Technology in cancer research & treatment
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Technol. Cancer Res. Treat. · Dec 2011
Comparative StudyComparison of internal target volumes for hepatocellular carcinoma defined using 3DCT with active breathing coordinator and 4DCT.
The aim of this paper is to study the feasibility for determining the individual internal target volume (ITV) for hepatocellular carcinoma (HCC) using 3DCT associated with active breathing coordinator (ABC), comparing the ITVs defined by 3DCT associated with ABC and 4DCT. Thirteen patients with HCC after transarterial chemoembolization (TACE) treatment underwent 4DCT simulation and 3DCT simulation associated with ABC in free breathing (FB), end inspiration hold (EIH) and end expiration hold (EEH). The 4DCT images were sorted into 10 phases according to the respiratory cycle and labeled as CT(0), CT(10)... ⋯ The three ITVs were larger than the GTV(MIP) (P < 0.05), but there was no significant difference among three ITVs. It's similar to the differences both in the margins of three dimensions from GTV(FB) to ITV(1-3) and in the volumes among ITV(FB-1), ITV(FB-2) and ITV(FB-3) (P > 0.05). This study shows that it's safe and feasible to determine the individual ITV for HCC using 3DCT associated with ABC in comparison with 4DCT.
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Technol. Cancer Res. Treat. · Oct 2011
Case ReportsElectrochemotherapy: a new technological approach in treatment of metastases in the liver.
Electrochemotherapy is now in development for treatment of deep-seated tumors, like in bones and internal organs, such as liver. The technology is available with a newly developed electric pulse generator and long needle electrodes; however the procedures for the treatment are not standardized yet. In order to describe the treatment procedure, including treatment planning, within the ongoing clinical study, a case of successful treatment of a solitary metastasis in the liver of colorectal cancer is presented. ⋯ The patient is disease-free 16 months after the procedure. In conclusion, treatment procedure for electrochemotherapy proved to be a feasible technological approach for treatment of liver metastasis. Due to the absence of the side effects and the first complete destruction of the treated tumor, treatment procedure for electrochemotherapy seems to be a safe method for treatment of liver metastases with good treatment effectiveness even in difficult-to-reach locations.
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Technol. Cancer Res. Treat. · Jun 2011
Investigating the clinical aspects of using CT vs. CT-MRI images during organ delineation and treatment planning in prostate cancer radiotherapy.
In order to apply highly conformal dose distributions, which are characterized by steep dose fall-offs, it is necessary to know the exact target location and extension. This study aims at evaluating the impact of using combined CT-MRI images in organ delineation compared to using CT images alone, on the clinical results. For 10 prostate cancer patients, the respective CT and MRI images at treatment position were acquired. ⋯ According to these results, the expected clinical effectiveness of IMRT can be increased by a maximum ΔP(+) of around 0.9%, whereas of 3D-CRT by about 4.2% when combined CT-MRI delineation is performed instead of using CT images alone. It is apparent that in both IMRT and 3D-CRT radiation modalities, the better knowledge of the CTV extension improved the produced dose distribution. It is shown that the CTV is irradiated more effectively, while the complication probabilities of bladder and rectum, which is the principal organs at risk, are lower in the CT-MRI based treatment plans.
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Technol. Cancer Res. Treat. · Feb 2011
Radiobiological and dosimetric analysis of daily megavoltage CT registration on adaptive radiotherapy with Helical Tomotherapy.
Pre-treatment patient repositioning in highly conformal image-guided radiation therapy modalities is a prerequisite for reducing setup uncertainties. In Helical Tomotherapy (HT) treatment, a megavoltage CT (MVCT) image is usually acquired to evaluate daily changes in the patient's internal anatomy and setup position. This MVCT image is subsequently compared to the kilovoltage CT (kVCT) study that was used for dosimetric planning, by applying a registration process. ⋯ Our analysis showed that the very good daily patient setup and dose delivery were very close to the intended ones. With the exception of the pancreas cancer case, the deviations observed between the dose distributions with and without patient setup correction were within ±2% in terms of P(+). In the radiobiologically optimized dose distributions, the role of patient setup correction using MVCT images could appear to be more important than in the cases of dosimetrically optimized treatment plans were the individual tissue radiosensitivities are not precisely considered.
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Technol. Cancer Res. Treat. · Dec 2010
Clinical TrialStereotactic body radiotherapy as boost for organ-confined prostate cancer.
Stereotactic body radiotherapy (SBRT) boost following external beam radiation therapy (EBRT) for advanced localized prostate cancer may reduce toxicity while escalating the dose. We present preliminary biochemical control and urinary, rectal and sexual toxicities for 73 patients treated with SBRT as a boost to EBRT. Forty-one intermediate- and 32 high-risk localized prostate cancer patients received 45 Gy EBRT with SBRT boost. ⋯ SBRT boost for prostate cancer treatment is safe and feasible with minimal acute toxicity. At 33 months late toxicity and biochemical control are promising. Long-term durability of these findings remains to be established.