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radiation therapy urgency

Jeong-Eun Lee, Kyung-Hwa Kwak, Seong Wook Hong, Hoon Jung, Seung-Yeon Chung, Jun-Mo Park
Adjuvant radiation therapy (RT) after colorectal cancer surgery can prevent local recurrence, but has several side effects. Precise injection of drugs into the affected areas is complicated by radiation-induced fibrosis of soft or connective tissue. A 48-year-old woman experienced severe intractable perineal pain, dysuria, urinary urgency, and frequent urination after rectal cancer surgery and adjuvant RT, and was diagnosed with radiation-induced cystitis and vulvodynia. Her symptoms persisted despite two fluoroscopy-guided ganglion impar blocks...
February 2017: Korean Journal of Anesthesiology
Brandyn A Castro, Ruby Kuang, Priscilla K Brastianos
Metastases to the brain are a common complication of various cancers and are associated with poor prognosis. Management of these patients requires a multidisciplinary approach including whole-brain radiation therapy, stereotactic radiosurgery, surgical resection, chemotherapy, and supportive treatment. Because of recent technological advancements in genomics, our understanding of the genetics of brain metastases is rapidly advancing. This has led to the discovery of many potential genetic therapeutic targets in metastatic brain lesions...
November 2016: Discovery Medicine
Karen E Hoffman, Heath Skinner, Thomas J Pugh, Khinh R Voong, Lawrence B Levy, Seungtaek Choi, Steven J Frank, Andrew K Lee, Usama Mahmood, Sean E McGuire, Pamela J Schlembach, Weiliang Du, Jennifer Johnson, Rajat J Kudchadker, Deborah A Kuban
OBJECTIVES: Hypofractionated prostate radiotherapy may increase biologically effective dose delivered while shortening treatment duration, but information on patient-reported urinary, bowel, and sexual function after dose-escalated hypofractionated radiotherapy is limited. We report patient-reported outcomes (PROs) from a randomized trial comparing hypofractionated and conventional prostate radiotherapy. METHODS: Men with localized prostate cancer were enrolled in a trial that randomized men to either conventionally fractionated intensity-modulated radiation therapy (CIMRT, 75...
September 15, 2016: American Journal of Clinical Oncology
Lawrence R Schiller, Darrell S Pardi, Joseph H Sellin
Chronic diarrhea is a common problem affecting up to 5% of the population at a given time. Patients vary in their definition of diarrhea, citing loose stool consistency, increased frequency, urgency of bowel movements, or incontinence as key symptoms. Physicians have used increased frequency of defecation or increased stool weight as major criteria and distinguish acute diarrhea, often due to self-limited, acute infections, from chronic diarrhea, which has a broader differential diagnosis, by duration of symptoms; 4 weeks is a frequently used cutoff...
February 2017: Clinical Gastroenterology and Hepatology
G D'Agostino, C Franzese, F De Rose, D Franceschini, T Comito, E Villa, F Alongi, R Liardo, S Tomatis, P Navarria, P Mancosu, G Reggiori, L Cozzi, M Scorsetti
AIMS: The aim of this phase II study was to evaluate the efficacy and toxicity of stereotactic body radiotherapy in patients with low or intermediate risk prostate cancer. MATERIALS AND METHODS: Biopsy-confirmed prostate cancer patients were enrolled, provided that they had the following characteristics: initial prostate-specific antigen (PSA) ≤ 20 ng/ml, Gleason Score < 7, International Prostate Symptom Score < 7. The treatment schedule was 35 Gy in five fractions, delivered with volumetric modulated arcs with flattening filter free beams...
July 4, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Gregory W Hosier, Karthik K Tennankore, Jeffrey G Himmelman, Jerzy Gajewski, Ashley R Cox
OBJECTIVE: To describe the rate of overactive bladder (OAB) and storage lower urinary tract symptoms following radical prostatectomy (RP) and determine if subsequent radiation increases the risk of OAB. METHODS: We reviewed all patients who underwent open RP at our tertiary care institution from January 2006 to June 2011. Primary outcomes were the proportion of patients with new OAB and time to development of OAB in those treated with RP alone vs RP plus radiation...
August 2016: Urology
Fleur T van de Wetering, Leen Verleye, H Jervoise N Andreyev, Jane Maher, Joan Vlayen, Bradley R Pieters, Geertjan van Tienhoven, Rob J P M Scholten
BACKGROUND: This is an update of a Cochrane review first published in 2002, and previously updated in 2007. Late radiation rectal problems (proctopathy) include bleeding, pain, faecal urgency, and incontinence and may develop after pelvic radiotherapy treatment for cancer. OBJECTIVES: To assess the effectiveness and safety of non-surgical interventions for managing late radiation proctopathy. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 11, 2015); MEDLINE (Ovid); EMBASE (Ovid); CANCERCD; Science Citation Index; and CINAHL from inception to November 2015...
April 25, 2016: Cochrane Database of Systematic Reviews
Maha Saada Jawad, Joshua T Dilworth, Gary S Gustafson, Hong Ye, Michelle Wallace, Alvaro Martinez, Peter Y Chen, Daniel J Krauss
PURPOSE: We report the outcomes associated with 3 high-dose-rate (HDR) brachytherapy regimens used as monotherapy for favorable-risk prostate cancer. METHODS AND MATERIALS: Four hundred ninety-four patients with stage ≤T2b prostate cancer, Gleason score ≤7, and prostate-specific antigen levels ≤15 ng/mL underwent HDR brachytherapy as monotherapy. Of those, 319 received 38 Gy in 4 fractions, 79 received 24 Gy in 2 fractions, and 96 received 27 Gy in 2 fractions...
March 15, 2016: International Journal of Radiation Oncology, Biology, Physics
N E Samalavicius, A Dulskas, M Lasinskas, G Smailyte
BACKGROUND: Up to 90 % of patients undergoing low anterior resection complain of increased daily bowel movements, urgency, and a variable degree of incontinence. A symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer has recently been developed and validated. The aim of our study was to adapt the low anterior resection syndrome (LARS) scale questionnaire to the Lithuanian language, and assess its psychometric properties. METHODS: The LARS questionnaire was translated into Lithuanian by the Scientific Advisory Committee of the Medical Outcomes Trust using a standard procedure of double-back translation...
April 2016: Techniques in Coloproctology
Zhonglin Liang, Wenjun Ding, Wei Chen, Zhongchuan Wang, Peng Du, Long Cui
BACKGROUND: Anterior resection syndrome (ARS) is common after sphincter-saving surgery for rectal cancer. It includes changes in the frequency and urgency of bowel movements and fecal incontinence. The therapeutic efficacy of biofeedback on ARS is unclear. We sought to evaluate the effectiveness of biofeedback therapy in patients with ARS after anterior resection for rectal cancer and to investigate the associated factors for therapeutic success. PATIENTS AND METHODS: The study was designed as a retrospective review of the data from 61 patients with ARS collected from a prospectively maintained institutional cancer database...
September 2016: Clinical Colorectal Cancer
Elie Mulhem, Nikolaus Fulbright, Norah Duncan
Among American men, prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death. Although prostate-specific antigen (PSA) testing has been used to screen for prostate cancer for more than 25 years, the test has low sensitivity and specificity, and there is no clear evidence for determining what threshold warrants prostate biopsy. Only one of five randomized controlled trials of PSA screening showed an effect on prostate cancer-specific mortality, and the absolute reduction in deaths from prostate cancer was one per 781 men screened after 13 years of follow-up...
October 15, 2015: American Family Physician
Stephanie M de Boer, Remi A Nout, Ina M Jürgenliemk-Schulz, Jan J Jobsen, Ludy C H W Lutgens, Elzbieta M van der Steen-Banasik, Jan Willem M Mens, Annerie Slot, Marika C Stenfert Kroese, Simone Oerlemans, Hein Putter, Karen W Verhoeven-Adema, Hans W Nijman, Carien L Creutzberg
PURPOSE: To evaluate the long-term health-related quality of life (HRQL) after external beam radiation therapy (EBRT) or vaginal brachytherapy (VBT) among PORTEC-2 trial patients, evaluate long-term bowel and bladder symptoms, and assess the impact of cancer on these endometrial cancer (EC) survivors. PATIENTS AND METHODS: In the PORTEC-2 trial, 427 patients with stage I high-intermediate-risk EC were randomly allocated to EBRT or VBT. The 7- and 10-year HRQL questionnaires consisted of EORTC QLQ-C30; subscales for bowel and bladder symptoms; the Impact of Cancer Questionnaire; and 14 questions on comorbidities, walking aids, and incontinence pads...
November 15, 2015: International Journal of Radiation Oncology, Biology, Physics
Xavier Liem, Fred Saad, Guila Delouya
Radiation-induced hemorrhagic cystitis (HC) is a complication of pelvic radiotherapy, mainly for prostate and uterine cancers. In the acute phase, patients feel urinary urgency and bladder pain. This phase is reversible after radiotherapy. In the chronic stage, an irritative syndrome is coupled with hematuria during the 2-10 years following radiotherapy. Cystoscopy shows white and frosted mucosa with telangiectasia. The incidence is estimated at 5 % or less. It is suggested that the radiation oncologist reviews the dosimetry plan to validate that the lesions coincide with significant radiation exposure confirming diagnosis of radiation-induced HC...
September 2015: Drugs
Alexandra Gilbert, Lucy Ziegler, Maisie Martland, Susan Davidson, Fabio Efficace, David Sebag-Montefiore, Galina Velikova
The use of multimodal treatments for rectal cancer has improved cancer-related outcomes but makes monitoring toxicity challenging. Optimizing future radiation therapy regimens requires collection and publication of detailed toxicity data. This review evaluated the quality of toxicity information provided in randomized controlled trials (RCTs) of radiation therapy in rectal cancer and focused on the difference between clinician-reported and patient-reported toxicity. Medline, EMBASE, and the Cochrane Library were searched (January 1995-July 2013) for RCTs reporting late toxicity in patients treated with regimens including preoperative (chemo)radiation therapy...
July 1, 2015: International Journal of Radiation Oncology, Biology, Physics
Mattia F Osti, Luca Nicosia, Linda Agolli, Giovanna Gentile, Teresa Falco, Stefano Bracci, Francesco Di Nardo, Giuseppe Minniti, Vitaliana De Sanctis, Maurizio Valeriani, Marianna Maglio, Marina Borro, Maurizio Simmaco, Riccardo M Enrici
OBJECTIVES: To investigate the association between polymorphisms of DNA repair genes and xenobiotic with acute adverse effects in locally advanced rectal cancer patients treated with neoadjuvant radiochemotherapy. METHODS: Sixty-seven patients were analyzed for the current study. Genotypes in DNA repair genes XRCC1 (G28152A), XRCC3 (A4541G), XRCC3 (C18067T), RAD51 (G315C), and GSTP1 (A313G) were determined by pyrosequencing technology. RESULTS: The observed grade ≥3 acute toxicity rates were 23...
March 24, 2015: American Journal of Clinical Oncology
Nikesh Thiruchelvam, Francesco Cruz, Mike Kirby, Andrea Tubaro, Christopher R Chapple, Karl-Dietrich Sievert
There are various forms of treatment for prostate cancer. In addition to oncologic outcomes, physicians, and increasingly patients, are focusing on functional and adverse outcomes. Symptoms of overactive bladder (OAB), including urinary frequency, urgency and incontinence, can occur regardless of treatment modality. This article examines the prevalence, pathophysiology and options for treating OAB after radical prostate cancer treatment. OAB seems to be more common and severe after radiation therapy than after surgical therapy and even persisted longer with complications, suggesting an advantage for surgery over radiotherapy...
December 2015: BJU International
Jennifer M Levine, Joanne Frankel Kelvin, Gwendolyn P Quinn, Clarisa R Gracia
Improved survival rates among reproductive-age females diagnosed with cancer have increased the focus on long-term quality of life, including maintenance of the ability to conceive biological children. Cancer-directed therapies such as high-dose alkylating agents and radiation to the pelvis, which deplete ovarian reserve, radiation to the brain, which affects the hypothalamic-pituitary-gonadal axis, and surgical resection of reproductive structures can decrease the likelihood of having biological children. Standard fertility preservation strategies such as embryo and oocyte cryopreservation before the onset of therapy offer the opportunity to conserve fertility, but they may not be feasible because of the urgency to start cancer therapy, financial limitations, and a lack of access to reproductive endocrinologists...
May 15, 2015: Cancer
Martin A Ebert, Kerwyn Foo, Annette Haworth, Sarah L Gulliford, Angel Kennedy, David J Joseph, James W Denham
PURPOSE: To use a high-quality multicenter trial dataset to determine dose-volume effects for gastrointestinal (GI) toxicity following radiation therapy for prostate carcinoma. Influential dose-volume histogram regions were to be determined as functions of dose, anatomical location, toxicity, and clinical endpoint. METHODS AND MATERIALS: Planning datasets for 754 participants in the TROG 03.04 RADAR trial were available, with Late Effects of Normal Tissues (LENT) Subjective, Objective, Management, and Analytic (SOMA) toxicity assessment to a median of 72 months...
March 1, 2015: International Journal of Radiation Oncology, Biology, Physics
Anish Patel, Rahul Pathak, Vrushak Deshpande, Sunil H Patel, Prasanna C Wickremesinghe, Deepak Vadada
Radiation proctopathy is a complication of pelvic radiotherapy, which occurs in patients treated for carcinoma of the prostate, rectum, urinary bladder, cervix, uterus, and testes. If it presents within 6 weeks to 9 months after therapy, it is called acute radiation proctitis/proctopathy (ARP), and if it occurs 9 months to a year after treatment, it is classified as chronic radiation proctitis/proctopathy (CRP). CRP occurs in 5%-20% of patients receiving pelvic radiation, depending on the radiation dose and the presence or absence of chemotherapy...
2014: Clinical and Experimental Gastroenterology
Daniel Y Joh, Leonard N Chen, Gerald Porter, Aditi Bhagat, Sumit Sood, Joy S Kim, Rudy Moures, Thomas Yung, Siyuan Lei, Brian T Collins, Andrew W Ju, Simeng Suy, John Carroll, John H Lynch, Anatoly Dritschilo, Sean P Collins
BACKGROUND: Proctitis after radiation therapy for prostate cancer remains an ongoing clinical challenge and critical quality of life issue. SBRT could minimize rectal toxicity by reducing the volume of rectum receiving high radiation doses and offers the potential radiobiologic benefits of hypofractionation. This study sought to evaluate the incidence and severity of proctitis following SBRT for prostate cancer. METHODS: Between February 2008 and July 2011, 269 men with clinically localized prostate cancer were treated definitively with SBRT monotherapy at Georgetown University Hospital...
2014: Radiation Oncology
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