• Title/Summary/Keyword: Therapeutic oncology

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The using of megavoltage computed tomography in image-guided brachytherapy for cervical cancer: a case report

  • Tharavichitkul, Ekkasit;Janla-or, Suwapim;Wanwilairat, Somsak;Chakrabandhu, Somvilai;Klunklin, Pitchayaponne;Onchan, Wimrak;Supawongwattana, Bongkot;Galalae, Razvan M.;Chitapanarux, Imjai
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.155-159
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    • 2015
  • We present a case of cervical cancer treated by concurrent chemoradiation. In radiation therapy part, the combination of the whole pelvic helical tomotherapy plus image-guided brachytherapy with megavoltage computed tomography of helical tomotherapy was performed. We propose this therapeutic approach could be considered in a curative setting in some problematic situation as our institution.

Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography for patients with Roux-en-Y gastric bypass anatomy: technical overview

  • Hirokazu Honda;Jeffrey D. Mosko;Ryosuke Kobayashi;Andras Fecso;Bong Sik Kim;Schoeman Scott;Gary R. May
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.736-741
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    • 2022
  • Endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y gastric bypass anatomy is a well-documented challenge. Traditionally, this problem has been overcome with adjunctive techniques, such as device-assisted ERCP, including double-balloon or single-balloon enteroscopy and laparoscopy-assisted transgastric ERCP. Endoscopic ultrasound-directed transgastric ERCP (EDGE) is a novel technique that enables access to the ampulla using a duodenoscope without surgical intervention and has shown high clinical and technical success rates in recent studies. However, this approach is technically demanding, necessitating a thorough understanding of the gastrointestinal anatomy as well as high operator experience. In this review, we provide a technical overview of EDGE in parallel with our personal experience at our center and propose a simple algorithm to select patients for its appropriate application. In conjunction, the outcomes of EDGE compared with those of device-assisted and laparoscopy-assisted transgastric ERCP will be discussed.

Anticancer Therapy for Breast Cancer Patients with Skin Metastases Refractory to Conventional Treatments

  • Varol, Umut;Yildiz, Ibrahim;Alacacioglu, Ahmet;Uslu, Ruchan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1885-1887
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    • 2014
  • Skin metastases of breast cancer are usually late events in the course of tumor progression and signify a poor prognosis. They may remain as a therapeutic challenge especially after failure of standard treatments. Topical interventions, together with or without radiotherapy, may only palliate the symptoms temporarily. However, there may be alternative treatment modalities for unresectable breast cancer skin metastases resistant to chemotherapy and radiotherapy. There are various genetic alterations in tumors and therapeutic potential of expression patterns for factors like epidermal growth factor receptor may have important clinical implications in case of disease refractory to the conventional treatments. Here, we clarified the therapeutic options and genetic alterations in skin metastatic breast cancer patients refractory to standard chemotherapeutics.

Novel biological strategies to enhance the radiation therapeutic ratio

  • Kim, Jae Ho;Jenrow, Kenneth A.;Brown, Stephen L.
    • Radiation Oncology Journal
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    • v.36 no.3
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    • pp.172-181
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    • 2018
  • Successful anticancer strategies require a differential response between tumor and normal tissue (i.e., a therapeutic ratio). In fact, improving the effectiveness of a cancer therapeutic is of no clinical value in the absence of a significant increase in the differential response between tumor and normal tissue. Although radiation dose escalation with the use of intensity modulated radiation therapy has permitted the maximum tolerable dose for most locally advanced cancers, improvements in tumor control without damaging normal adjacent tissues are needed. As a means of increasing the therapeutic ratio, several new approaches are under development. Drugs targeting signal transduction pathways in cancer progression and more recently, immunotherapeutics targeting specific immune cell subsets have entered the clinic with promising early results. Radiobiological research is underway to address pressing questions as to the dose per fraction, irradiated tumor volume and time sequence of the drug administration. To exploit these exciting novel strategies, a better understanding is needed of the cellular and molecular pathways responsible for both cancer and normal tissue and organ response, including the role of radiation-induced accelerated senescence. This review will highlight the current understanding of promising biologically targeted therapies to enhance the radiation therapeutic ratio.

A Correction Method of Dose to Attenuation Rate of Transmitting Photon Beam Through Couch Top for Radiosurgery Using Novalis (노발리스를 이용한 방사선 수술시 치료테이블을 투과하는 광자선의 감쇠율에 따른 선량 보정방법)

  • Kim, Sung-Joon;Shin, Hyun-Soo;Ko, Seung-Young;Park, Hye-Li;Kim, Ja-Young;Lee, Bo-Mi;Yea, Ji-Woon;Kim, Sung-Kyu
    • Progress in Medical Physics
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    • v.22 no.1
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    • pp.12-17
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    • 2011
  • This study has its own goal to deliver the accurate dose on the target volume by calculating and modifying the attenuation rate of photon beam transmitting the couch top with geometric model. The experiment was that the transmission rate and attenuation rate of photon beam transmitting the couch top was predicted by the geometric model, then compared and analyzed with what was measured experimentally based on that. The result showed that the predicted value by the geometric model accorded closely with the experimental value. In addition, in order to judge whether the practical clinical application is available, the point dose, measured after modifying the attenuation rate modelinged according to the treatment plan of a patient of spine radiosurgery, was compared with the one done nothing. The result was that the former showed decreased error range with treatment planned one than the latter. This papers calculated the transmission and attenuation rate with the geometric model transmitting the couch top and verified it experimentally. This method is expected to be very useful in not only the radiosurgery using Novalis but also the general radiation therapy.

The association of rectal equivalent dose in 2 Gy fractions (EQD2) to late rectal toxicity in locally advanced cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University

  • Tharavichtikul, Ekkasit;Meungwong, Pooriwat;Chitapanarux, Taned;Chakrabandhu, Somvilai;Klunklin, Pitchayaponne;Onchan, Wimrak;Wanwilairat, Somsak;Traisathit, Patrinee;Galalae, Razvan;Chitapanarux, Imjai
    • Radiation Oncology Journal
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    • v.32 no.2
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    • pp.57-62
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    • 2014
  • Purpose: To evaluate association between equivalent dose in 2 Gy (EQD2) to rectal point dose and gastrointestinal toxicity from whole pelvic radiotherapy (WPRT) and intracavitary brachytherapy (ICBT) in cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University. Materials and Methods: Retrospective study was designed for the patients with locally advanced cervical cancer, treated by radical radiotherapy from 2004 to 2009 and were evaluated by rectosigmoidoscopy. The cumulative doses of WPRT and ICBT to the maximally rectal point were calculated to the EQD2 and evaluated the association of toxicities. Results: Thirty-nine patients were evaluated for late rectal toxicity. The mean cumulative dose in term of EQD2 to rectum was 64.2 Gy. Grade 1 toxicities were the most common findings. According to endoscopic exam, the most common toxicities were congested mucosa (36 patients) and telangiectasia (32 patients). In evaluation between rectal dose in EQD2 and toxicities, no association of cumulative rectal dose to rectal toxicity, except the association of cumulative rectal dose in EQD2 >65 Gy to late effects of normal tissue (LENT-SOMA) scale ${\geq}$ grade 2 (p = 0.022; odds ratio, 5.312; 95% confidence interval, 1.269-22.244). Conclusion: The cumulative rectal dose in EQD2 >65 Gy have association with ${\geq}$ grade 2 LENT-SOMA scale.

ATM-induced Radiosensitization in vitro and in vivo

  • Choi, E.K.;Ahn, S.D.;Rhee, Y.H.;Chung, H.S.;Ha, S.W.;Song, C.W.;Griffin, R.J.;Park, H.J.
    • Proceedings of the Korean Biophysical Society Conference
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    • 2002.06b
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    • pp.52-52
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    • 2002
  • It has been known that ATM plays a central role in response of cells to ionizing radiation by enhancing DNA repair. We have investigated the feasibility of increasing radiosensitivity of tumor cells with the use of ATM inhibitors such as caffeine, pentoxifylline and wortmannin. Human colorecta1 cancer RKO.C cells and RKO-ATM cells (RKO cells overexpressing ATM) were used in the present study. (omitted)

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An Experimental Dosimetry of Irregularly Shaped Fields Using Therapeutic Planning Computer (치료계획용 컴퓨터를 이용한 부정형조사면의 선량분포에 관한 실험)

  • Kwon Hyoung Cheol;Oh Yoon Kyeong;Yoon Sei Chul;Bahk Young Whee
    • Radiation Oncology Journal
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    • v.2 no.2
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    • pp.281-285
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    • 1984
  • The authors have intended to measure intrinsic dose distribution by Farmer dosimeter in irregularly shaped fields such as L.M and T shape models in order to determine dose inhomogeneity in those models. We made 2 off·axis points in each model and measured the depth dose at 1.5, 5 and 9cm below surface. The results showed $l\~3\%$ dose discrepancy between 2 points. We also measured the depth dose by geometric approximation and computer calculation in those models, and came to the conclusion that computer calculation using Clarkson's principle is simpler and the measurements are closer to the ideal data obtained by the experiment in three models of irregularly shaped fields than those of geometric approximation method.

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