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anorectal dose sparing

I Troussier, F Huguet, S Servagi-Vernat, C Benahim, J Khalifa, I Darmon, C Ortholan, L Krebs, C Dejean, P Fenoglietto, S Vieillot, R-J Bensadoun, J Thariat
The standard treatment of locally advanced (stage II and III) squamous cell carcinoma of the anal canal consists of concurrent chemoradiotherapy (two cycles of 5-fluoro-uracil, mitomycin C, on a 28-day cycle), with a dose of 45 Gy in 1.8 Gy per fraction in the prophylactic planning target volume and additional 14 to 20 Gy in the boost planning target volume (5 days per week) with a possibility of 15 days gap period between the two sequences. While conformal irradiation may only yield suboptimal tumor coverage using complex photon/electron field junctions (especially on nodal areas), intensity modulated radiation therapy techniques (segmented static, dynamic, volumetric modulated arc therapy and helical tomotherapy) allow better tumour coverage while sparing organs at risk from intermediate/high doses (small intestine, perineum/genitalia, bladder, pelvic bone, etc...
April 2015: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Isália Miguel, João Freire, Maria José Passos, António Moreira
Anorectal melanoma is an uncommon cancer with a poor prognosis. We aim to describe the clinical presentation, treatment and outcome of patients with anorectal melanoma in our center. Retrospective study of patients with anorectal melanoma treated between 2000 and 2011 at a cancer center in Lisbon. Ten patients were identified, eight females and two males, with median age 70.5 years (32-79). Symptoms at presentation were rectal bleeding (8), anal pain (4) and discomfort (3). Tumor location was anal (6), rectal (3) and anorectal transition (2)...
January 2015: Medical Oncology
Rovel J Colaco, Romaine Charles Nichols, Soon Huh, Nataliya Getman, Meng Wei Ho, Zuofeng Li, Christopher G Morris, William M Mendenhall, Nancy P Mendenhall, Bradford S Hoppe
BACKGROUND: To assess the potential benefit of proton therapy (PT) over photon therapy, we compared 3-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and PT plans in patients undergoing neoadjuvant chemoradiation for resectable rectal cancer at our institution. METHODS: Eight consecutive patients with resectable (T2-T3) rectal cancers underwent 3DCRT, IMRT, and 3-dimensional conformal PT treatment planning. Initial target volumes (PTV1) were contoured using the Radiation Therapy Oncology Group anorectal atlas guidelines...
February 2014: Journal of Gastrointestinal Oncology
John Marks, George Nassif, Henry Schoonyoung, Al DeNittis, Eric Zeger, Mohammed Mohiuddin, Gerald Marks
BACKGROUND: Ideal treatment of rectal cancer includes controlling the cancer; minimizing trauma, morbidity, and mortality; and avoiding a colostomy with preservation of adequate function. These goals become more challenging the further distal in the rectum the cancer is located. We sought to determine whether minimally invasive sphincter-preservation surgery (SPS) can accomplish good cancer control, maintaining sphincter function with minimal morbidity and mortality in rectal cancers of the distal 3 cm after receiving neoadjuvant chemoradiotherapy...
December 2013: Surgical Endoscopy
S M Murad-Regadas, F S P Regadas, L V Rodrigues, F J Crispin, V T Kenmoti, G O d S Fernandes, G Buchen, F C C Monteiro
AIM: The aim of this study was to identify criteria for three-dimensional anorectal ultrasonography (3D-AUS) to assess the response of rectal cancer to chemoradiotherapy; the 3D-AUS results were compared with the histopathological findings of the resected specimen. METHOD: Thirty-five patients underwent 3D-AUS and were grouped according to the presence (GI; n = 19) or absence (GII; n = 16) of anal canal invasion. All patients received chemoradiotherapy, then underwent a second 3D-AUS...
December 2011: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Robert Jan Smeenk, Bin S Teh, E Brian Butler, Emile N J Th van Lin, Johannes H A M Kaanders
BACKGROUND AND PURPOSE: Endorectal balloons (ERBs) are being used in prostate radiotherapy for prostate immobilization and rectal wall (Rwall) sparing. Some of their aspects, however, have been questioned, like patient's tolerance and their value in modern high-precision radiotherapy. This paper gives an overview of published data concerning ERB application in prostate radiotherapy. MATERIALS AND METHODS: Systematic literature review based on PubMed/MEDLINE database searches...
June 2010: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Jivko Kamarashev, Christoph E Riess, Josephine Mosimann, Severin Läuchli
BACKGROUND: Whereas until 2003 Lymphogranuloma venereum (LGV) was rare in industrialised countries, there have been increasing reports of cases of LGV proctitis in men having sex with men (MSM) over the last six years in Europe, America and Australia. PATIENTS AND METHODS: After the alarming message from the Netherlands in 2003, physicians in a dermatological and STI private clinic in Zurich started examining rectal swabs from patients with proctitis for LGV serovars of C...
April 3, 2010: Swiss Medical Weekly
David Russell-Jones, Rehman Khan
Insulin therapy or intensification of insulin therapy commonly results in weight gain in both type 1 and type 2 diabetes. This weight gain can be excessive, adversely affecting cardiovascular risk profile. The spectre of weight gain can increase diabetic morbidity and mortality when it acts as a psychological barrier to the initiation or intensification of insulin, or affects adherence with prescribed regimens. Insulin-associated weight gain may result from a reduction of blood glucose to levels below the renal threshold without a compensatory reduction in calorie intake, a defensive or unconscious increase in calorie intake caused by the fear or experience of hypoglycaemia, or the 'unphysiological' pharmacokinetic and metabolic profiles that follow subcutaneous administration...
November 2007: Diabetes, Obesity & Metabolism
Rachel J Placidi, Paula C Chandler, Kimberly D Oswald, Christine Maldonado, Pamela K Wauford, Mary M Boggiano
OBJECTIVE: We examined the effect of fluoxetine to suppress binge eating in rats with a history of caloric restriction (CR) and the extent to which this effect was altered by stress and hunger. METHOD: To detect heightened sensitivity to fluoxetine, young female rats were used to determine a subthreshold anorectic dose (2 mg/kg, intraperitonally). Another group of rats was either fed ad libitum or given multiple CR (to 90% body weight) and refeeding-to-satiety cycles...
November 2004: International Journal of Eating Disorders
Eric P Zorrilla, Lindsay E Reinhardt, Glenn R Valdez, Koki Inoue, Jean E Rivier, Wylie W Vale, George F Koob
Two corticotropin-releasing factor (CRF) receptor families have been identified (CRF1 and CRF2). Whereas anxiogenic-like roles for the CRF1 receptor have been identified, behavioral functions of the CRF2 receptor remain obscure. Urocortin 2 (Ucn 2), a CRF-related peptide that selectively binds CRF2 receptors, was recently identified and recognized for its central anorectic properties. The present study tested the hypothesis that the anorexigenic mode of action of Ucn 2 differed from that of ovine CRF (oCRF), a preferential CRF1 receptor agonist...
September 2004: Journal of Pharmacology and Experimental Therapeutics
Daniel R Nathanson, N Joseph Espat, Garrett M Nash, Matthew D'Alessio, Howard Thaler, Bruce D Minsky, Warren Enker, Douglas Wong, Jose Guillem, Alfred Cohen, Philip B Paty
PURPOSE: Preoperative radiotherapy for rectal cancer avoids radiation to the reconstructed rectum and may circumvent the detrimental effects on bowel function associated with postoperative radiotherapy. We compared the long-term functional results of patients who received preoperative radiotherapy, postoperative radiotherapy, or no radiotherapy in conjunction with low anterior resection and coloanal anastomosis to assess the impact of pelvic radiation on anorectal function. METHODS: One hundred nine patients treated by low anterior resection and straight coloanal anastomosis for rectal cancer between 1986 and 1997 were assessed with a standardized questionnaire at two to eight years after resection...
July 2003: Diseases of the Colon and Rectum
Oliver M Jones, Alison F Brading, Neil J McC Mortensen
Recent research into the physiology and pharmacology of the internal anal sphincter has elucidated the importance of this structure in health and disease. Its pharmacological manipulation for therapeutic gain has focused mainly on agents to reduce internal anal sphincter tone, a 'chemical sphincterotomy' that might heal chronic anal fissure. However, drugs to increase sphincter tone, and augment intermittent and appropriate relaxation are also being evaluated. The initial results with this medical approach to anorectal disease have often been disappointing, failing to match the results achievable with surgery, and many of these drugs have a high rate of side effects in the short term...
April 2002: Canadian Journal of Gastroenterology, Journal Canadien de Gastroenterologie
J P Bannon, G J Marks, M Mohiuddin, J Rakinic, N Z Jian, D Nagle
BACKGROUND: Despite conventional attitudes that interdict sphincter-preservation surgery (SPS) for cancers arising in the terminal 3 cm of rectum, we have selectively employed high-dose preoperative external radiation (HDPER) and either radical or local excisional SPS techniques for rectal cancer arising between the 0.5 and 3 cm levels above the anorectal ring. We have reported a preliminary experience with HDPER and full-thickness local excision (FTLE) and three different methods of radical SPS...
May 1995: Annals of Surgical Oncology
N Orthen-Gambill, R B Kanarek
Daily caloric intakes and dietary self-selection of the three macronutrients, protein, fat and carbohydrate were examined in female rats following administration of d-amphetamine sulfate (0.0, 0.5, 1.0 and 2.0 mg/kg, IP) or fenfluramine hydrochloride (0.0, 1.5, 3.0 and 6.0 mg/kg, IP). Animals were maintained on ground Purina Chow or one of two self-selection regimes, one with a high-caloric fat ration (7.85 kcal/g) and the other with a fat ration isocaloric to the carbohydrate and protein rations (3.76 kcal/g)...
February 1982: Pharmacology, Biochemistry, and Behavior
N Orthen-Gambill
The present study examined the acute effects of the anorectic agents, fenfluramine and amphetamine, on nutrient selection in male Sprague-Dawley rats. One group of animals received continuous access to both granulated sucrose and Purina chow (presented in separate cups), while the other group received only Purina chow. Four doses of fenfluramine (0, 1.5, 3.0, 6.0 mg/kg) and four doses of amphetamine (0, 0.5, 1.0, 2.0 mg/kg) were tested. Injections were given at the beginning of the feeding period, and nutrient intakes were measured at 2, 4, and 8 h postinjection...
1985: Psychopharmacology
N M Appel, W M Mitchell, J F Contrera, E B De Souza
Fenfluramine is an amphetamine derivative that in humans is used primarily as an anorectic agent in the treatment of obesity. In rats, subchronic high-dose d,l-fenfluramine treatment (24 mg/kg subcutaneously, twice daily for 4 days) causes long-lasting decreases in brain serotonin (5HT), its metabolite 5-hydroxyindoleacetic acid, and high-affinity 5HT uptake sites. Moreover, this high-dose treatment regimen causes both selective long-lasting decreases in fine-caliber 5HT-immunoreactive axons and appearance of other 5HT-immunoreactive axons with morphology characteristic of degenerating axons...
1990: Synapse
J J Wurtman, R J Wurtman
The effects of fenfluramine and other sanorectic drugs on the consumption of both protein and total calories by rats given simultaneous access to two isocaloric diets containing 5 or 45 percent casein were examined. Anorectic doses of fenfluramine failed to decrease protein intake but increased the proportion of total dietary calories represented by protein. In contrast, anorectic doses of d-amphetamine decreased protein and calorie consumption proportionately. Subanorectic doses of fenfluramine also increased the proportion of caloric intake represented by protein among animals given prior treatment with the serotonin precursor tryptophan...
December 16, 1977: Science
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