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Retreatment radiotherapy

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...
February 16, 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...
February 12, 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)
M Orlandi, A Botti, R Sghedoni, E Cagni, P Ciammella, C Iotti, M Iori
PURPOSE: Glioblastoma Multiforme (GBM) is the most common malignant brain tumor and frequently recurs in the same location after radiotherapy. Intensive treatment targeting localized lesion is required to improve GBM outcome, but dose escalation using conventional methods is limited by healthy tissue tolerance. Helical Tomotherapy (HT) Dose Painting (DP) treatments were simulated to safely deliver high doses in the recurrent regions. MATERIALS AND METHODS: Apparent Diffusion Coefficient (ADC) data from five recurrent GBM were retrospectively considered for planning...
December 2016: Physica Medica: PM
Audrey Tetreault-Laflamme, Juanita Crook
Biochemical failure after primary external beam radiotherapy for prostate cancer is common, and a significant proportion of these failures are due to local residual or recurrent disease. Early or delayed palliation using androgen deprivation therapy is the most common approach. Although a conservative approach is appropriate for many individuals, selected patients would benefit from retreatment with curative intent. We review the pertinent literature on salvage of locally recurrent prostate cancer after primary radiotherapy, including the modalities of surgery, cryotherapy, high-intensity focused ultrasound, or reirradiation with brachytherapy or stereotactic body radiotherapy...
January 2017: Seminars in Radiation Oncology
James E Neffendorf, Riti Desai, Yanzhong Wang, Joanna Kelly, Caroline Murphy, Barnaby C Reeves, Usha Chakravarthy, Sarah Wordsworth, Cornelius Lewis, Janet Peacock, Shahir Uddin, Joe M O'Sullivan, Timothy L Jackson
BACKGROUND: The standard of care for neovascular age-related macular degeneration (nAMD) involves ongoing intravitreal injections of anti-angiogenic drugs targeting vascular endothelial growth factor (VEGF). The most commonly used anti-VEGF drugs are ranibizumab, bevacizumab and aflibercept. The main objective of the STAR trial is to determine if stereotactic radiotherapy can reduce the number of anti-VEGF injections that patients with nAMD require. METHODS/DESIGN: STAR is a multicentre, double-masked, randomised, sham-controlled clinical trial...
November 24, 2016: Trials
Mudit Chowdhary, Arpit M Chhabra, Shivam Kharod, Gaurav Marwaha
Mycosis fungoides (MF) is the most prevalent subtype of cutaneous T-cell lymphoma, which is characterized by the proliferation of CD4(+) T cells. While often an indolent disease, most patients eventually develop progression from isolated patches to tumors and finally nodal or visceral involvement. Treatment choice is largely based on disease burden, though prognostic factors such as disease stage, patient age, and extracutaneous involvement must be taken into consideration. Radiotherapy represents one of the most effective therapeutic modalities in the treatment of MF...
December 2016: Clinical Lymphoma, Myeloma & Leukemia
Osamu Tanaka, Masahiko Oguchi, Takayoshi Iida, Senji Kasahara, Hideko Goto, Takeshi Takahashi
AIM: To determine the efficacy of low-dose palliative radiotherapy in patients with refractory aggressive lymphoma. BACKGROUND: There are few reports on the administration of palliative radiotherapy to patients with aggressive lymphoma. MATERIALS AND METHODS: The present study included 11 patients with 30 sites of aggressive lymphoma (diffuse large cell lymphoma, n = 7; mantle cell lymphoma, n = 2; follicular large cell lymphoma, n = 1; and peripheral T cell lymphoma, n = 1)...
November 2016: Reports of Practical Oncology and Radiotherapy
I Latorzeff, D Antoni, S Gaudaire-Josset, L Feuvret, A Tallet-Richard, G Truc, G Noël
Radiotherapy for brain metastases has become more multifaceted. Indeed, with the improvement of the patient's life expectancy, side effects must be undeniably avoided and the retreatments or multiple treatments are common. The cognitive side effects should be warned and the most modern techniques of radiation therapy are used regularly to reach this goal. The new classifications of patients with brain metastases help guiding treatment more appropriately. Stereotactic radiotherapy has supplanted whole brain radiation therapy both for patients with metastases in place and for those who underwent surgery...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Giacomo G Baldi, Samantha Di Donato, Rossana Fargnoli, Manjola Dona, Rossella Bertulli, Elisabetta Parisi, Lorenzo Fantini, Marta Sbaraglia, Mauro Panella
Evidence supporting rechallenge in patients responding to first exposure to trabectedin is limited. We report on a 39-year-old woman with advanced high-grade undifferentiated sarcoma (US) retreated twice with trabectedin after first response. The patient presented in June 2006 with an abdominal mass originating from the rear fascia of the rectus abdominis. Staging examinations did not indicate metastases and she underwent surgery; pathology showed a high-grade (FNCLCC G3) US. Subsequently, the patient received five cycles of adjuvant chemotherapy with epirubicin and ifosfamide...
October 2016: Anti-cancer Drugs
J Hof, M W J L A E Wertenbroek, P M J G Peeters, J Widder, E Sieders, K P de Jong
BACKGROUND: Repeat liver resection for colorectal liver metastases (CRLMs) is possible in a limited number of patients, with radiofrequency ablation (RFA) as an alternative for unresectable CRLMs. The aim of this study was to analyse survival rates with these interventions. METHODS: This was a database analysis of patients who underwent first and repeat interventions for synchronous and metachronous CRLMs between 2000 and 2013. Descriptive and survival statistics were calculated...
July 2016: British Journal of Surgery
Lucie Collinson, Giorgi Kvizhinadze, Nisha Nair, Melissa McLeod, Tony Blakely
INTRODUCTION: Single- and multiple-fraction external beam radiotherapy (SFX-EBRT and MFX-EBRT) are palliative treatment options for localized metastatic bone pain. MFX is the preferred choice in many developed countries. Evidence shows little difference in how effectively SFX and MFX reduce pain. However, SFX is associated with higher retreatment and (in one meta-analysis) pathological fracture rates. MFX is, however, more time-consuming and expensive. We estimated the cost-effectiveness of SFX versus MFX for metastatic bone pain in breast, prostate and lung cancer in New Zealand...
October 2016: Journal of Medical Imaging and Radiation Oncology
Lin Kong, Jiyi Hu, Xiyin Guan, Jing Gao, Rong Lu, Jiade J Lu
BACKGROUND: Radiation therapy is the mainstay strategy for the treatment of nasopharyngeal cancer (NPC). Intensity-modulated X-ray therapy (IMXT) alone is the current standard for stage I and II NPC. For stage III and IV A/B diseases, concurrent chemotherapy should be provided in addition to IMXT. However, optimal treatment for locally recurrent NPC after previous definitive dose of radiotherapy is lacking. Various techniques including brachytherapy, IMXT, stereotactic radiosurgery or radiotherapy (SRS or SBRT) have been used in the management of locally recurrent NPC...
2016: Journal of Cancer
Kimmen Quan, Karen M Xu, Yongqian Zhang, David A Clump, John C Flickinger, Ron Lalonde, Steven A Burton, Dwight E Heron
Stereotactic ablative radiotherapy (SABR) with concomitant cetuximab is an effective treatment option for previously irradiated, locally recurrent squamous cell carcinoma of the head and neck. Its local control and overall survival are similar to those of other available treatment options. Each retreatment depends heavily on the prior treatment and every patient is a special case. Based on the experience of our institution and previously published studies, for patients who receive concomitant cetuximab with a median prior radiation therapy dose of 70Gy, we recommend a total dose of 40-44Gy delivered in 5 fractions on alternating days over 1-2 weeks...
April 2016: Seminars in Radiation Oncology
Pètra Braam, Philippe Lambin, Johan Bussink
BACKGROUND: Painful spinal metastases have been treated with conventional radiotherapy for decades, but one-third of the patients have insufficient pain relief after treatment and one-fifth need retreatment. Stereotactic radiotherapy is a method to increase the dose in the spinal metastases with a potentially longer lasting palliative effect without increasing the side effects of the treatment and thereby is expected to improve the quality of life significantly. METHODS/DESIGN: This study is a multicenter prospective randomized clinical trial comparing conventional radiotherapy (1 x 8 Gy) with stereotactic radiotherapy (1 x 20 Gy) for pain reduction and quality of life in patients with painful spinal metastases...
February 2, 2016: Trials
Neil K Taunk, Brian Kushner, Katarzyna Ibanez, Suzanne L Wolden
We report a severe and not previously reported toxicity after short-interval retreatment with stereotactic body radiotherapy (SBRT) in a pediatric patient with neuroblastoma. This patient experienced Grade III radiation myositis after treatment with conventional radiation therapy followed by high-dose SBRT for persistent disease a short interval after the initial radiotherapy course. While SBRT shows outstanding rates of local control in adult disease, data in pediatric cancers are extremely limited. In this report, we discuss the rationale of SBRT in this patient's multimodality neuroblastoma treatment, management of the toxicity, and future perspectives on the use of SBRT in pediatric cancer...
April 2016: Pediatric Blood & Cancer
Taro Murai, Kengo Sato, Michio Iwabuchi, Yoshihiko Manabe, Hiroyuki Ogino, Hiromitsu Iwata, Koshi Tatewaki, Naoki Yokota, Seiji Ohta, Yuta Shibamoto
PURPOSE: Recurrent ependymomas were retreated with stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT). The efficacy, toxicities, and differences between SRS and FSRT were analyzed. METHODS: Eight patients with recurrent ependymomas fulfilling the criteria described below were evaluated. Inclusion criteria were: (1) the patient had previously undergone surgery and conventional radiotherapy as first-line treatment; (2) targets were located in or adjacent to the eloquent area or were deep-seated; and (3) the previously irradiated volume overlapped the target lesion...
March 2016: Japanese Journal of Radiology
Derek S Tsang, Vivian Yau, Hamid Raziee, Mark Niglas, Hany Soliman, Edward Chow, May Tsao
There is controversy surrounding the optimal radiotherapy dose-fractionation for retreatment of painful bone metastases. Two commonly used regimens are 8 Gy in a single-fraction or 20 Gy in five or eight fractions. Randomized evidence, including the NCIC SC.20 randomized clinical trial, has failed to standardize clinical practice. Practitioners who use single-fraction regimens cite patient convenience, fewer acute adverse effects, and better cost-effectiveness. Practitioners who prefer multiple fractions raise questions about the interpretation of data that justifies single-fraction treatment, and the possibility that single-fraction treatment may provide inferior pain relief...
October 2015: Annals of Palliative Medicine
Antonio Pontoriero, Giuseppe Iatì, Dario Aiello, Stefano Pergolizzi
AIM: To evaluate the role of stereotactic body radiation therapy in the retreatment of locally recurrent cervical cancers. Brachytherapy is the main choice to treat gynecologic cancers. METHODS: Patients with recurrent cervical cancer, previously submitted to radiotherapy, were treated with stereotactic body radiation therapy using a CyberKnife system (Accuray Incorporated, Sunnyvale, California) with a fiducial tracking system. RESULTS: From August 2011 to October 2014, 5 patients have been treated...
December 2016: Technology in Cancer Research & Treatment
Peter Hoskin, Santhanam Sundar, Krystyna Reczko, Sharon Forsyth, Natasha Mithal, Bruce Sizer, David Bloomfield, Sunil Upadhyay, Paula Wilson, Amy Kirkwood, Michael Stratford, Mark Jitlal, Allan Hackshaw
BACKGROUND: The radiotherapy or ibandronate (RIB) trial was a randomized multicenter nonblind two-arm trial to compare intravenous ibandronate given as a single infusion with single-dose radiotherapy for metastatic bone pain. METHODS: Four hundred seventy prostate cancer patients with metastatic bone pain who were suitable for local radiotherapy were randomly assigned to radiotherapy (single dose, 8 Gy) or intravenous infusion of ibandronate (6mg) in a noninferiority trial...
October 2015: Journal of the National Cancer Institute
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