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Prophylactic Cranial Irradiation

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https://www.readbyqxmd.com/read/28535095/managing-cns-disease-in-adults-with-acute-lymphoblastic-leukemia
#1
Richard A Larson
The central nervous system (CNS) is an important site of involvement by acute lymphoblastic leukemia (ALL) in adults. The prevalence is sufficiently high that prophylactic treatment is routinely given to this sanctuary site in order to eradicate occult disease that might otherwise lead to a relapse. A lumbar puncture should be routinely performed in all newly diagnosed patients with ALL. The risks of CNS leukemia vary by phenotype and genotype. Preventive treatment of the CNS during post-remission therapy has become an integral part of all current ALL treatment protocols...
May 23, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28469334/clinical-profile-of-pediatric-oncology-patients-treated-by-external-beam-radiotherapy-an-institutional-experience
#2
Virender Suhag, B S Sunita, Pankaj Vats, Arti Sarin, A K Singh, Mayuri Jain
INTRODUCTION: Pediatric tumors are a heterogeneous group of malignant conditions requiring multimodal treatment, and management of such cases is at time challenging. We present the clinical profile of pediatric cancer patients who received radiation, either alone or as adjuvant to surgery and chemotherapy; in prophylactic, radical or palliative clinical setting. AIM: This study was envisaged to review our experience of pediatric oncology cases, their clinical and morphological profile, dosage schedule of radiotherapy, and the therapy induced complications...
January 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28457584/prophylactic-lower-para-aortic-irradiation-using-intensity-modulated-radiotherapy-mitigates-the-risk-of-para-aortic-recurrence-in-locally-advanced-cervical-cancer-a-10-year-institutional-experience
#3
Jie Lee, Jhen-Bin Lin, Chih-Long Chang, Ya-Ting Jan, Fang-Ju Sun, Meng-Hao Wu, Yu-Jen Chen
OBJECTIVE: To evaluate the effects of prophylactic sub-renal vein radiotherapy (SRVRT) using intensity-modulated radiotherapy (IMRT) for cervical cancer. METHODS: A total of 206 patients with FIGO stage IB2-IVA cervical cancer and negative para-aortic lymph nodes (PALNs) who underwent pelvic IMRT (PRT) or SRVRT between 2004 and 2013 at our institution were reviewed. SRVRT cranially extended the PRT field for PALNs up to the left renal vein level. The prescribed dose was consistent 50...
April 27, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28447257/recent-developments-in-radiotherapy-for-small-cell-lung-cancer-a-review-by-the-oncologic-group-for-the-study-of-lung-cancer-spanish-radiation-oncology-society
#4
REVIEW
N Rodriguez de Dios, P Calvo, M Rico, M Martín, F Couñago, A Sotoca, B Taboada, A Rodríguez
Small-cell lung cancer (SCLC) accounts for 13% of all lung tumours. The standard treatment in patients with limited-stage disease is radiotherapy combined with chemotherapy. In extensive SCLC, the importance of consolidation thoracic radiotherapy in patients with a good treatment response has become increasingly recognized. In both limited and extensive disease, prophylactic cranial irradiation is recommended in patients who respond to treatment. New therapeutic approaches such as immunotherapy are being increasingly incorporated into the treatment of SCLC, although more slowly than in non-small cell lung cancer (NSCLC)...
April 26, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#5
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28408183/outcomes-of-stereotactic-body-radiotherapy-for-t1-t2n0-small-cell-carcinoma-according-to-addition-of-chemotherapy-and-prophylactic-cranial-irradiation-a-multicenter-analysis
#6
Vivek Verma, Charles B Simone, Pamela K Allen, Steven H Lin
BACKGROUND: Although T1-T2N0 non-small cell lung cancer can be managed with stereotactic body radiotherapy (SBRT) alone, this management has often been extrapolated to T1-T2N0 small cell lung cancer (SCLC). This secondary analysis of a multi-institutional cohort study investigated whether the addition of chemotherapy and prophylactic cranial irradiation (PCI) improved the outcomes for these patients. MATERIALS AND METHODS: All cases of histologically confirmed T1-T2N0M0 SCLC were obtained from 24 institutions' prospectively collected SBRT databases...
March 16, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28391424/optimal-radiation-therapy-for-small-cell-lung-cancer
#7
REVIEW
Michael F Gensheimer, Billy W Loo
Radiation therapy plays an important role in the management of both limited stage and extensive stage small cell lung cancer. For limited stage disease, there has been a trend toward reduced size of thoracic radiation fields, which has the potential to reduce toxicity. FDG-PET staging helps make this possible by more accurately identifying areas of nodal and metastatic involvement. Trials have demonstrated similar outcomes using a range of radiation fractionation schedules, allowing flexibility in individualizing treatment...
April 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28382303/evaluation-of-the-efficacy-of-cisplatin-etoposide-and-the-role-of-thoracic-radiotherapy-and-prophylactic-cranial-irradiation-in-lcnec
#8
Arsela Prelaj, Sara Elena Rebuzzi, Gabriella Del Bene, Julio Rodrigo Giròn Berrìos, Alessandra Emiliani, Lucilla De Filippis, Alessandra Anna Prete, Silvia Pecorari, Gaia Manna, Carla Ferrara, Daniele Rossini, Flavia Longo
In small-cell lung cancer (SCLC), the role of chemotherapy and radiotherapy is well established. Large-cell neuroendocrine carcinoma (LCNEC) shares several clinicopathological features with SCLC, but its optimal therapy is not defined. We evaluated clinical response and survival outcomes of advanced LCNEC treated in first-line therapy compared with SCLC. 72 patients with stage III-IV LCNEC (n=28) and extensive-stage SCLC (ES-SCLC) (n=44) received cisplatin-etoposide with/without thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI)...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28343976/prophylactic-cranial-irradiation-versus-observation-in-patients-with-extensive-disease-small-cell-lung-cancer-a-multicentre-randomised-open-label-phase-3-trial
#9
Toshiaki Takahashi, Takeharu Yamanaka, Takashi Seto, Hideyuki Harada, Hiroshi Nokihara, Hideo Saka, Makoto Nishio, Hiroyasu Kaneda, Koichi Takayama, Osamu Ishimoto, Koji Takeda, Hiroshige Yoshioka, Motoko Tachihara, Hiroshi Sakai, Koichi Goto, Nobuyuki Yamamoto
BACKGROUND: Results from a previous phase 3 study suggested that prophylactic cranial irradiation reduces the incidence of symptomatic brain metastases and prolongs overall survival compared with no prophylactic cranial irradiation in patients with extensive-disease small-cell lung cancer. However, because of the absence of brain imaging before enrolment and variations in chemotherapeutic regimens and irradiation doses, concerns have been raised about these findings. We did a phase 3 trial to reassess the efficacy of prophylactic cranial irradiation in the treatment of extensive-disease small-cell lung cancer...
March 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28343972/time-to-reconsider-prophylactic-cranial-irradiation-in-extensive-stage-small-cell-lung-cancer
#10
Ben J Slotman
No abstract text is available yet for this article.
March 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28340924/hippocampal-sparing-whole-brain-radiotherapy-for-lung-cancer
#11
REVIEW
Ren Zhao, Wei Kong, Jun Shang, Hong Zhe, Yan-Yang Wang
Brain metastases occur in 20% to 40% of lung cancer patients. Whole-brain radiotherapy (WBRT) has long been considered the treatment of choice for many patients with lung cancer, because of its wide availability, ease of delivery, and effectiveness in prolonging survival. However, WBRT is also associated with several side effects, such as decline in memory and other cognitive functions. There exists significant preclinical and clinical evidence that radiation-induced injury to the hippocampus correlates with neurocognitive decline of patients who receive WBRT...
March 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28326834/thoracic-radiation-therapy-could-give-survival-benefit-to-elderly-patients-with-extensive-stage-small-cell-lung-cancer
#12
Changchun An, Wang Jing, Yan Zhang, Sujing Liu, Haiyong Wang, Kunli Zhu, Li Kong, Hongbo Guo, Hui Zhu
AIM: To evaluate the effect of thoracic radiation therapy (TRT) in elderly patients (aged ≥65 years) with extensive-stage small-cell lung cancer (ES-SCLC). PATIENTS & METHODS: This study reviewed the records of 118 elderly patients with ES-SCLC (all with distant metastasis) through January 2006-December 2013. The patients were divided into either a chemotherapy (ChT)/TRT-combination group or a ChT-alone group. RESULTS: The median survival time and 3-year overall survival rates in the ChT/TRT group were significantly higher than those in the ChT-alone group (17...
February 24, 2017: Future Oncology
https://www.readbyqxmd.com/read/28325618/thoracic-irradiation-in-3weeks-for-limited-stage-small-cell-lung-cancer-is-twice-a-day-fractionation-really-needed
#13
G A Turgeon, L Souhami, N Kopek, V Hirsh, L Ofiara, S L Faria
PURPOSE: Many Canadian institutions treat limited-disease small cell lung cancer with 40Gy in 15 fractions delivered once-a-day in 3weeks concomitantly with chemotherapy. This regimen is convenient and seems to be effective. Here, we report and compare with a literature review the outcomes of patients with limited-stage small cell lung cancer treated in our institution with this hypofractionated regimen. PATIENTS AND METHODS: From January 2004 to December 2012, patients with limited-stage small cell lung cancer treated curatively with platinum-based chemotherapy and concurrent thoracic radiotherapy at a dose of 40Gy in 16 fractions once-a-day were eligible for this review...
March 18, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28314330/prognostic-factors-and-treatment-of-early-stage-small-cell-lung-cancer
#14
Lukas Käsmann, Louisa Bolm, Stefan Janssen, Dirk Rades
BACKGROUND/AIM: Only 0.1-0.17% of all lung cancer patients are diagnosed with stage I or II small cell lung cancer (SCLC). Radiochemotherapy remains the standard treatment for limited stage disease. This study focused on prognostic factors in early stage SCLC treated with radiochemotherapy. PATIENTS AND METHODS: Seven factors in eight patients with early stage SCLC were analyzed concerning the impact on overall survival, namely gender, age, Karnofsky performance score, N-category, UICC-stage, concurrent chemotherapy and prophylactic cranial irradiation (PCI)...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28275490/erroneous-diagnosis-of-small-cell-lung-cancer-based-on-small-biopsies-with-far-reaching-consequences-case-report-of-a-typical-carcinoid-tumor
#15
Ioannis Kyritsis, Bettina Krebs, Sandra Kampe, Dirk Theegarten, Clemens Aigner, Stefan Welter
Although neuroendocrine tumors (NETs) of the lung are frequently discussed together, carcinoids are very different from high-grade small cell lung carcinoma (SCLC). SCLC is found in heavy-smoking, older patients, whereas smoking is not strongly associated with carcinoid tumors. We present the case of a 46-year-old never smoking woman who was misdiagnosed with SCLC. The patient was not responsive to radio-chemotherapy plus prophylactic cranial irradiation (PCI); she had a typical carcinoid (TC) tumor according to the final pathology report...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28274393/low-dose-cranial-boost-in-high-risk-adult-acute-lymphoblastic-leukemia-patients-undergoing-bone-marrow-transplant
#16
William Su, Marcher Thompson, Ren-Dih Sheu, Amir Steinberg, Luis Isola, Richard Stock, Richard L Bakst
PURPOSE: Acute lymphoblastic leukemia (ALL) has a predilection for CNS involvement. Patients with high-risk ALL are often managed with transplant using a radiation-based conditioning regimen. Historically, a high-dose prophylactic cranial boost (CB) of ≥12 Gy was given to reduce risk of central nervous system (CNS) recurrence. However, the use of CB has fallen out of favor because of toxicity concerns. In high-risk adults undergoing transplant at our institution, we have used a low-dose 6 Gy CB to reduce toxicity while conditioning adults with fully developed brains...
March 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28202905/risk-factors-for-brain-metastases-after-prophylactic-cranial-irradiation-in-small-cell-lung-cancer
#17
Haiyan Zeng, Peng Xie, Xue Meng, Shuanghu Yuan, Xindong Sun, Wanlong Li, Bingjie Fan, Xiaolin Li, Jinming Yu
Despite administration of prophylactic cranial irradiation (PCI), some small cell lung cancer (SCLC) patients still suffer from brain metastases (BM) with unknown risk factors. We conducted this study to identify patients with higher BM risk after PCI and improve their outcome. The characteristics and survival of all the SCLC patients underwent PCI in our institute from 2003 to 2014 were analyzed. Kaplan-Meier method was applied to estimate BM free survival (BMFS) and overall survival (OS). Cox regression analyses were performed to explore risk factors for BM...
February 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28182655/regional-analysis-of-volumes-and-reproducibilities-of-automatic-and-manual-hippocampal-segmentations
#18
Fabian Bartel, Hugo Vrenken, Fetsje Bijma, Frederik Barkhof, Marcel van Herk, Jan C de Munck
PURPOSE: Precise and reproducible hippocampus outlining is important to quantify hippocampal atrophy caused by neurodegenerative diseases and to spare the hippocampus in whole brain radiation therapy when performing prophylactic cranial irradiation or treating brain metastases. This study aimed to quantify systematic differences between methods by comparing regional volume and outline reproducibility of manual, FSL-FIRST and FreeSurfer hippocampus segmentations. MATERIALS AND METHODS: This study used a dataset from ADNI (Alzheimer's Disease Neuroimaging Initiative), including 20 healthy controls, 40 patients with mild cognitive impairment (MCI), and 20 patients with Alzheimer's disease (AD)...
2017: PloS One
https://www.readbyqxmd.com/read/28169879/long-term-results-of-the-risk-adapted-treatment-for-childhood-b-cell-acute-lymphoblastic-leukemia-report-from-the-japan-association-of-childhood-leukemia-study-all-97-trial
#19
Keizo Horibe, Keiko Yumura-Yagi, Tooru Kudoh, Shinichiro Nishimura, Megumi Oda, Makoto Yoshida, Yoshihiro Komada, Junichi Hara, Akio Tawa, Ikuya Usami, Akihiko Tanizawa, Koji Kato, Ryoji Kobayashi, Keitaro Matsuo, Hiroki Hori
PURPOSE: This study was conducted as the first clinical trial by Japan Association of Childhood Leukemia Study to improve the outcome of B-cell acute lymphoblastic leukemia and explore a less toxic reinduction block. PATIENTS AND METHODS: From 1997 to 2002, 563 patients with B-cell acute lymphoblastic leukemia aged 1 to 15 years were enrolled. The patients were assigned into 4 risk groups (standard, intermediate, high, or extremely high risk) and treated with regimens intensified according to the risk...
March 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28154994/neutrophil-to-lymphocyte-ratio-predicts-outcome-in-limited-disease-small-cell-lung-cancer
#20
Lukas Käsmann, Louisa Bolm, Steven E Schild, Stefan Janssen, Dirk Rades
INTRODUCTION: Patients with limited disease small-cell lung cancer (SCLC) receive radiochemotherapy followed by prophylactic cranial irradiation. The prognosis of these patients remains poor with a median survival of 16-24 months. Systemic inflammation was suggested as an important prognostic factor for outcomes. This study investigated the impact of systemic inflammation measured with neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at first diagnosis in patients with limited disease SCLC for outcomes...
February 2, 2017: Lung
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