-up. The median survival time was 8 months. Actuarial 1-year overall survival was 40%. Type of surgery, timing of radiotherapy after surgery, and initial Karnofsky performance status were significant prognostic factors for survival. No grade 3-4 acute or late neurotoxicity was observed. The tolerance of patients to hypofractionated RT was not different from that for conventional radiotherapy. This treatment schedule can be used for patients with high-grade gliomas. Future investigations are needed to determine the optimal fractionation for high-grade gliomas.

Brain metastasis of cardiac myxoma: case report and review of the literature.

Cardiac myxoma is the most common benign heart tumor. Cardiac myxoma can be a sporadic lesion (93% of cases) and usually occurs in women over 30 years. Complete surgical removal of the myxoma and its cardiac attachment is usually curative. The frequency of recurrences in cardiac myxomas varies between 3% for sporadic cases and 22% for cases of Carney complex. Recurrence has been related to incomplete excision, multifocality, and embolism of tumor fragments. We report a case with multiple brain metastases presumably due to tumor embolization from previously operated cardiac myxoma.