• Title/Summary/Keyword: radiation dermatitis

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Evaluations and Comparisons of Body Surface Doses during Breast Cancer Treatment by Tomotherapy and LINAC Radiotherapy Devices

  • Lee, Hyun-Jik;Bae, Sun-Hyun;Cho, Kwang Hwan;Jeong, Jae-Hong;Kwon, Su-Il;Lee, Kil-Dong
    • Progress in Medical Physics
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    • v.28 no.4
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    • pp.218-225
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    • 2017
  • Effects on skin caused by the dose from linear accelerator (LINAC) opposing portal irradiation and TomoDirect 3-D modeling treatment according to the radiation devices and treatment methods were measured, and a comparative analysis was performed. Two groups of 10 patients each were created and measurements were carried out using an optically stimulated luminescence dosimeter. These patients were already receiving radiation treatment in the hospital. Using the SPSS statistical program, the minimum and maximum average standard deviations of the measured skin dose data were obtained. Two types of treatment method were selected as independent variables; the measured points and total average were the dependent variables. An independent sample T-test was used, and it was checked whether there was a significance probability between the two groups. The average of the measured results for the LINAC opposing portal radiation was 117.7 cGy and PDD 65.39% for the inner breast, 144.7 cGy and PDD 80.39% for the outer breast, 143.2 cGy and PDD 79.56% for the upper breast, 151.4 cGy and PDD 84.11% for the lower breast, 149.6 cGy and PDD 83.11% for the axilla, and 141.32 cGy and PDD 78.51% for the total average. In contrast, for TomoDirect 3-D conformal radiotherapy, the corresponding measurement values were 137.6 cGy and PDD 76.44%, 152.3 cGy and PDD 84.61%, 148.6 cGy and PDD 82.56%, 159.7 cGy and PDD 88.72%, and 148.6 cGy PDD 82.56%, respectively, and the total average was 149.36 cGy and PDD 82.98%. To determine if the difference between the total averages was statistically significant, the independent sample T-test of the SPSS statistical program was used, which indicated that the P-value was P=0.024, which was 0.05 lower than the significance level. Thus, it can be understood that the null hypothesis can be dismissed, and that there was a difference in the averages. In conclusion, even though the treatment dose was similar, there could be a difference in the dose entering the body surface from the radiation treatment plan; however, depending on the properties of the treatment devices, there is a difference in the dose affecting the body surface. Thus, the absorbed dose entering the body surface can be high. During breast cancer radiotherapy, radiation dermatitis occurs in almost all patients. Most patients have a difficult time while undergoing treatment, and therefore, when choosing a radiotherapy treatment method, minimizing radiation dermatitis is an important consideration.

Three Weekly Versus Weekly Cisplatin as Radiosensitizer in Head and Neck Cancer: a Decision Dilemma

  • Negi, Preety;Kingsley, Pamela Alice;Srivastava, Himanshu;Sharma, Surender Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1617-1623
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    • 2016
  • Cisplatin-based concurrent chemoradiation plays an undisputed key role as definitive treatment in unresectable patients with locally advanced squamous cell carcinoma head and neck or as an organ preservation strategy. Treatment with 100 mg/m2 3-weekly cisplatin is considered the standard of care but is often associated with several adverse events. The optimum drug schedule of administration remains to be defined and presently, there is insufficient data limiting conclusions about the relative tolerability of one regimen over the other. This review addresses regarding the optimal dose schedule of cisplatin focusing mainly on three-weekly and weekly dose of cisplatin based concurrent chemoradiotherapy in locally advanced head and neck cancer with an emphasis on mucositis, dermatitis, systemic toxicity, compliance, and treatment interruptions. To derive a definitive conclusion, large prospective randomized trials are needed directly comparing standard 3-weekly cisplatin ($100mg/m^2$) with weekly schedule ($30-40mg/m^2$) of concurrent cisplatin based chemoradiotherapy in locally advanced squamous cell carcinoma head and neck.

Prognostic Value of Osteopontin in Patients Treated with Primary Radiotherapy for Head and Neck Cancer

  • Etiz, Durmus;Ataizi, Fulya Colak;Bayman, Evrim;Akcay, Melek;Acikalin, Mustafa Fuat;Colak, Ertugrul;Ciftci, Evrim
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5175-5178
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    • 2013
  • Background: The prognostic value of tumor osteopontin (OPN) in patients with squamous-cell head and neck cancer (SCHNC) was investigated. Materials and Methods: OPN expression was assessed by immunohistochemical methods in 50 patients, who were treated with primary radiotherapy (RT) for locally advanced SCHNC. The effects of OPN on clinical parameters, local-regional control after RT and metastasis-free survival, was assessed. Results: The rate of OPN expression in tumor tissue was 76%. OPN positive cases had lower Hb levels (p=0.088). Mean time to local recurrence was 53.8 months (SE 3.9) in OPN-negative cases and 39.1 months (SE 4.7) in OPN-positive cases (p=0.047). OPN increased the risk of local recurrence 5.9 times (p=0.085). It had no effect on metastasis-free (p=0.116) or overall survival (p=0.123). OPN was positive in 12 of 19 cases that developed grade 3-4 acute radiation dermatitis (p=0.096). Conclusions: OPN expression is associated with an increase in local recurrence in patients who were treated with primary RT for locally advanced SCHNC.

Comparison of dose-variation in skin due to Set-up error in case of radiation therapy for left breast using Volumetric Modulated Arc Therapy(VMAT) (좌측 유방에 대한 용적 변조 회전 방사선 치료 시 자세 오차로 인한 피부 선량)

  • Kwon, Yongjae;Park, Ryeunghwang;Kim, Seyoung;Jung, Dongmin;Baek, Jonggeol;Cho, Jeonghee
    • The Journal of Korean Society for Radiation Therapy
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    • v.33
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    • pp.55-62
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    • 2021
  • Purpose: This study aims to contribute to the reduction of complications of breast cancer radiation therapy by analyzing skin dose differences due to Set-up error. Materials and Method: Pseudo breast was produced using a 3D printer, applied to the phantom, and images were acquired through CT. Treatment plan was carried out that the PTV, which contains 95% of the prescription dose, could be more than 95% of the volume, so that Dmax did not exceed 107% of the prescription dose. The Set-up error was evaluated by applying ±1mm/±3mm/±5mm to the X-axis, Y-axis, and Z-axis. Results: The dose-variation in skin due to Set-up error was approximately 106% to 123% compared to prescription dose, and the highest dose in skin was 49.24 Gy at 5mm Set-up error in the lateral direction of the X-axis. More than 107% of the prescription dose was the widest at 6.87 cc in skin lateral. Conclusions: If a Set-up error occurs during left breast cancer VMAT, a great difference in skin dose was shown in the lateral direction of the X-axis. If more effort is made to align the X-axis of the breast treated during CBCT registration, the dose-variation of skin will be reduced.

Treatment outcomes of radiotherapy for anaplastic thyroid cancer

  • Park, Jong Won;Choi, Seo Hee;Yoon, Hong In;Lee, Jeongshim;Kim, Tae Hyung;Kim, Jun Won;Lee, Ik Jae
    • Radiation Oncology Journal
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    • v.36 no.2
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    • pp.103-113
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    • 2018
  • Purpose: Anaplastic thyroid cancer (ATC) is a rare tumor with a lethal clinical course despite aggressive multimodal therapy. Intensity-modulated radiotherapy (IMRT) may achieve a good therapeutic outcome in ATC patients, and the role of IMRT should be assessed. We retrospectively reviewed outcomes for ATC treated with three-dimensional conformal radiotherapy (3D-CRT) or IMRT to determine the optimal treatment option and explore the role of radiotherapy (RT). Materials and Methods: Between December 2000 and December 2015, 41 patients with pathologically proven ATC received RT with a sufficient dose of ${\geq}40Gy$. Among them, 21 patients (51%) underwent surgery before RT. Twenty-eight patients received IMRT, and 13 received 3D-CRT. Overall survival (OS) and progression-free survival (PFS), patterns of failure, and toxicity were examined. Results: The median follow-up time for survivors was 38.0 months. The median and 1-year OS and PFS rates were 7.2 months and 29%, 4.5 months and 15%, respectively. Surgery significantly improved the prognosis (median OS: 10.7 vs. 3.9 months, p = 0.001; median PFS: 5.9 vs. 2.5 months, p = 0.007). IMRT showed significantly better PFS and OS than 3D-CRT, even in multivariate analysis (OS: hazard ratio [HR] = 0.30, p = 0.005; PFS: HR = 0.33, p = 0.005). Significantly higher radiation dose could be delivered with IMRT than 3D-CRT ($EQD2_{10}$ 66 vs. 60 Gy, p = 0.005). Only 2 patients had grade III dermatitis after IMRT. No other severe toxicity ${\geq}grade$ III occurred. Conclusion: Patients with ATC showed better prognosis through multimodal treatment. Furthermore, IMRT could achieve favorable survival rates by safely delivering higher dose than 3D-CRT.

Suppressive Effects of Fucoxanthin on Degranulation in IgE-antigen complex-stimulated RBL-2H3 Cells

  • NamKoong, Seung;Joo, Hae-Mi;Jang, Seon-A;Kim, Ye-Jin;Kim, Tae-Seong;Sohn, Eun-Hwa
    • Korean Journal of Plant Resources
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    • v.25 no.3
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    • pp.339-345
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    • 2012
  • The marine carotenoid fucoxanthin can be found in marine brown seaweeds, macroalgae, diatoms, and microalgae, and has remarkable biological properties. Numerous studies have shown that fucoxanthin has considerable potential and promising applications in human health, but the underlying mechanisms involved in its anti-allergic activity are not fully understood. We here investigated the mechanisms by anti-allergic activity of fucoxanthin fraction from Eisenia bicyclis in immunoglobulin E-antigen complex (IgE/DNP-BSA)-stimulated RBL-2H3 mast cells. This study we found that the fucoxanthin inhibits the release of ${\beta}$-hexosaminidase and suppressed not only transcriptional activation of NF-${\kappa}B$, but also phosphorylation of ERK and JNK in IgE/DNP-BSA-treated RBL-2H3 cells. Fucoxanthin may be useful for preventing allergic diseases, including asthma and atopic dermatitis.

급성 화폐상 습진을 동반한 아토피 피부염 환자의 한방치험 1례

  • Kim, Hye-Jeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.1
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    • pp.111-116
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    • 2001
  • Nummular eczema is well-shaped, coin-like lesion. Usually it is surrounded by the papules and vesicles, and is likely to be the impetigo. It's said that nummular eczema is combined with atopic dermititis, contact dermatitis, bacterial infection and so on. Recently, we experienced a nummular eczema with impetigo and that was successfully treated by the herb-medication and the ceramic resonance therapy. The medications taken by the patient were yunwhasagnatang and gamisopungsan which is used to treat allergic disease and make immune system be strong. The former effects the liver to be cool down and healthy and it also has anti-imflamatory reactions like the corticosteroid hormone. Ceramic resonance therapy utilises irradiation within the frequency range of the radiation emitted by the human body. So we report this case with a brief review of the oriental medical and medical literatures.

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Radiation Therapy in Elderly Skin Cancer (노령의 피부암에서 방사선치료)

  • Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.26 no.2
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    • pp.113-117
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    • 2008
  • Purpose: To evaluate the long term results(local control, survival, failure, and complications) after radiation therapy for skin cancer in elderly patients. Material and Methods: The study spanned from January 1990 to October 2002. Fifteen elderly patients with skin cancer were treated by radiotherapy at the Keimyung University Dongsan Medical Center. The age distribution of the patients surveyed was 72 to 95 years, with a median age of 78.8 years. The pathologic classification of the 15 patients included squamous cell carcinoma(10 patients), basal cell carcinoma(3 patients), verrucous carcinoma(1 patient) and skin adnexal origin carcinoma(1 patient). The most common tumor location was the head(13 patients). The mean tumor diameter was 4.9 cm(range 2 to 9 cm). The radiation dose was delivered via an electron beam of 6 to 15 MeV. The dose range was adjusted to the tumor diameter and depth of tumor invasion. The total radiation dose ranged from $50{\sim}80$ Gy(mean: 66 Gy) with a 2 Gy fractional dose prescribed to the 80% isodose line once a day and 5 times a week. One patient with lymph node metastasis was treated with six MV photon beams boosted with electron beams. The length of the follow-up periods ranged from 10 to 120 months with a median follow-up period of 48 months. Results: The local control rates were 100%(15/15). In addition, the five year disease free survival rate(5YDFS) was 80% and twelve patients(80%) had no recurrence and skin cancer recurrence occurred in 3 patients(20%). Three patients have lived an average of 90 months($68{\sim}120$ months) without recurrence or metastasis. A total of 9 patients who died as a result of other causes had a mean survival time of 55.8 months after radiation therapy. No severe acute or chronic complications were observed after radiation therapy. Only minor complications including radiation dermatitis was treated with supportive care. Conclusion: The results suggest that radiation therapy is an effective and safe treatment method for the treatment of skin cancer in elderly patients who achieved a good survival rate and few minor complications.

Concurrent Chemoradiation with Weekly Cisplatin for the Treatment of Head and Neck Cancers: an Institutional Study on Acute Toxicity and Response to Treatment

  • Ghosh, Saptarshi;Rao, Pamidimukkala Brahmananda;Kumar, P Ravindra;Manam, Surendra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7331-7335
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    • 2015
  • Background: Concurrent chemoradiation with three weekly high dose cisplatin is the non-surgical standard of care for the treatment of locally advanced head and neck cancers. Although this treatment regime is efficacious, it has high acute toxicity, which leads not only to increased treatment cost, but also to increased overall treatment time. Hence, the current study was undertaken to evaluate the acute toxicity and tumor response in head and neck cancer patients treated with concurrent chemoradiation using $40mg/m^2$ weekly cisplatin, which has been our institutional practice. Materials and Methods: This single institution retrospective study included data for 287 head and neck cancer patients treated with concurrent chemoradiation from 2012 to 2014. Results: The mean age of the patients was 48.8 years. The most common site of involvement was oral cavity. Most of the study patients presented with advanced stage disease. The mean overall treatment time was 56.9 days. Some 67.2% had overall complete response to treatment as documented till 90 days from the start of treatment. According to the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, mucositis was seen in 95.1% of the patients. Dermatitis and emesis were observed in 81.9% and 98.6%, respectively. Regarding haematological toxicity, 48.8% and 29.6% suffered from anaemia and leukopenia, respectively, during treatment. Acute kidney injury was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), and was found in 18.8% of the patients. Conclusions: Concurrent chemoradiotherapy with weekly cisplatin is an effective treatment regime for head and neck cancers with reasonable toxicity which can be used in developing countries, where cost of treatment is so important.

Chemoradiation Related Acute Morbidity in Carcinoma Cervix and Correlation with Hematologic Toxicity: A South Indian Prospective Study

  • Kumaran, Aswathy;Guruvare, Shyamala;Sharan, Krishna;Rai, Lavanya;Hebbar, Shripad
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4483-4486
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    • 2014
  • Purpose: To assess chemoradiation related acute morbidity in women with carcinoma cervix and to find and correlation between hematologic toxicity and organ system specific damage. Materials and Methods: A prospective study was carried out between August 2012 and July 2013 enrolling 79 women with cancer cervix receiving chemo-radiotherapy. Weekly assessment of acute morbidity was done using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 4 and the toxicities were graded. Results: Anemia [77 (97.5%)], vomiting [75 (94.8%)] and diarrhea [72 (91.1%)], leukopenia [11 (13.9%)], cystitis [28 (35.4%], dermatitis [19 (24.1%)] and fatigue [29 (36.71%)] were the acute toxicities noted. The toxicities were most severe in $3^{rd}$ and $5^{th}$ week. All women could complete radiotherapy except two due to causes unrelated to radiation morbidity; seven (8.86%) had to discontinue chemotherapy due to leukopenia and intractable diarrhea. Though there was no correlation between anemia and other toxicities, it was found that all with leukopenia had diarrhea. Conclusions: Chemoradiation for cancer cervix is on the whole well tolerated. Leukopenia and severe diarrhea were the acute toxicities that compelled discontinuation of chemotherapy in two women. Though anemia had no correlation with gastrointestinal toxicity, all of those with leukopenia had diarrhea.