The aim of this study is to present evaluation of treatment toxicity and the rate of local control in non-small cell lung cancer patients (NSCLC) treated with stereotactic body radiotherapy (SBRT). The analysis was performed on heterogenous group of 61 NSCLC patients, treated with SBRT between 2005 and 2008. It included 26 patients in clinical stage I, 5 in stage II, 22 in III and 8 in stage IV. In 30 patients SBRT was the only treatment, in 20 patients SBRT was a salvage therapy and in 11 patients SBRT was used as a boost after conventionally fractionated radiotherapy (CRT). The mean age was 67 yrs. Fifteen patients received chemotherapy in the course of treatment. Radiation doses were converted into Linear Quadratic Equivalent Dose at 2Gy per fraction (LQED2). The survival curves were plotted using Kaplan-Maier estimator and analyzed using log-rank test and Cox method. The LQED2 doses administered in stereotactic technique ranged from 8 Gy to 150 Gy and the fraction doses from 5 Gy to 24 Gy. The rate of 2 years local control correlated with LQED2: it was 81% in a group of patients who received over 110 Gy, compared to 51% and 33% in a group of patients who received 60-110 Gy and less than 30 Gy respectively. Prior radiotherapy and advanced clinical stage correlated with lower doses at SBRT and hence lower rate of local control. The tolerance of SBRT was satisfactory: there was no RTOG grade 3 - 4 toxicity. The results are consistent with findings of other authors and indicate that LQED2 doses delivered by SBRT in the treatment of NSCLC should be higher than 110 Gy whenever clinically feasible. SBRT used as a salvage therapy was less effective, because use of high doses was precluded due to consideration of normal tissue tolerance.

Purpose/Objective(s): Curative radiation therapy (RT) for locally advanced nasopharyngeal carcinoma (NPC) is based on the gross tumor volume (GTV), but the magnitude and timing of GTV changes during combined modality therapy remain unclear. This study analyzes GTV changes at phases of induction chemotherapy and sequential concurrent chemoradiation therapy (CRT) in patients with locally advanced NPC. Materials/Methods: Subjects included 13 patients with newly diagnosed stage III-IV NPC who underwent treatment between 2011 and 2014. Criteria for eligibility included 2 cycles of neoadjuvant chemotherapy, at least 5 cycles of concurrent chemotherapy and 3 magnetic resonance imaging (MRI) scans at specific phases of treatment (T0: before treatment, T1: postinduction, and T3: 3 months after CRT). The induction phase consisted of 2 cycles of gemcitabine and cisplatin. The CRT phase consisted of weekly cisplatin and RT delivered using volumetric modulated arc therapy (VMAT). The total dose was 70 Gy over 35 daily fractions administered 5 days/week. A subset of 3 patients received an additional MRI 4 to 5 weeks into CRT (T2). Primary gross tumor volume (GTVp) was defined as the GTV and adjacent involved retropharyngeal lymph nodes. Tumor volumes were delineated on gadolinium-enhanced fatsaturation T1 weighted MRIs by 2 observers. Mean values are reported +/one standard deviation. Results: Preliminary analysis included 6 (out of 13) subjects. The mean initial GTVp was 62.7 +/-32.8 mL. The mean GTVp response after induction phase was 21.4% +/-12.3% with a mean rate of volume change of 0.31 +/-0.19 mL/day which corresponded to a 0.56% +/-0.35% daily reduction in tumor volume. The total mean GTVp response after completion of treatment (T3) was 77.6% AE 21.6%. Subgroup analysis of subjects who underwent an additional MRI showed a mean GTVp reduction of 42.5% AE 22.6% and a mean rate of volume change of 0.87 AE 0.08 mL/day which corresponded to a 1.7% AE 0.93% daily reduction in tumor volume (from T1 to T2). Conclusion: Preliminary results suggest that the GTVp progressively diminishes following both induction chemotherapy and CRT. The mean GTVp response after 4 to 5 weeks of CRT exceeded the response observed after induction chemotherapy by a factor of 2. The mean rate of volume change at 4 to 5 weeks of CRT was threefold the rate seen during induction chemotherapy. These observations may support the optimal timing of imaging for replanning in the context of adaptive field RT. Analysis of the full NPC patient dataset is ongoing and will be reported.

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Circulating DNA is easy to obtain, convenient biological material, although quantitative analysis cannot be used as diagnostic tool, but it can be applied to determination of EGFR mutations, basis of the tyrosine kinase inhibitors application.

Hyperglycemia is frequently occurring in critically ill patients and the incidence is particularly high in patients receiving nutrition support. One of the forms of such nutrition is enteral nutrition, which is used particularly often. There are patients with type 1 diabetes, type 2 diabetes and other forms of diabetes as well as patients who have not previously been diagnosed with diabetes in this group of patients. The basis of pharmacotherapy in this case is an insulin therapy. The principles of such a therapy in patients with previously diagnosed diabetes are regulated by PTD guidelines. According to literature data, hyperglycemic patients with no previously diagnosed diabetes require special attention. The pathomechanism of these disorders is very complex and these patients require special care in determining the insulin therapy program. So far, there are no unambiguous guidelines in this area. (Clin