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elderly radiotherapy

Jose L Guinot, Agata Rembielak, Jose Perez-Calatayud, Silvia Rodríguez-Villalba, Janusz Skowronek, Luca Tagliaferri, Benjamin Guix, Victor Gonzalez-Perez, Vincenzo Valentini, György Kovacs
PURPOSE: The aim of this publication is to compile available literature data and expert experience regarding skin brachytherapy (BT) in order to produce general recommendations on behalf of the GEC-ESTRO Group. METHODS: We have done an exhaustive review of published articles to look for general recommendations. RESULTS: Randomized controlled trials, systemic reviews and meta-analysis are lacking in literature and there is wide variety of prescription techniques successfully used across the radiotherapy centers...
February 15, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
J Remon, N Vilariño, N Reguart
Immune checkpoint inhibitors (ICIs) have been incorporated in the treatment strategy of advanced non-small cell lung cancer (NSCLC). Beyond the already approved indications in first- and second-line setting of advanced NSCLC, new data has recently emerged demonstrating its efficacy in locally advanced disease as maintenance after chemo-radiotherapy and currently several trials are also exploring its efficacy in earlier stages of the disease to evaluate whether these results could be extrapolated to the adjuvant setting...
February 8, 2018: Cancer Treatment Reviews
Sunita Ghosh, Sarah Baker, Douglas Guedes de Castro, Lucyna Kepka, Narendra Kumar, Valery Sinaika, Juliana Matiello, Darejan Lomidze, Katarzyna Dyttus-Cebulok, Eduardo Rosenblatt, Elena Fidarova, Wilson Roa
BACKGROUND AND PURPOSE: Short-course radiotherapy (25 Gy in five fractions) was recently shown in a randomized phase III trial to be non-inferior to 40 Gy in 15 fractions in elderly and/or frail patients with glioblastoma multiforme. This study compared the cost-effectiveness of the two regimens. MATERIAL AND METHODS: The direct unit costs of imaging, radiotherapy (RT), and dexamethasone were collected from the five primary contributing countries to the trial, constituting the data of 88% of all patients...
February 13, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Anita Mamtani, Julie J Gonzalez, Dayna T Neo, Robb S Friedman, Abram Recht, Michele R Hacker, Ranjna Sharma
BACKGROUND: Octogenarians with early-stage breast cancer often have low-risk tumor biology. However, optimal treatment strategies for those with high-risk biology remain unclear. METHODS: We reviewed the records of women ages 80-89 years with biopsy-proven, Stage I-II invasive breast cancer who were referred for surgical evaluation from January 2001 through December 2010. High-risk was defined as human epidermal growth factor receptor-positive (HER2+), triple-negative (TN), or histologic grade 3 disease...
February 9, 2018: Annals of Surgical Oncology
Paolo Dell'Oglio, Marco Bandini, Sami-Ramzi Leyh-Bannurah, Zhe Tian, Vincent Trudeau, Alessandro Larcher, Nicola Fossati, Marco Moschini, Giorgio Gandaglia, Umberto Capitanio, Alberto Briganti, Markus Graefen, Francesco Montorsi, Fred Saad, Pierre I Karakiewicz
OBJECTIVE: Several randomized controlled trials have documented significant overall survival benefit in high metastatic risk prostate cancer (PCa) patients treated with combination of androgen deprivation therapy (ADT) at radiotherapy (RT) relative to RT alone. Unfortunately, elderly patients are either not included or are underrepresented in these trials. In consequence, the survival benefit of combination of ADT at RT in the elderly warrants detailed reassessment, including its cost...
February 6, 2018: Urologic Oncology
Fangzheng Wang, Chuner Jiang, Zhiming Ye, Quanquan Sun, Tongxin Liu, Min Xu, Peng Wu, Kaiyuan Shi, Bin Long, Zhenfu Fu, Yangming Jiang
OBJECTIVE: This study was conducted to assess the efficacy and safety of nimotuzumab combined with radiotherapy (RT) in elderly patients with nasopharyngeal carcinoma. MATERIALS AND METHODS: The clinical data of 75 nasopharyngeal carcinoma patients, who were initially treated with nimotuzumab combined with RT, were collected and retrospectively reviewed from December 2008 to April 2014. They were aged 60 to 81 years (median 64 years). The distribution of disease was stage II in 10 (13...
February 6, 2018: Translational Oncology
D Tio, C A C Prinsen, B Dréno, R Hoekzema, M Augustin, C van Montfrans
BACKGROUND: Lentigo maligna (LM), a form of melanoma in situ, is treated to prevent progression to lentigo maligna melanoma (LMM). Surgical treatment is the gold standard. However, treatment guidelines are based on expert opinion and comparative studies are lacking. OBJECTIVE: The objective of this study is to assess the diagnostic methods and clinical management of LM patients among European dermatologists and residents. METHODS: A survey consisting of 29 questions about diagnostic methods and treatment options used for LM patients was sent to 3308 members of the European association of Dermatologists and Venereologists (EADV)...
February 8, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Waqar Haque, Vivek Verma, E Brian Butler, Bin S Teh
PURPOSE: Multiple studies have evaluated the omission of radiation therapy (RT) in elderly women with invasive carcinoma; no studies to date have assessed this question for metaplastic breast cancer (MBC). This study is the only known study describing national practice patterns and addressing the impact of RT versus observation on survival in elderly women with T1-2N0 MBC. METHODS: The National Cancer Data Base was queried (2004-2013) for women aged ≥70 years with T1-T2N0 MBC that underwent lumpectomy...
January 29, 2018: Breast: Official Journal of the European Society of Mastology
Peng Diao, Julien Langrand-Escure, Max-Adrien Garcia, Sophie Espenel, Amel Rehailia-Blanchard, Blandine de Lavigerie, Nicolas Vial, Guy de Laroche, Alexis Vallard, Nicolas Magné
BACKGROUND AND PURPOSE: There is paucity of data on the efficacy and toxicity of radiotherapy in rectal cancer (RC) elderly patients. The objective was to identify management strategies and resulting outcomes in RC patients ≥70 years undergoing radiotherapy. MATERIAL AND METHODS: A retrospective study included consecutive RC patients ≥70 years undergoing rectal radiotherapy. RESULTS: From 2004-2015, 340 RC patients underwent pre-operative (n = 238; 70%), post-operative (n = 41, 12%), or exclusive (n = 61, 18%) radiotherapy, with a median age of 78...
February 3, 2018: Digestive and Liver Disease
E C Rijkmans, B van Triest, R A Nout, E M Kerkhof, J Buijsen, T Rozema, J H Franssen, L A Velema, M S Laman, A Cats, C A M Marijnen
INTRODUCTION: The HERBERT study evaluated a high-dose-rate endorectal brachytherapy boost (HDREBT) after EBRT in medically inoperable/elderly patients with rectal cancer. The response-rates are promising but not without risk of toxicity. The current analysis provides a comprehensive overview of patient reported, physician reported and endoscopically observed toxicity. MATERIAL AND METHODS: A brachytherapy dose finding study was performed in 38 inoperable/elderly patients with T2-T4N0-1 rectal cancer...
February 2, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Amol J Ghia
Fractionated radiotherapy (FRT) plays a critical role in the management of gliomas. For glioblastoma, the irradiation dose of 60 Gy in 30 fractions with concomitant and adjuvant temozolomide is currently considered as a standard of treatment, and further dose escalation has failed to be of benefit in clinical trials. Hypofractionated radiation schedules may be applied in elderly patients or those with poor performance status. For anaplastic gliomas, the high-risk region is typically irradiated to a total dose of approximately 60 Gy in 1...
2018: Progress in Neurological Surgery
Chunbo Zhao, Qian Zhang, Wenbo Qiao
RATIONALE: The outcomes of locally advanced non-small cell lung cancer (NSCLC) remain poor, in particular, the frail elderly patients cannot tolerate chemotherapy. The new efficient, safe, and more specific treatments are needed. Radiation combined with targeted therapy is the focus of research in recent years. Apatinib is highly selective tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2, studies have revealed that apatinib inhibit the growth of solid tumors including NSCLC...
December 2017: Medicine (Baltimore)
Swarupa Mitra, Manoj Kumar Sharma, Inderjeet Kaur, Ruparna Khurana, Kanika Batra Modi, Raman Narang, Avik Mandal, Soumya Dutta
Vulvar carcinoma is a rare and aggressive gynecological malignancy. It affects elderly females, with the mean age at diagnosis being 55-60 years. Regional metastasis to inguinal lymph nodes is common. There is a high incidence of pelvic node involvement, especially in those with pathologically positive inguinal nodes. Surgery appears to be the only curative treatment option in the early stages of the disease. But in most patients, surgery is associated with considerable morbidities and psychosexual issues. Hence, in the quest for a less morbid form of treatment, multimodality approaches with various combinations of surgery, chemotherapy, and radiation therapy have been suggested for advanced vulvar cancers...
2018: Cancer Management and Research
Almadani A, Dixit S, Rowland-Hill C, Achawal S, Rajaraman Cr, Gerry Go, R Highley, Hussain Masood, Baker L, Gill L, Morris H, Hingorani M
The management of elderly patients with glioblastoma-multiforme (GBM) remains poorly defined with many experts advocating best supportive care in view of limited evidence on efficacy of more aggressive treatment protocols. There is randomised evidence (NORDIC and NA-O8 studies) to support the use of surgery followed by adjuvant monotherapy with either radiotherapy (RT) using hypo-fractionated regimes (e.g. 36 Gy in 6 fractions OR 40 Gy in 15 fractions) or chemotherapy with temozolomide (TMZ) in patients expressing methylation of promoter for O6-methylguanine-DNA methyltransferase (MGMT) enzyme...
January 29, 2018: British Journal of Radiology
Bemnet G Mengesha, Heather R Conti
Interleukin-17 (IL-17) is a proinflammatory cytokine produced by adaptive CD4+ T helper cells and innate lymphocytes, such as γδ-T cells and TCRβ+ "natural" Th17 cells. IL-17 activates signaling through the IL-17 receptor, which induces other proinflammatory cytokines, antimicrobial peptides and neutrophil chemokines that are important for antifungal activity. The importance of IL-17 in protective antifungal immunity is evident in mice and humans, where various genetic defects related to the IL-17-signaling pathway render them highly susceptible to forms of candidiasis such oropharyngeal candidiasis (OPC) or more broadly chronic mucocutaneous candidiasis (CMC), both caused mainly by the opportunistic fungal pathogen Candida albicans...
September 27, 2017: Journal of Fungi (Basel, Switzerland)
Karis Kin-Fong Cheng, Ethel Yee-Ting Lim, Ravindran Kanesvaran
OBJECTIVES: The measurement of quality of life (QoL) in elderly cancer population is increasingly being recognised as an important element of clinical decision-making and the evaluation of treatment outcome. This systematic review aimed to summarise the evidence of QoL during and after adjuvant therapy in elderly patients with cancer. METHODS: A systematic search was conducted of studies published in CINAHL plus, CENTRAL, PubMed, PsycINFO and Web of Science from the inception of these databases to December 2016...
January 24, 2018: BMJ Open
Waqar Haque, Vivek Verma, Edward B Butler, Bin S Teh
PURPOSE: This study evaluated practice patterns, outcomes, and predictors of survival for elderly patients with glioblastoma (GBM) receiving definitive chemoradiotherapy (CRT) with either hypofractionated radiotherapy or conventionally fractionated radiotherapy. MATERIALS AND METHODS: The National Cancer Data Base was queried for patients age 65 years and above diagnosed with GBM between 2006 and 2012 that received definitive CRT with either hypofractionated radiotherapy (hCRT) or conventionally fractionated radiotherapy (cCRT)...
February 2018: American Journal of Clinical Oncology
Melinda Pattanasri, Kenneth Elder, Carolyn Nickson, Samuel Cooke, Dorothy Machalek, Allison Rose, Arlene Mou, John P Collins, Allan Park, Richard De Boer, Claire Phillips, Vicki Pridmore, Helen Farrugia, G Bruce Mann
BACKGROUND: Adjuvant therapy for breast cancer is routinely discussed and recommended in multi-disciplinary meetings (MDMs). Current literature explores how treatments received by patients differ from national guidelines; however, it does not explore whether treatment is concordant with MDMs. This study provides an Australian perspective on the uptake of MDM recommendations and reasons for non-concordance. METHODS: A retrospective cohort study of patients with breast cancer presented at The Royal Melbourne Hospital MDM in 2010 and 2014 to investigate the concordance between MDM recommendations and treatment received...
January 23, 2018: ANZ Journal of Surgery
Yusuf Dundar, Richard B Cannon, Jason P Hunt, Marcus Monroe, Gita Suneja, Ying J Hitchcock
BACKGROUND: To assess the effectiveness and outcomes of adjuvant radiotherapy regimens for nonmelanoma skin cancers (NMSC) of the head and neck, particularly for elderly patients. METHODS: A retrospective review of patients with head and neck NMSC was conducted. Radiotherapy dose per fraction regimens included ≤200, 240-250, 300-400, and 500-600 cGy. Demographics, tumor characteristics, local control (LC), regional control (RC), and survival outcomes were analyzed...
January 22, 2018: International Journal of Dermatology
Rudresha A Haleshappa, Suparna Ajit Rao, Sunny Garg, C Lakshmaiah Kuntegowdanahalli, Govinda Babu Kanakasetty, Lokanatha Dasappa
Background: Colorectal cancer (CRC) is considered a disease of elderly. There has been a steady decrease in the incidence in those aged >50 years, with an alarming increase noted in adults aged <50 years. Subjects and Methods: We retrospectively analyzed 89 patients diagnosed with CRC aged <40 years between the years 2010 and 2014. Their clinical profile, treatment, and outcomes were studied. Results: The median age was 33 years with a male preponderance (56...
October 2017: Indian Journal of Medical and Paediatric Oncology
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