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109 results on '"interventional radiotherapy"'

101. EROS study: Evaluation between high-dose-rate and low-dose-rate vaginal interventional radiotherapy (brachytherapy) in terms of overall survival and rate of stenosis

Author

Autorino, R., Tagliaferri, L., Campitelli, M., Smaniotto, D. (ORCID:0000-0002-1246-8001), Nardangeli, A., Mattiucci, G. C. (ORCID:0000-0001-6500-0413), Macchia, G., Gui, B., Micco, M., Mascilini, F., Ferrandina, G. (ORCID:0000-0003-4672-4197), Kovacs, G., Valentini, V. (ORCID:0000-0003-4637-6487), Gambacorta, M. A. (ORCID:0000-0001-5455-8737), Autorino, R., Tagliaferri, L., Campitelli, M., Smaniotto, D. (ORCID:0000-0002-1246-8001), Nardangeli, A., Mattiucci, G. C. (ORCID:0000-0001-6500-0413), Macchia, G., Gui, B., Micco, M., Mascilini, F., Ferrandina, G. (ORCID:0000-0003-4672-4197), Kovacs, G., Valentini, V. (ORCID:0000-0003-4637-6487), and Gambacorta, M. A. (ORCID:0000-0001-5455-8737)

Abstract

Purpose: To compare the survival and toxicity outcomes in patients with endometrial cancer treated with either high-dose-rate (HDR) or low-dose-rate (LDR) vaginal brachytherapy (VBT) following external beam radiotherapy (EBRT). Material and methods: From January 2000 to December 2014, patients with endometrial cancer after radical hysterectomy with/without pelvic and/or para-aortic lymphadenectomy were treated with adjuvant EBRT (45 Gy, 1.8 Gy/ day to the whole pelvis) and subsequent VBT boost (HDR dose of 7 Gy in one fraction or LDR VBT dose of 25 Gy). The dose was prescribed at 0.5 cm from the surface of the applicator and the proximal half to two-thirds of the vagina was irradiated. The outcomes of patients were evaluated in terms of local control (LC), overall survival (OS), and rates of adverse events. Results: We analyzed data of 200 patients treated with EBRT followed by HDR VBT boost in 78 patients and LDR VBT boost in 122 patients. With a median follow-up of 25 months (range, 6-163), 5-year OS was 98% and 97% in the LDR and HDR groups, respectively (p = 0.37). The 5-year LC was similar (93% in both groups) (p = 0.81). In multivariate analyses, none of the factors assessed (age, stage, grade) impacted OS (p = 0.37) or LC (p = 0.81). Patients treated with LDR VBT after EBRT had higher rates of acute gastrointestinal toxicity. No differences were found in acute genitourinary or hematological toxicities. Late toxicity such as vaginal stenosis was registered during regular follow-up visits and was similar in the two groups (p = 0.67). Conclusions: In our analysis, there were no differences in terms of OS and late toxicity outcomes for patients receiving LDR or HDR VBT. HDR VBT is a safe technique in comparison to LDR VBT.

Published
2018

102. Ruthenium brachytherapy for uveal melanomas: Factors affecting the development of radiation complications

Author

Pagliara, Monica Maria, Tagliaferri, Luca, Azario, Luigi, Lenkowicz, Jacopo, Lanza, Angela, Autorino, Rosa, Caputo, Carmela Grazia, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Blasi, Maria Antonietta, Pagliara, Monica M., Tagliaferri, Luca (ORCID:0000-0003-2308-0982), Azario, Luigi (ORCID:0000-0001-8575-8627), Caputo, Carmela G., Gambacorta, Maria A. (ORCID:0000-0001-5455-8737), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Blasi, Maria A. (ORCID:0000-0001-7393-7644), Pagliara, Monica Maria, Tagliaferri, Luca, Azario, Luigi, Lenkowicz, Jacopo, Lanza, Angela, Autorino, Rosa, Caputo, Carmela Grazia, Gambacorta, Maria Antonietta, Valentini, Vincenzo, Blasi, Maria Antonietta, Pagliara, Monica M., Tagliaferri, Luca (ORCID:0000-0003-2308-0982), Azario, Luigi (ORCID:0000-0001-8575-8627), Caputo, Carmela G., Gambacorta, Maria A. (ORCID:0000-0001-5455-8737), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), and Blasi, Maria A. (ORCID:0000-0001-7393-7644)

Abstract

Purpose: To investigate how treatment complications are related to dosimetric parameters after ruthenium-106 brachytherapy for uveal melanoma, in a large, clinically homogeneous population. Methods and Materials: A retrospective review was performed to evaluate patients affected by small and medium size uveal melanoma, treated with ruthenium-106 brachytherapy from December 2006 to December 2014. We excluded tumors with posterior margin within 1 mm from the edge of the optic disc and foveola. Main outcome measures were occurrence and time to radiation-related maculopathy, cataract, and optic neuropathy. Secondary end points included local recurrence and distant metastases. Kaplan-Meier analysis with log-rank test and univariate Cox proportional hazards model at 3 years were performed to identify the covariates affecting the outcome of radiation complications. Results: Two hundred thirty-nine patients, with sufficient data to evaluate the end points, were enrolled. Three years after plaque treatment, radiation maculopathy was found in 61 (25.5%) patients, cataract developed in 10 patients (4.2%) receiving a dose of 27 Gy or higher to the lens, and optic neuropathy was observed in 13 patients (5.4%) with an optic nerve dose exceeding 50 Gy and tumor proximity to optic disc of less than 4 mm. Tumor recurrences and tumor-related metastasis were found respectively in 20 (8.36%) and 14 (5.85%) patients. Conclusions: Radiation maculopathy occurs within a median time of 31 months in 25% of cases after plaque treatment for uveal melanoma. The most significant risk factors are total dose and distance of tumor margin from the fovea. If the distance is greater than 11.22 mm, no signs of retinal damage are detected.

Published
2018

103. EROS study: Evaluation between high-dose-rate and low-dose-rate vaginal interventional radiotherapy (brachytherapy) in terms of overall survival and rate of stenosis

Author

Gabriella Macchia, Maura Miccò, Alessia Nardangeli, Maria Antonietta Gambacorta, Gabriella Ferrandina, Floriana Mascilini, M. Campitelli, Daniela Smaniotto, Rosa Autorino, György Kovács, Vincenzo Valentini, Benedetta Gui, Gian Carlo Mattiucci, and Luca Tagliaferri

Subjects
0106 biological sciences, medicine.medical_specialty, medicine.medical_treatment, Brachytherapy, Urology, Endometrial cancer, Interventional radiotherapy, Vaginal stenosis, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, medicine, Radiology, Nuclear Medicine and imaging, External beam radiotherapy, Stage (cooking), Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, business.industry, medicine.disease, Radiation therapy, Stenosis, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Vagina, Lymphadenectomy, business, 010606 plant biology & botany
Abstract

Purpose To compare the survival and toxicity outcomes in patients with endometrial cancer treated with either high-dose-rate (HDR) or low-dose-rate (LDR) vaginal brachytherapy (VBT) following external beam radiotherapy (EBRT). Material and methods From January 2000 to December 2014, patients with endometrial cancer after radical hysterectomy with/without pelvic and/or para-aortic lymphadenectomy were treated with adjuvant EBRT (45 Gy, 1.8 Gy/day to the whole pelvis) and subsequent VBT boost (HDR dose of 7 Gy in one fraction or LDR VBT dose of 25 Gy). The dose was prescribed at 0.5 cm from the surface of the applicator and the proximal half to two-thirds of the vagina was irradiated. The outcomes of patients were evaluated in terms of local control (LC), overall survival (OS), and rates of adverse events. Results We analyzed data of 200 patients treated with EBRT followed by HDR VBT boost in 78 patients and LDR VBT boost in 122 patients. With a median follow-up of 25 months (range, 6-163), 5-year OS was 98% and 97% in the LDR and HDR groups, respectively (p = 0.37). The 5-year LC was similar (93% in both groups) (p = 0.81). In multivariate analyses, none of the factors assessed (age, stage, grade) impacted OS (p = 0.37) or LC (p = 0.81). Patients treated with LDR VBT after EBRT had higher rates of acute gastrointestinal toxicity. No differences were found in acute genitourinary or hematological toxicities. Late toxicity such as vaginal stenosis was registered during regular follow-up visits and was similar in the two groups (p = 0.67). Conclusions In our analysis, there were no differences in terms of OS and late toxicity outcomes for patients receiving LDR or HDR VBT. HDR VBT is a safe technique in comparison to LDR VBT.

Published
2018

104. Quality Assurance in Modern Gynecological HDR-Brachytherapy (Interventional Radiotherapy): Clinical Considerations and Comments.

Author

Soror, Tamer, Siebert, Frank-André, Lancellotta, Valentina, Placidi, Elisa, Fionda, Bruno, Tagliaferri, Luca, Kovács, György, and Dinulescu, Daniela M.

Subjects
*SURVIVAL, *INTERVENTIONAL radiology, *QUALITY assurance, *RADIOISOTOPE brachytherapy, *FEMALE reproductive organ tumors
Abstract

Simple Summary: This is a focused review discussing quality assurance during interventional brachytherapy in gynecological cancers. This topic is very large and is usually addressed from the technical and physical sides, therefore, we decided to select "hot-spots" under this large title and discuss them from the point of view of clinicians. We hope that this concise and focused review will help clinicians in improving their quality assurance protocols and draw attention to the discussed issues. The use of brachytherapy (interventional radiotherapy) in the treatment of gynecological cancers is a crucial element in both definitive and adjuvant settings. The recent developments in high-dose rate remote afterloaders, modern applicators, treatment-planning software, image guidance, and dose monitoring systems have led to improvement in the local control rates and in some cases improved the survival rates. The development of these highly advanced and complicated treatment modalities has been accompanied by challenges, which have made the existence of quality assurance protocols a must to ensure the integrity of the treatment process. Quality assurance aims at standardizing the technical and clinical procedures involved in the treatment of patients, which could eventually decrease the source of uncertainties whether technical (source/equipment related) or clinical. This commentary review sheds light (from a clinical point of view) on some potential sources of uncertainties associated with the use of modern brachytherapy in the treatment of gynecological cancers. [ABSTRACT FROM AUTHOR]

Published
2021
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106. Interventional radiotherapy (brachytherapy) achieves very good long-term quality of life in children and adolescents with soft-tissue sarcoma.

Author

Sütterlin AL, Demmert M, Kovács G, Claviez A, Schulz C, and Lauten M

Subjects
Adolescent, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Male, Prognosis, Retrospective Studies, Sarcoma pathology, Survival Rate, Brachytherapy mortality, Quality of Life, Sarcoma radiotherapy
Abstract

Background: Effective local therapy (surgery, radiation) and systemic multidrug chemotherapy are mandatory for curing childhood sarcoma. The standard radiation therapy for pediatric patients with soft-tissue sarcoma (STS) is external beam radiotherapy (EBRT). Because EBRT may cause long-term side effects with adverse effects on the patients' health and quality of life (QoL), alternative strategies are required. Interventional radiotherapy (IRT; brachytherapy) is established as a standard treatment for several tumors in adulthood. Single-center series have reported low levels of late effects and improved QoL in survivors treated with IRT in childhood. However, IRT is still applied infrequently in pediatric patients., Methods: Thirty patients with STS were treated with IRT between 1992 and 2012 at the University Hospital Schleswig Holstein, Germany. Five patients were lost to follow-up, and 25 patients (mean age at time of data collection 24.8 years [range, 10.7-36.1]) could be analyzed focusing on overall survival and QoL (EORTC-C30 questionnaire). For more detailed information regarding general and health-specific questions, a separate questionnaire was developed., Results: Nineteen of 25 patients were alive 13.4 [1.6-25.2] years after first cancer disease, and the three-year overall survival was 76% (SE, 0.09). The score of QoL/global health status (76.2 [16.6-100]) in our patients outvalues the European (66.1) and equals the German (75.9) reference value., Conclusion: IRT is an effective treatment option for pediatric patients with localized STS. Its role among other radiation dose-sparing techniques such as proton beam therapy has to be defined in prospective studies., (© 2020 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.)

Published
2020
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107. PO-1045 Retreatment using Ru-106 or I-125 plaque in uveal melanoma locally recurrent after brachytherapy

Author

Tagliaferri, L. (Luca)

Subjects
Brachytherapy, Interventional Radiotherapy, Ruthenium-106, Oncology
Abstract

Purpose or Objective:To present the results of a patient therapeutic approach using a second course of Interventional Radiotherapy (Brachytherapy) in a setting of patients with local recurrence of uveal melanoma. Material and Methods: Patients who had already undergone ocular brachytherapy at IOC (Interventional Oncology Center) of the “Gemelli ART” (Advanced Radiation Therapy) of Rome were considered. In this group, five patients with a local recurrence that received a second course of treatment with a plaque were included in our analysis. The reirradiation was performed with a plaque of Ruthenium-106 (dose prescribed to the apex 100 Gy) or of Iodine-125 (dose prescribed to the apex 85Gy).

Published
2019

108. HDR interventional radiotherapy (brachytherapy) in the treatment of primary and recurrent head and neck malignancies.

Author

Bussu F, Tagliaferri L, Mattiucci G, Parrilla C, Rizzo D, Gambacorta MA, Lancellotta V, Autorino R, Fonnesu C, Kihlgren C, Galli J, Paludetti G, Kovács G, and Valentini V

Subjects
Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Head and Neck Neoplasms mortality, Head and Neck Neoplasms pathology, Humans, Male, Middle Aged, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local pathology, Prognosis, Radiotherapy Dosage, Radiotherapy, Adjuvant, Brachytherapy, Head and Neck Neoplasms therapy, Neoplasm Recurrence, Local therapy
Abstract

Background: Interventional radiotherapy (brachytherapy; IRT) reemerged in the last decades as a potentially useful tool in head and neck oncology after a set of clear technical improvements were developed., Methods: Sixty-one high dose ratio (HDR) IRT treatments were recommended and performed on 58 patients. We classified the cases into four relatively homogeneous groups based on the clinical needs that led to the recommended IRT. Also, we separately evaluated primary and recurrent cases., Results: Disease-specific survival was significantly different among the four treatment groups. The group with the best prognosis was the cohort treated locally by exclusive interstitial IRT for resectable midface malignancies (2-year relapse-free survival = 82%, disease-specific survival = 89%)., Conclusion: HDR IRT is a valuable tool in well-defined clinical situations and, in particular, in recurrences. In midface malignancies, it could become the preferred primary treatment., (© 2019 Wiley Periodicals, Inc.)

Published
2019
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109. The role of personalized Interventional Radiotherapy (brachytherapy) in the management of older patients with non-melanoma skin cancer.

Author

Lancellotta V, Kovács G, Tagliaferri L, Perrucci E, Rembielak A, Stingeni L, Tramontana M, Hansel K, Colloca G, Saldi S, Valentini V, and Aristei C

Subjects
Aged, Aged, 80 and over, Carcinoma, Basal Cell diagnostic imaging, Carcinoma, Basal Cell pathology, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell pathology, Female, Frail Elderly, Humans, Male, Radiotherapy Dosage, Skin Neoplasms diagnostic imaging, Skin Neoplasms pathology, Treatment Outcome, Brachytherapy methods, Carcinoma, Basal Cell radiotherapy, Carcinoma, Squamous Cell radiotherapy, Skin Neoplasms radiotherapy
Abstract

Objective: Non-melanoma skin cancer (NMSC) has been rapidly increasing in incidence over the past 30 years. Mainstays of treatment remain surgery and radiotherapy, particularly in older and/or frail patients (≥75 years old) that often require a personalized treatment strategy using innovative biotechnologies. High-dose-rate interventional radiotherapy (HDR-IRT) seems to be an excellent option for NMSC., Material and Methods: Nineteen aged patients with advanced, biopsy proven NMSC were treated with exclusively HDR-IRT. A personalized double-layer mould of thermoplastic mask material was applied to the skin surface. Plastic tubes were fixed on the mould in appropriate geometry over the target area. Planning computed tomography (CT) images were acquired with 2.5 mm slice thickness and transmitted to the planning system. Treatment intention was to deliver ≥95% of the prescribed dose to the Planning Target Volume (PTV), accepting 90% as satisfactory. Toxicities were assessed using the Common Terminology Criteria for Adverse Events scale (CTCAE) v. 4.0., Results: Median age was 86 years. Acute toxicity: Grade 2 erythema appeared in all 19 patients. Towards the end of each treatment schedule, epidermolysis developed which was resolved within 6 weeks of completing HDR-IRT. Late toxicity: Grade 1 skin atrophy, pigmentation changes and alopecia in field were observed in all patients. At last follow-up, all patients were disease free., Conclusions: Personalized HDR-IRT appears to be safe and effective for frail older patients and a valid alternative to supportive care for those with contraindication to surgery. Future investigations using also large database analysis seem to be advisory., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Published
2019
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