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Retreatment radiotherapy

Yvan Pin, Adrien Paix, Clara Le Fèvre, Delphine Antoni, Cyrille Blondet, Georges Noël
Palliative radiotherapy has been shown to have effects on Quality of Life during painful bone metastasis. This review aimed to determine equivalence in pain relief (PR) and retreatment rate (RR) using both single and multi-fraction irradiations, based on evaluation of the trial's quality. We performed a systematic review since ICRU 50 Report (1993) to June 2017, then evaluated trials for reproducibility and good methodology criteria. We found five studies that were reproducible in both dose and volume prescription...
March 2018: Critical Reviews in Oncology/hematology
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
Jeongshim Lee, Sung Soo Ahn, Jong Hee Chang, Chang Ok Suh
PURPOSE: To evaluate the adequacy of retreatment, including hypofractionated re-irradiation (HFReRT), after surgery for recurrent glioblastoma (GBM) and related prognosticators of outcomes. MATERIALS AND METHODS: From 2011 to 2014, 25 consecutive patients with recurrent (n=17) or secondary (n=7) disease underwent maximal surgery and subsequent HFReRT after meeting the following conditions: 1) confirmation of recurrent or secondary GBM after salvage surgery; 2) Karnofsky performance score (KPS) ≥60; and 3) interval of ≥12 months between initial radiotherapy and HFReRT...
March 2018: Yonsei Medical Journal
Henk G van der Poel, Roderick C N van den Bergh, Erik Briers, Philip Cornford, Alex Govorov, Ann M Henry, Thomas B Lam, Malcolm D Mason, Olivier Rouvière, Maria De Santis, Peter-Paul M Willemse, Hendrik van Poppel, Nicolas Mottet
Radical treatment of localised prostate cancer is recognised to be an unnecessary intervention or overtreatment in many men. Consequently, there has been a rapid uptake in the use of focal ablative therapies. However, there are several biological and practical concerns about such approaches as they have yet to be proved as robust treatment options. In particular, the multifocal nature of prostate cancer argues against unifocal treatment, while limitations in imaging can preclude the accurate identification of the number, location, and extent of prostate cancer foci...
January 17, 2018: European Urology
Carsten Nieder, Laurie E Gaspar, Dirk De Ruysscher, Matthias Guckenberger, Minesh P Mehta, Chad G Rusthoven, Arjun Sahgal, Eleni Gkika
BACKGROUND: Improved survival of patients with spinal bone metastases has resulted in an increased number of referrals for retreatment and repeat reirradiation. METHODS: A consortium of expert radiation oncologists (RO) has been established with the aim of providing treatment recommendations for challenging clinical scenarios for which there are no established guidelines. In this case, a patient developed local progression of a T5 vertebral lesion after two prior courses of palliative radiotherapy (time interval >12 months, assumed cumulative biologically equivalent dose in 2‑Gy fractions [EQD2] for spinal cord [alpha/beta 2 Gy] 75 Gy)...
January 23, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Daniela Musio, Irene De Francesco, Alessandro Galdieri, Claudia Marsecano, Alfonso Piciocchi, Alessandro Napoli, Francesca De Felice, Vincenzo Tombolini
PURPOSE: Bone metastases are a common cause of cancer-related pain. The aim of this study is to determine the optimal radiotherapy schedule for the treatment of painful bone metastases and verify if could cause different biological effects on bone. This has been achieved using functional Magnetic Resonance Imaging (MRI) with diffusion-weighted imaging (DWI). PATIENTS AND METHODS: Fifteen patients received Multiple Fractions Radiation Therapy (MFRT) with a total dose of 30Gy in 10 daily fractions of 3Gy given over 2 weeks and 15 patients received a Single Fraction Radiation Therapy (SFRT) with a dose of 8Gy...
January 2018: European Journal of Radiology
W Dörr, D Gabryś
Long-term cancer survivors are at risk of the development of recurrence or a new primary cancer that requires a second (or third) radio-oncological treatment. Publications on re-irradiation have been followed and are summarised in this overview. Information from clinical and experimental animal studies suggests that specific normal tissues can tolerate a considerable retreatment radiation dose. However, the risk of normal tissue damage and the impact on the quality of life must be considered. If a second course of radiotherapy needs to be administered, this should be done with maximum care and accuracy...
February 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Brigitte Zurl, Anja Bayerl, Alexander De Vries, Hans Geinitz, Robert Hawliczek, Tomas-Henrik Knocke-Abulesz, Peter Lukas, Richard Pötter, Wolfgang Raunik, Brigitte Scholz, Annemarie Schratter-Sehn, Felix Sedlmayer, Dietmar Seewald, Edgar Selzer, Karin S Kapp
BACKGROUND: A comprehensive evaluation of the current national and regional radiotherapy capacity in Austria with an estimation of demands for 2020 and 2030 was performed by the Austrian Society for Radiation Oncology, Radiobiology and Medical Radiophysics (ÖGRO). MATERIALS AND METHODS: All Austrian centers provided data on the number of megavoltage (MV) units, treatment series, fractions, percentage of retreatments and complex treatment techniques as well as the daily operating hours for the year 2014...
December 8, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
M Loi, V Di Cataldo, G Simontacchi, B Detti, P Bonomo, L Masi, I Desideri, D Greto, G Francolini, V Carfora, D Pezzulla, M Perna, G A Carta, L Livi
AIMS: Robotic stereotactic body radiotherapy (rSBRT) to local recurrences emerged as a valuable option for exclusive local failure after prior external beam radiation therapy (EBRT) for localised prostate cancer. The aim of this study was to assess the efficacy and safety of rSBRT in patients experiencing locally recurrent prostate cancer after prior definitive or postoperative radiotherapy using the Cyberknife. MATERIALS AND METHODS: Data from 50 patients were retrospectively reviewed...
February 2018: Clinical Oncology: a Journal of the Royal College of Radiologists
Motoo Nomura, Atsushi Otsuka, Tomohiro Kondo, Hiroki Nagai, Yumi Nonomura, Yo Kaku, Shigemi Matsumoto, Manabu Muto
BACKGROUND: Nivolumab is a monoclonal antibody directed against programmed death-1 that has been shown to improve survival in patients with metastatic melanoma. However, the efficacy of nivolumab and other agents in melanoma remains limited. The objective of this study was to evaluate the efficacy and safety of retreatment with nivolumab in metastatic melanoma patients who previously progressed on nivolumab. PATIENTS AND METHODS: A retrospective review was performed on eight consecutive metastatic melanoma patients retreated with nivolumab who progressed on previous nivolumab...
November 2017: Cancer Chemotherapy and Pharmacology
Eeva Boman, Mika Kapanen, Lyndsey Pickup, Sirpa-Liisa Lahtela
The purpose of this study is to evaluate the effect of nonrigid and fractionation-corrected dose summation on total doses in radiotherapy and to demonstrate the benefits of such dose summation on clinical decision-making for planning of retreatments. Dose summation of organs at risk (OARs) was investigated for 3 clinical cases with need of retreatment to the same site: head and neck, brain, and mediastinum. Three different summation methods over old and new radiotherapy treatment plans are presented and compared: (1) rigid raw sum with rigid registration of the planning images and direct dose summing; (2) deformable raw sum with deformable image registration and direct dose summing; and (3) deformable biological sum with deformable registration and takes into account the dose per fraction in biological manner in certain critical organs...
July 20, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Sten Myrehaug, Arjun Sahgal, Motohiro Hayashi, Marc Levivier, Lijun Ma, Roberto Martinez, Ian Paddick, Jean Régis, Samuel Ryu, Ben Slotman, Antonio De Salles
OBJECTIVE Spinal metastases that recur after conventional palliative radiotherapy have historically been difficult to manage due to concerns of spinal cord toxicity in the retreatment setting. Spine stereotactic body radiation therapy (SBRT), also known as stereotactic radiosurgery, is emerging as an effective and safe means of delivering ablative doses to these recurrent tumors. The authors performed a systematic review of the literature to determine the clinical efficacy and safety of spine SBRT specific to previously irradiated spinal metastases...
October 2017: Journal of Neurosurgery. Spine
Rajal A Patel, Derrick Lock, Thomas Kim, Sandeep Samant, James P Chandler, Bharat B Mittal, Tim J Kruser
INTRODUCTION: Recurrent head and neck carcinomas are notoriously difficult to treat. Salvage surgery, brachytherapy, and repeat external beam radiotherapy have all been utilized, achieving modest local control at the expense of elevated toxicity. We performed a retrospective review to evaluate the efficacy of single fraction stereotactic radiosurgery (SRS) for the treatment of recurrent head and neck carcinomas. METHODS: Eighteen previously irradiated patients diagnosed with a locoregionally recurrent head and neck malignancy and treated with single fraction SRS from 2000 to 2016 were analyzed...
May 1, 2017: Curēus
P Aluffi Valletti, F Taranto, A Chiesa, F Pia, G Valente
The management of positive resection margins in micro-endoscopic glottic laser surgery remains a controversial and critical point. This study aims to assess the impact of margin status after transoral laser surgery on local control, survival and organ preservation rates; the decision- making process and treatment options in cases with positive margins are also discussed. We retrospectively reviewed the clinical and histological records of 308 consecutive patients with primary early glottic carcinoma (T1a, T1b, selected T2) and treated with endoscopic laser cordectomy...
May 22, 2017: Acta Otorhinolaryngologica Italica
Carsten Nieder, Dirk De Ruysscher, Laurie E Gaspar, Matthias Guckenberger, Minesh P Mehta, Patrick Cheung, Arjun Sahgal
BACKGROUND: Practice guidelines have been developed for early-stage and locally advanced non-small cell lung cancer (NSCLC). However, many common clinical scenarios still require individualized decision making. This is true for locoregional relapse after initial stereotactic radiotherapy (stereotactic body radiation therapy or stereotactic ablative radiotherapy; SBRT or SABR), an increasingly utilized curative treatment option for stage I NSCLC. METHODS: A consortium of expert radiation oncologists was established with the aim of providing treatment recommendations...
July 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Tabassum Wadasadawala, Rohit Vadgaonkar, Jyoti Bajpai
Locoregional recurrence (LRR) after adequate treatment of primary breast cancer poses a therapeutic challenge. Advances in the management of breast cancer have led to significant improvements in survival. With this advantage, it is observed that the incidence of LRR has relatively decreased. Systemic involvement should be ruled out in patients presenting with locoregionally recurrent disease, as isolated LRR requires a treatment with curative intent. Salvage mastectomy following ipsilateral breast tumor recurrence is a time-tested treatment option and widely accepted...
November 2017: Clinical Breast Cancer
Yeon Sil Kim
Locoregional failure is the most frequent pattern of failure in locally advanced head and neck cancer patients and it leads to death in most of the patients. Second primary tumors occurring in the other head and neck region reach up to almost 40% of long-term survivors. Recommended and preferred retreatment option in operable patients is salvage surgical resection, reporting a 5-year overall survival of up to 40%. However, because of tumor location, extent, and underlying comorbidities, salvage surgery is often limited and compromised by incomplete resection...
March 2017: Radiation Oncology Journal
T de Baere, L Tselikas, G Gravel, F Deschamps
Today, in addition to surgery, other local therapies are available for patients with small-size non-small-cell lung cancer (NSCLC) and oligometastatic disease from various cancers. Local therapies include stereotactic ablation radiotherapy (SABR) and thermal ablative therapies through percutaneously inserted applicators. Although radiofrequency ablation (RFA) has been explored in series with several hundreds of patients with pulmonary tumours, investigation of the potential of other ablation technologies including microwave ablation, cryoablation, and irreversible electroporation is ongoing...
August 2017: Clinical Radiology
E Donovan, E Timotin, T Farrell, B Donde, S Puksa, R Sur
PURPOSE: Endobronchial metastasis (EBM) originating from primary cancers outside the lung is rare. External beam radiotherapy is often attempted for control of symptoms with variable effectiveness and retreatment is challenging if symptoms recur. There is limited documentation of high-dose-rate brachytherapy for EBM in the literature. METHODS AND MATERIALS: A prospective database was created from 2006 to 2015. Patients with EBM who received high-dose-rate brachytherapy were included...
May 2017: Brachytherapy
Mahdy Ranjbar, Maximilian Kurz, Annekatrin Holzhey, Corinna Melchert, Dirk Rades, Salvatore Grisanti
Stereotactic radiotherapy (SRT) is a new approach to treat neovascular age-related macular degeneration (nAMD). The INTREPID trial suggested that SRT could reduce the frequency of regular intravitreal injections (IVIs) with antivascular endothelial growth factor drugs, which are necessary to control disease activity. However, the efficacy of SRT in nAMD and resulting morphological changes have not been validated under real-life circumstances, an issue, which we would like to address in this retrospective analysis...
December 2016: Medicine (Baltimore)
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