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cancer care, 'radiation therapy,

Waldemar Schreiner, Sofiia Gavrychenkova, Wojciech Dudek, Sebastian Lettmaier, Ralf Rieker, Rainer Fietkau, Horia Sirbu
BACKGROUND: The outcomes of so called "salvage" resections after definitive chemoradiation vs. curative resections after neoadjuvant chemoradiation therapy (IT-resection) in patients with stage IIIA/B locally advanced non-small cell lung cancer have rarely been compared. The aim of our study was to compare perioperative results, postoperative and recurrence-free survival and to identify relevant prognostic survival factors for both therapy strategies. PATIENTS AND METHODS: Between June 2008 and May 2017, 43 patients underwent pulmonary resection following induction therapy (group 1) and 14 patients underwent salvage resection after definitive chemoradiation (group 2)...
June 2018: Zentralblatt Für Chirurgie
Balkees Abderrahman, V Craig Jordan
The signing of the National Cancer Act in 1971, was designed to take laboratory discoveries rapidly from the bench to the bedside. A "war on cancer" had been declared. Combination cytotoxic chemotherapy was predicted to cure all cancers based on the stunning success in treating childhood leukemia. Breast cancer treatments were primitive; radical mastectomy and radiation was standard of care for disease that had not spread. Ablative endocrine surgery (oophorectomy, hypophysectomy, and adrenalectomy) was a palliative last option for metastatic breast cancer...
June 19, 2018: Endocrinology
Geraldine Jacobson, Linus Chuang, Maximilian Pankow
The purpose of this report is to describe the interventions implemented between 2012 and 2017 at the National Cancer Institute Paraguay (NCI Paraguay) to improve treatment quality and efficiency for patients with cervical cancer, with an emphasis on radiation quality and access. The NCI Paraguay requested collaboration with Health Volunteers Overseas (HVO), an international volunteer organization, to improve the care of patients with cervical cancer. This report is based on site visits to NCI Paraguay by HVO volunteers in 2012, 2013, and 2016, with a follow-up report from the site in 2017...
August 2018: Gynecologic Oncology Reports
T H Lam, K H Wong, K Kl Chan, M Cm Chan, D Vk Chao, A Ny Cheung, C Ym Fan, J Ho, E P Hui, K O Lam, C K Law, W L Law, H Hf Loong, R Kc Ngan, T Hf Tsang, M Cs Wong, R Mw Yeung, A Ch Ying, R Ching
In Hong Kong, breast cancer is the most common cancer among women and poses a significant health care burden. The Cancer Expert Working Group on Cancer Prevention and Screening (CEWG) was set up in 2002 by the Cancer Coordinating Committee to review and assess local and international scientific evidence, and to formulate recommendations for cancer prevention and screening. After considering the local epidemiology, emerging scientific evidence, and local and overseas screening practices, the CEWG concluded that it was unclear whether population-based breast cancer screening did more harm than good in local asymptomatic women at average risk...
June 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Pei-Hsin Chu, Ngan-Ming Tsang, Li-Ang Lee, Chun-Ta Liao, Tuan-Jen Fang
PURPOSES: The management of recurrent hypopharyngeal cancer after primary curative-intent radiation or chemoradiation therapy is inconclusive. The benefit of salvage surgery may be reduced by its high complication rate. The improvement of medical care modalities may change the survival after management for loco-reginal recurrences. The present study aims to determine the role of salvage surgery. METHODS: From December 2007 to November 2013, 46 patients with recurrent hypopharyngeal squamous cell carcinoma (HPSCC) after radiation or chemoradiation therapy and without double cancers were recruited...
June 20, 2018: European Archives of Oto-rhino-laryngology
Lei Huang, Lina Jansen, Yesilda Balavarca, Lydia van der Geest, Valery Lemmens, Liesbet Van Eycken, Harlinde De Schutter, Tom B Johannesen, Maja Primic-Žakelj, Vesna Zadnik, Margit Mägi, Dianne Pulte, Petra Schrotz-King, Hermann Brenner
The role of chemotherapy in the treatment of pancreatic cancer (PaC) has been well-established, while radiation plays ambiguous roles. This international large-scale population-based study aimed to investigate the real-world application of chemotherapy and radiotherapy for resected and unresected PaC in Europe and USA. Population-based data from multiple European national cancer registries and the US Surveillance, Epidemiology, and End Results (SEER)-18 database during 2003-2014 were analyzed. Temporal trends and geographical variations in the application rates of chemotherapy and radiotherapy were quantified using age standardization...
June 20, 2018: International Journal of Cancer. Journal International du Cancer
C Griffiths, R S Howell, H Boinpally, E Jimenez, E Chalas, F Musa, S Gorenstein
Postoperative management of patients with vulvar cancer is associated with a high incidence of poor wound healing and radiation -induced late tissue necrosis. This case series demonstrates the impact on wound healing with the use of hyperbaric oxygen therapy and advanced wound care following radical vulvectomy and/or radiation therapy. A retrospective case series was performed of all patients from 2016 to 2017 with lower genital cancer who underwent radical surgery with or without chemoradiation treatment, experienced wound dehiscence or late tissue radionecrosis, and were treated with advanced wound care, including hyperbaric oxygen therapy (HBO)...
May 2018: Gynecologic Oncology Reports
Jonathan Chen, Xian Wu, Paul Christos, Weisi Yan, Akkamma Ravi
INTRODUCTION: Breast cancer patients with tumors > 5 cm but without nodal disease who undergo mastectomy present a clinical challenge regarding the appropriate adjuvant treatment. Traditionally, postmastectomy radiation therapy (PMRT) was the standard of care. However, recent studies have suggested local failure rates without PMRT might be low enough to omit RT. This might be especially true in the elderly. PATIENTS AND METHODS: Women aged ≥ 75 years with a diagnosis of T3N0 breast cancer who had undergone mastectomy were identified from the Surveillance, Epidemiology, and End Results (SEER) 18 database...
June 15, 2018: Clinical Breast Cancer
Piotr Wranicz, Bente Brokstad Herlofson, Jan F Evensen, Ulf E Kongsgaard
Introduction Trismus, or limited mouth opening, is a well-known complication of head and neck cancer and its treatment. It may be caused by tumour infiltration into the masticatory muscles or by treatment like surgery and radiotherapy. A limited mouth opening may have a negative effect on nutrition, phonation, dental hygiene and treatment, and quality of life. The severity of this complication depends on the location of the tumour, the type of reconstruction, the total radiation dose, fractionation, and treatment techniques...
December 29, 2017: Scandinavian Journal of Pain
Sarah Barrett, Gerard G Hanna, Laure Marignol
Standard of care radiotherapy in LA-NSCLC is 60-66 Gy in 30-33 fractions. However outcomes for these patients are poor with 5-year survival in the range of 10-20%. Randomised controlled trials have shown that dose escalation in a linear fashion does not improve outcomes for all patients, thus there is a need to tailor the prescription to the individual patient. This review assesses the strategies published to personalise the radiation therapy dose prescription in LA-NSCLC. A systematic and scoping search of the literature was performed to identify studies that met the inclusion criteria...
June 13, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Lindsay M Burt, Dennis C Shrieve, Jonathan D Tward
Purpose: The aim of this study is to describe the trends and factors that influence the initial treatment of men with localized prostate cancer (PC) in the United States between 2004 and 2014. Methods and materials: The National Cancer Institute's Surveillance, Epidemiology and End Results database was used to identify patients with primary prostate adenocarcinoma between 2004 and 2014. Patients were staged in accordance with the American Joint Committee on Cancer 7th edition criteria and stratified according to the National Comprehensive Cancer Network guidelines risk group classification...
April 2018: Advances in Radiation Oncology
Austin Lammers, Timur Mitin, Drew Moghanaki, Charles R Thomas, Robert Timmerman, Sara E Golden, Sujata Thakurta, Rafal Dziadziuszko, Christopher G Slatore
Purpose: The current standard of care for surgically eligible stage I non-small cell lung cancer (NSCLC) is surgical resection, but emerging data suggest that stereotactic body radiation therapy (SBRT) is potentially as effective as surgery. However, specialist views of the current evidence about SBRT and how they would incorporate a randomized controlled trial (RCT) into practice is unclear. We sought to understand specialist opinions about evidence regarding treatment of stage I NSCLC and how this translates into practice and clinical trial implementation...
April 2018: Advances in Radiation Oncology
Allen M Chen, Taeko Yoshizaki, Pin-Chieh Wang, Darlene Veruttipong, Phillip J Beron, Robert Chin, Argin G Mikaeilian, Minsong Cao
Purpose: The practice of deliberately sparing the ipsilateral parotid gland with intensity modulated radiation therapy (IMRT) in patients with node-positive head and neck cancer is controversial. We sought to compare the clinical outcomes among consecutive cohorts of patients with head and neck cancer who were treated with differing strategies to spare the parotid gland that is ipsilateral to the involved neck using IMRT. Methods and materials: A total of 305 patients were treated with IMRT for node-positive squamous cell carcinoma of the head and neck...
April 2018: Advances in Radiation Oncology
Trevor J Royce, Muhammad M Qureshi, Minh Tam Truong
BACKGROUND: The changing use of radiation as a first-line cancer therapy in the United States is poorly characterized. This study aims to report radiotherapy utilization and fractionation patterns during the first course of cancer treatment. METHODS: We extracted all solid tumor cases from 2004 to 2014 in the National Cancer Data Base, which captures only the first course of treatment. Patients were subcategorized by disease site: breast, central nervous system (CNS), gastrointestinal, genitourinary, gynecologic, head and neck (HN), musculoskeletal, skin, or thoracic...
June 11, 2018: Journal of the American College of Radiology: JACR
Apar Gupta, Nisha Ohri, Bruce G Haffty
The standard treatment for early-stage breast cancer is breast conservation therapy, consisting of breast conserving surgery followed by adjuvant radiation treatment (RT). Conventionally-fractionated whole breast irradiation (CF-WBI) has been the standard RT regimen, but recently shorter courses of hypofractionated whole breast irradiation (HF-WBI) have been advocated for patient convenience and reduction in healthcare costs and resources. Areas covered: This review covers the major randomized European and Canadian trials comparing HF-WBI to CF-WBI with long-term follow-up, as well as additional recently closed randomized trials that further seek to define the applicability of HF-WBI in clinical practice...
June 14, 2018: Expert Review of Anticancer Therapy
Daniel J Boffa
On occasion, clinicians may be motivated to offer local therapy (eg, surgery, radiation, ablation) to patients with advanced cancer in the hope of prolonging survival (as opposed to palliating a symptom). An appropriately informed discussion of risks and benefits should push clinicians to reflect on the rationale for use of local therapy in a patient who is far more likely to die as a result of systemic progression. Ultimately, the justification for local therapy in advanced cancer must be based on several assumptions of what a patient's cancer will and will not do...
June 2018: Journal of Oncology Practice
Desmond A Brown, Benjamin T Himes, Panagiotis Kerezoudis, Yirengah M Chilinda-Salter, Sanjeet S Grewal, Joshua A Spear, Mohamad Bydon, Terry C Burns, Ian F Parney
Background: The current standard of care for glioblastoma (GBM) constitutes maximal safe surgical resection, followed by fractionated radiation and temozolomide. This treatment regimen is logistically burdensome, and in a healthcare system in which access to care is variable, there may be patients with worsened outcomes due to inadequate access to optimal treatment. Methods: The National Cancer Database was queried for patients diagnosed with GBM in 2006-2014. Patients were grouped according to insurance status: private insurance, Medicare, Medicaid, or uninsured...
June 11, 2018: Neuro-oncology
Traci LeMasters, S Suresh Madhavan, Usha Sambamoorthi, Hannah W Hazard-Jenkins, Kimberly M Kelly, Dustin Long
Background: This study examined receipt of guideline-concordant care (GCC) according to evidence-based treatment guidelines and quality measures and specific types of treatment among older women with breast cancer. Patients and Methods: A total of 142,433 patients aged ≥66 years diagnosed with stage I-III breast cancer between 2007 and 2011 were identified in the SEER-Medicare linked database. Algorithms considering cancer characteristics and the appropriate course of care as per guidelines versus actual care received determined receipt of GCC...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Francesco Tommasino, Francesco Fellin, Stefano Lorentini, Paolo Farace
PURPOSE: Proton therapy for the treatment of breast cancer is acquiring increasing interest, due to the potential reduction of radiation-induced side effects such as cardiac and pulmonary toxicity. While several in silico studies demonstrated the gain in plan quality offered by pencil beam scanning (PBS) compared to passive scattering techniques, the related dosimetric uncertainties have been poorly investigated so far. METHODS: Five breast cancer patients were planned with Raystation 6 analytical pencil beam (APB) and Monte Carlo (MC) dose calculation algorithms...
June 2018: Physica Medica: PM
Arya Amini, Tyler P Robin, Chad G Rusthoven, Tracey E Schefter, David Akhavan, Yi-Jen Chen, Scott M Glaser, Bradley R Corr, Kimlin T Ashing, Christine M Fisher
OBJECTIVES: The treatment of choice for locally advanced cervical cancer is definitive chemoradiation (CRT). Hysterectomy is not indicated due to higher-rates of cut-through resections leaving gross disease behind, requiring additional therapy with increasing morbidity and no benefit in overall survival (OS). The objectives of this study were to determine factors associated with cut-through hysterectomies and evaluate OS outcomes. MATERIALS AND METHODS: The National Cancer Database (NCDB) was queried for patients 18 years and older with clinical Federation of Gynecology and Obstetrics stage IB2 to IVA...
June 7, 2018: American Journal of Clinical Oncology
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