Purpose The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques. Patients and Methods Radiotherapy was applied using the 2D conventional technique between 1991 and 2004 (130 patients), 3DCRT until 2014 (125 patients), and by VMAT until January 2017 (44 patients). Clinical T stages were 38 (12.7%) for Tis, 209 (69.9%) for T1, and 52 (17.4%) for T2. Radiotherapy technique and energy, anterior commissure involvement, and stage were analyzed as prognostic factors. Results The median total dose was 66 (50–70) Gy, and median follow-up time was 72 (3–288) months; 5-year disease-specific survival (DSS) rates were 95.8%, 95.5%, and 88.6%, respectively, in Tis, T1, and T2 stages. In multivariate analyses, anterior commissure involvement was found significant for all survival and local control rates. The patients treated with VMAT technique had better local control and DSS rates. However, these results were not statistically significant. Conclusion In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality, regardless of treatment techniques.
This study aimed to compare the dose-volume parameters of organs at risk (OAR) (bladder, rectum, sigmoid and bowel) for the bladder filling of 50cc versus 150cc in high-dose-rate (HDR) (3-D) vaginal cuff (VC) brachytherapy (BRT). METHODS The treatment data of eight hysterectomized patients with gynecological malignancy who received postoperative pelvic external radiotherapy (RT)+3-D HDR VC-BRT were analyzed. Recontouring was performed on CT images, and BRT plans were reformed. Proximal 1/3 vagina was treated in all patients using a cylinder. A total dose of 18 Gy (3x6Gy) was given (0.5 cm depth from the vaginal mucosa). OAR and clinical target volume (CTV) were recontoured in a 3-D manner. Afterwards, treatment planning was performed by a medical physicist using the BRT treatment planning system. Bladder V50%, D50% and D2cc, rectum D2cc, sigmoid D2cc, bowel D50% and D2cc were recorded from the dose-volume histograms obtained in the treatment planning system. Paired comparisons were made for the parameters above for the bladder filling of 50cc versus 150cc. Two different amounts of bladder filling were compared using the Wilcoxon Signed-Rank Test in the SPSS 15.0 statistics program. RESULTS Bladder D50% decreased (p=0.012) while bladder D2cc increased (p=0.025) in the case of 150cc bladder filling instead of 50cc. Rectum D2cc showed a statistical trend for increase (p=0.05); however, bowel D50% decreased (p=0.012) in 150cc bladder filling compared to 50cc. CONCLUSION The statistically significant decrease in bladder and especially bowel D50% parameters supports filling the bladder with 150cc instead of 50cc in 3-D VC-BRT.
Objective: Our study presents a case with locally-advanced non-small cell lung cancer (NSCLC) having salvage pneumonectomy due to persistent disease. Case Description: A 46-year old man with stage IIIB (cT4N3M0) NSCLC received 39Gy (13x3Gy) thoracic radiotherapy after neoadjuvant chemotherapy. Partial response was obtained after radiotherapy. Chemotherapy was continued after radiotherapy. At 28th month of followup without treatment, isolated local progression was detected. The patient underwent right pneumonectomy and mediastinal lymph node dissection revealing ypT2aN0 adenocarcinoma. After adjuvant chemotherapy, he's disease-free at 88 months after salvage surgery. Conclusion: In selected patients, salvage surgery seems to provide increased survival causing acceptable morbidity and mortality.
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