Search

Introduction: Intraoperative radiotherapy (IORT) based on low-kV photons may be an option for early breast cancer patients. Following Targit trial results some of those patients should undergo whole breast irradiation (WBRT) additionally., Material and Methods: Since April 2010, IORT has been applied to early breast cancer patients. One hundred and fifty patients were prospectively followed up and examined to evaluate the side effects (pain, fibrosis, breast edema, telangiectasias). We present the results 3 years post-treatment. WBRT was given to 82 (54.7%) patients., Results: Tumor cavity fibrosis grade II and more was observed in 18 (12%) patients, as grade III only in 2 (1.33%) patients. Breast tissue fibrosis outside tumor cavity grade II was observed only in 2 (1.33%) patients. Breast edema was present in 10 (6.66%) patients. WBRT administration led to increased frequency of higher grade tumor cavity fibrosis (P < .0001), breast fibrosis (P < .0001), breast edema (P = .003), and occurrence of telangiectasias (P = .03), with no influence on pain reported by patients. In case of WBRT, tumor location (P = .026) and size of the irradiated breast (P = .015) were independent risk factors for higher degree of breast fibrosis, as seroma evacuation 6 months post-WBRT (P = .036) was the only independent risk factor for higher level of tumor cavity fibrosis in multiple regression., Conclusions: The cosmetic result after IORT is good and comparable to other accelerated partial breast irradiation techniques. Administration of WBRT post-IORT in breast cancer patients increases the level of fibrotic changes, breast edema and telangiectasias 3 years post-treatment, but with no influence on pain., (© 2020 Wiley Periodicals, Inc.)

This work describes the use of 3D printing technology to create individualized boluses for patients treated with electron beam therapy for skin lesions of the eye canthi. It aimed to demonstrate the effectiveness of 3D-printed over manually fabricated paraffin boluses. The study involved 11 patients for whom the construction of individual boluses were required. CT scans of the fabricated 3D-printed boluses and paraffin boluses were acquired and superimposed onto patient CT scans to compare their fitting, bolus homogeneity, and underlying dose distribution. To quantify the level of matching, multiple metrics were utilized. Matching Level Index (ML) values ranged from 0 to 100%, where 100% indicated a perfect fit between the reference bolus (planned in treatment planning system) and 3D-printed and paraffin bolus. The average ML (± 1 SD) of the 3D-printed boluses was 95.1 ± 2.1%, compared to 46.0 ± 10.1% for the manually fabricated paraffin bolus. Correspondingly, mean doses were closer to the prescribed doses, and dose spreads were less for the dose distributions from the 3D-printed boluses, as compared to those for the manually fabricated paraffin boluses. It was concluded that 3D-printing technology is a viable method for fabricating boluses for small eye lesions and provides boluses superior to our boluses manually fabricated from paraffin sheets., (© 2016 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.)

Background: Novel techniques in oncology provide new treatment opportunities but also introduce different patterns of side effects. Intraoperative radiotherapy (IORT) allows a shortened overall treatment time for early breast cancer either combined with whole breast radiotherapy (WBRT), or alone. Although the early side effects of IORT are well known, data on clinically important late side effects, which require medical intervention, are scarce., Aim: In this study, we analyze risk factors for seroma evacuation more than 6 months after IORT., Materials and Methods: We evaluated 120 patients with a mean follow-up of 27.8 months (range: 7-52 months). Fifty-one patients received IORT only and 69 were additionally treated with WBRT., Results: Seroma evacuation was performed 6-38 months after IORT. Two (3.9%) events were observed in the IORT group and 14 (20%) in the IORT + WBRT group. Univariate (Kaplan-Meier) analysis showed that addition of WBRT to IORT increased the risk of seroma evacuation [hazard ratio = 5.5, 95% confidence interval: 2.0-14.7, P = 0.011]. In a multivariate analysis (Cox proportional hazards regression), WBRT and axillary lymph node dissection were significant risk factors for seroma evacuation (model P value = 0.0025)., Conclusions: WBRT applied after IORT is associated with increased risk of seroma evacuation, which might be considered as a late side effect.

Radiotherapy plays an important role in treatment of bone metastases. , The mayor problem associated with bone metastases is pain, pathological fractures and a spinal cord compression. Radiotherapy is employed as a palliative treatment, mainly to relieve pain., 1.Radiotherapy with a single dose of 5-8 Gy/T is an efficient method of pain management especially in patients with bone metastases outside the vertebral column. This treatment can be provided as a day procedure., 2.Multi-fractionated irradiation - patients receive 20 Gy/T in 5 fractions or 30 Gy/T in 10 fractions. This is advocated for patients with metastases in the vertebral column or bones of the pelvis., 3.Half- body irradiation is designed for patients with multiple bone metastases. It's a single dose treatment. The upper half of body is irradiated with a dose of 6 Gy/T, the lower part with a dose of 8 Gy/T. Patients need a special preparation beforehand (steroids, hydratation) and hospitalization afterwards.

Results of surgery treatment from the external access and radiotherapy in early, stage of vocal cords carcinoma were presented. Clinical material consisted of 94 cases with squamous cell carcinoma of vocal cords with stage T1a and T1b treated in Szczecin University Department of Otorhinolaryngology from 1987 to 1996. 51 cases were operated on (26 by chordectomy and 25 by frontolateral laryngectomy). Radiotherapy was applied in 43 patients. The 3 and 5 years' survival rate in the surgery group was 97% and after radiotherapy 88 to 80%. The functional results were also presented. It was concluded that the mode of treatment in early stages of vocal cord carcinoma should be individualized.

Unlabelled: This study concerns the optimization of the dose distribution in all variants of combined irradiation of uterine cervix cancer which are used in our Clinic (Tab. 1). The analysis of the doses of radiation in reference points as well as isodose distribution in the whole irradiated area has been done. All variants of combined irradiation and the localization of applicators in the intracavitary irradiation and field's arrangement of external beam irradiation have been shown. The second part of the study analyzes the physical parameters in conventional intracavitary irradiation by modified Manchester method in comparison with the Selectron-LDR (Tab. 5). The dose distribution around the applicators has been compared too. The biological equivalence of the doses in application of different dose rate sources has been estimated according to the principles of LQ-model (Tab. 3, 4). Relations between the reference point doses and such parameters as the length of intrauterine sond (Fig. 2), the size of applied ovoids (Fig. 3), the distance between them (Fig. 5) and the treatment sources' positions in the ovoids (Fig. 4) have been calculated. The dose distribution in all variants of combined irradiation of uteri cervix cancer has been demonstrated (Fig. 6). Total absorbed dose in the point A, as well as in the reference points of bladder, rectum and para-aortic, external iliac and common iliac lymph nodes have been calculated (Tab. 5). The position of regional lymph nodes was defined with the use of lymphography, two orthogonal radiograms and CT. In the last part of the work, after optimization of physical irradiation parameters and their biological equivalents, the dose distribution in all variants of combined irradiation has been calculated (Fig. 7)., Conclusions: 1. The LQ-model allows to calculate the biological equivalent of total physical dose in combined irradiation when intracavitary irradiation is realised with different dose rate sources, and external beam therapy with different doses per fraction. 2. The use of the smallest ovoids in intracavitary irradiation leads to increased dose in the bladder and rectum. The use of small ovoids increases the dose only in the bladder in comparison to utilisation of medium and large ovoids. In such cases individual treatment planning is necessary. 3. The external iliac nodes are located above the points defined in the Fletcher lymphatic trapezoid. Therefore the lateral fields of pelvis lymph nodes irradiation should be at least 10 cm wide. 4. Depending on clinical advancement of uterine cervix cancer the optimisation of combined irradiation allows to obtain the desired dose in the target volume as well as in regional lymph nodes in each variant of irradiation.