International Journal of Cancer Therapy and Oncology
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Simultaneous integrated boost by RapidArc therapy plus temozolomide for treatment of patients with glioblastoma multiform: A single institution experience
Get PDFPurpose: The aim of this study is to report the treatment outcomes, toxicities, and dosimetric feasibility of simultaneous integrated boost by RapidArc (RA-SIB) compared with 3dimentional-conformal radiation therapy (3D-CRT) for patients with glioblastoma. Methods: Eleven patients with unifocal glioblastoma (grade IV astrocytoma, WHO classification) were treated during the period from April 2011 until February 2013 with postoperative irradiation and concomitant temozolomide 75 mg/m2 followed by 6-12 months of adjuvant temozolomide 200 mg/m2 for 5 days/4weeks. One patient received temozolomide for 12 months, 5patients for 6 months, and 5patients did not receive adjuvant temozolomide. RA-SIB technique was used and patients received 46 Gy per fraction of 2 Gy in 23 sessions on the planning target volume (PTV1) (contrast enhancement + per-focal edema as seen in T2 MR + 2.3 cm) with concomitant daily superimposed boost (SIB) on PTV2 corresponding to the contrast enhancement + 2.3 cm. The treatment outcomes and toxicity were assessed. Dose Volume Histogram DVH analysis was performed between SIB-RA and 3D-CRT plans of each patient. For the PTV, the comparison parameters included, the mean dose, the standard deviation, maximum dose, conformity index (CI), and homogeneity index (HI). Results: The median progression free survival (PFS) and overall survival (OS) were 13 months (95% CI, 8.2-17.8), and 16 months (95% CI, 2.1-29.9) respectively. Four of six patients (67%) showed local progression (recurrence) after initial response, all recurrences occurred at the site of PTV2. Seven patients experienced acute grade 1-2 toxicities during the treatment. Late post radiation brain edema was reported in 3 patients. Conclusion: The SIB-RA did not prove the superiority in survival outcomes compared with the historical data using 3D-CRT. From the dosimetric standpoint, SIB-RA is a superior technique with respect to 3D-CRT when there are overlaps between organs at risk (OARs) and PTV
Total Body Irradiation using VMAT (RapidArc): A Planning Study of a novel treatment delivery method
Get PDFPurpose: To evaluate the feasibility of using volumetric modulated arc therapy (VMAT) using RapidArc to deliver total body irradiation (TBI) treatment. Methods: VMAT planning was performed a whole body computed tomography (CT) data set using Rapid Arc. The planning target volumes included entire body trimmed to 3 mm below the skin. The organs at risk included the lungs and kidneys. A dose of 12 Gy in 10 fractions was prescribed to the target volume. The VMAT-TBI technique consisted of three isocentres and three overlapping arcs: the head and neck, the chest, and the pelvis. The plans were prescribed to ensure, at a minimum, 95% planning target volume dose coverage with the prescription dose (percentage of volume receiving dose of 12 Gy was 95%) and maximum dose of 109.8%. Mean dose to lung was restricted at 8.6Gy. Results: The total body volume in the study was 15469cm3 and the PTV volume was 11322cm3. The mean dose to PTV was 104%. The homogeneity index was 0.09. Sparing of normal tissues with adequate coverage of skeletal bones was shown to be feasible with Rapid Arc. The study demonstrates that VMAT is feasible for TBI treatment. Unlike conventional TBI chest wall boost with electrons was not required. Conclusion: The technique for total body irradiation using RapidArc VMAT was found feasible and is undergoing further studies prior to clinical use
Accurate Determination of the Pathological Stage with the Gross Dissection Protocol for Radical Cystectomy (GDPRC) in Daily Routine Diagnostics
No full textPurpose: The currently protocol for reporting urinary bladder cancer in radical cystectomies may exhibit limitations in the diagnostic accuracy, such as the risk for understaging, especially of cases in prostatic involvement. Difficulty exists in the verification of stage pT0 and assessment of surgical margins is suboptimal. Eliminate the potential compromises in sampling, we developed a daily practice gross dissection protocol where the radical cystectomies were totally embedded and evaluated histologically in whole-mount sections.Methods: Here were reported the first 138 consecutive specimens from 99 men and 39 women from 2008 to the first quarter of 2012 inclusive; 9.2 macroblocks and 14 standard blocks were examined on overage. The incidence of cancer stages of our series was compared with the incidence of cancer stages, determined by retrieving the stage data of 15586 radical cystectomies from the literature. The differences were analyzed with the one-sample z-test (p <0.05).Results: The following values were obtained (the first refers to our series): pT0 8.7% and 6.1%; pTa 0.7% and 2.9%; pTis 2.9% and 6%; pT1 15.2% and 15.5%; pT2 21% and 23.3%; pT3 34.8% and 34.3%; and pT4 16.7% and 11%.Conclusion: Our findings closely reflected the means of the published statistical data based on a large number of cases. The differences were due to the more detailed processing: the case numbers in groups pTis-pT2 were comparatively low, those in groups pT3-pT4 were higher. The difference found in group pT4 was significant. (p = 0.0494) With this method only those samples were regarded as pT0 in which the granulomatous area and the haemosiderin deposition indicative of the earlier intervention were observable and the entire preparation was tumor-free. Although our protocol was three times more expensive than the currently used and the reporting time took four hours by identifying all features that can guide postoperative treatment has the monopoly of diagnostic accuracy.-----------------------------------------Cite this article as: Sükösd F, Iványi B, Pajor L. Accurate Determination of the Pathological Stage with the Gross Dissection Protocol for Radical Cystectomy (GDPRC) in Daily Routine Diagnostics . Int J Cancer Ther Oncol 2015; 3(4):3407.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
A mathematical model of cancer cells with phenotypic plasticity
No full textPurpose: The phenotypic plasticity of cancer cells is recently becoming a cutting-edge research area in cancer, which challenges the cellular hierarchy proposed by the conventional cancer stem cell theory. In this study, we establish a mathematical model for describing the phenotypic plasticity of cancer cells, based on which we try to find some salient features that can characterize the dynamic behavior of the phenotypic plasticity especially in comparison to the hierarchical model of cancer cells. Methods: We model cancer as population dynamics composed of different phenotypes of cancer cells. In this model, not only can cancer cells divide (symmetrically and asymmetrically) and die, but they can also convert into other cellular phenotypes. According to the Law of Mass Action, the cellular processes can be captured by a system of ordinary differential equations (ODEs). On one hand, we can analyze the long-term stability of the model by applying qualitative method of ODEs. On the other hand, we are also concerned about the short-term behavior of the model by studying its transient dynamics. Meanwhile, we validate our model to the cell-state dynamics in published experimental data.Results: Our results show that the phenotypic plasticity plays important roles in both stabilizing the distribution of different phenotypic mixture and maintaining the cancer stem cells proportion. In particular, the phenotypic plasticity model shows decided advantages over the hierarchical model in predicting the phenotypic equilibrium and cancer stem cells’ overshoot reported in previous biological experiments in cancer cell lines.Conclusion: Since the validity of the phenotypic plasticity paradigm and the conventional cancer stem cell theory is still debated in experimental biology, it is worthy of theoretically searching for good indicators to distinguish the two models through quantitative methods. According to our study, the phenotypic equilibrium and overshoot behavior can be good candidates to validate the phenotypic plasticity in comparison to the cellular hierarchy of cancer cells.-----------------------------------------Cite this article as: Zhou D, Chen X, Zhang X. A mathematical model of cancer cells with phenotypic plasticity. Int J Cancer Ther Oncol 2015; 3(4):3402.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
Prostate cancer research in India: A scientometric analysis of publications output during 2004-13
Get PDFThis review article examines 1,368 publications on prostate cancer in India, as covered in Scopus database during 2004-13, experiencing an annual average growth rate of 18.77% and citation impact of 5.23. The world prostate cancer output (89,994 publications) came from several countries, of which the top 15 (United States, United Kingdom, Germany, Canada, Italy, Japan, and China) accounts for 94.80% share of the global output during 2004-13. India’s global publication share was 1.52% and hold 14th rank in global publication output during 2004-13. The Indian prostate cancer output came from several organizations and authors, of which the top 20 and 19 contributed 41.81% and 24.05% share, respectively, during 2004-13. India’s international collaborative share in prostate cancer was 23.39%, which decreased from 24.42% to 22.98% from 2004-08 to 2009-13. Medicine accounted for the largest share (59.50%) of output in prostate cancer followed by biochemistry, genetics and molecular biology (40.13%), pharmacology, toxicology & pharmaceutics (27.63%), chemistry (8.55%), agricultural and biological sciences (4.31% share), and immunology and microbiology (2.70% share) during 2004-13. Diagnosis, screening, chemotherapy, radiotherapy, pathology and prognosis together account for 60.24% publications share among treatments methods used in Indian prostate cancer research during 2004-13. Only Delhi, Maharashtra, Uttar Pradesh and Tamil Nadu together contributed 57.82% share in Indian publications output in prostate cancer during 2004-13. The authors stressed the need for developing national policy for prostate cancer which should take care of screening for detection and diagnosis, management and treatment options of the prostate cancer patients in India.
Extramedullary plasmacytoma of maxilla with cervical nodal metastasis associated with sinonasal aspergillosis
Get PDFExtramedullary plasmacytoma (EMP) is defined as neoplastic proliferation of plasma cells in the soft tissue. It represents approximately 3% of all plasma cell neoplasms. EMP of the head and neck are very uncommon tumors, representing approximately 0.4% of all head and neck malignancies; amongst them, plasmacytoma of the maxilla is extremely rare. We present a rare case of EMP which had metastasized to multiple cervical lymph nodes and was associated with aspergillosis. The possibility of extramedullary plasmacytoma should be considered when an elderly patient presents with symptoms of recurrent rhinosinusitis not responding to conservative management and imaging shows a destructive soft tissue mass
The effect of halofuginone on radiation-induced cardiovascular injury
Get PDFPurpose: The main purpose of this study was to evaluate the effects of Halofuginone on radiation-induced cardiovascular injury in a rat model. Methods: Sixty Wistar-Albino rats were divided into six groups (the control group, radiotherapy (RT) only group Irradiation (IR), 2.5 and 5 μg Halofuginone groups (Hal (2.5)/C and Hal (5.0)/C), and RT plus 2.5 and 5 μg Halofuginone groups (Hal (2.5)/IR and Hal (5.0)/IR). Rats were exposed to a single dose of 12 Gy irradiation generated by a linear accelerator. Halofuginone was applied intraperitoneally with daily doses. At the 6th and 16th weeks of RT, 5 rats from each group sacrificed and; heart and thoracic aorta tissues removed for both light microscopic and electron microscopic examinations. Results: Light microscopic examinations revealed that the endocardial thickness of all study groups was significantly different at 6th and 16th week of RT (p < 0.001 for both). Pair-wise comparisons showed that the differences were significant in IR- Hal (2.5)/IR (p < 0.001); IR-Hal (5.0)/IR (p < 0.001); and Hal (2.5)/IR-Hal (5.0)/IR (p = 0.001) at 16th week of RT. There were significant differences within the study groups regarding to the thoracic aorta fibrosis scores only at 16th week of RT (p = 0.002). Electron microscopic examinations demonstrated that there were significant differences between all the groups with respect to heart mitochondria scores at both 6th week and 16th weeks of RT (p < 0.001 for both). The differences between Hal (2.5)/IR and Hal (5.0)/IR with respect to the heart mitochondria scores were significant only at 16th week of RT (p = 0.001). Conclusion: These data demonstrated that Halofuginone may improve radiation-induced cardiovascular injury. The most prominent improvement was observed in higher dose of Halofuginone group after long term follow-up
High Impact Papers from April – June, 2014
No full textHigh impact papers from a particular Issue are selected based on the quality of the article and the number of citations. High impact papers are typically recognized once the Issuecompletes the publication time period of 12 months.Following articles are recognized as High Impact Papers from April-June, 2014: Rana S, Pokharel S, Zheng Y, Zhao L, Risalvato D, Vargas C, Cersonsky N. Treatment planning study comparing proton therapy, RapidArc and intensity modulated radiation therapy for a synchronous bilateral lung cancer case. Int J Cancer Ther Oncol 2014; 2(2):020216. DOI: 10.14319/ijcto.0202.16Read Download Citations Ulmer W. A new calculation formula of the nuclear cross-section of therapeutic protons. Int J Cancer Ther Oncol 2014; 2(2):020211. DOI: 10.14319/ijcto.0202.11Read Download CitationsWu D, Wei S, Luo C, Wu X, Feng Y, Zhang F, Nie L, Xia X. Clinical study on the sensitivity test guided hepato-arterial/portal -vein chemotherapy in patients with unresectable hepatocellar carci-noma. Int J Cancer Ther Oncol 2014; 2(2):02029. DOI: 10.14319/ijcto.0202.9Read Download Citations Amankwaa-Frempong E, Vernimmen F, Blay S, Ezhilalan R. Irradiation of lung and esophagus tumors: A comparison of dose distributions calculated by anisotropic analytical algorithm and pencil beam convolution algorithm, a retrospective dosimetric study. Int J Cancer Ther Oncol 2014; 2(2):020210. DOI: 10.14319/ijcto.0202.10Read Download CitationsJassal K, Munshi A, Sarkar B, Paul S, Sharma A, Mohanti BK, Ganesh T, Chougule A, Sachdev K. Validation of an integrated patient positioning system: Exactrac and iViewGT on Synergy Platform. Int J Cancer Ther Oncol 2014; 2(2):020212. DOI: 10.14319/ijcto.0202.12Read Download Citations (High impact papers from July-September, 2014 will be recognized in the next Issue of the IJCTO
Decrease of anxio-depressive disorders in cancer with non drug psychotherapies
No full textBackground/Purpose: Cancer is well known for its psychological and psychiatric aftermath. About 40% of cancer patients present psychological or psychiatric troubles. First in contrast with the survival stakes, the psychopathological symptoms have been then ignored because they were confounding factors with the illness effect such as sadness, psychomotor slowing down or cognitive impairment. These troubles are now well known in international classifications (ICD, DSM-5) : from miss adaptation to delusion and especially anxio-depressive troubles.With its increasing worldwide frequency cancer has become a prominent figure of modern misfortune. Psycho-oncologyis the new branch of scientific knowledge that links cancer somatic consequences to their psychological expressions. Psycho-oncology opens a large area in psychopathology. But psycho-oncology is also interested in psychosociology. Cancer social representations interfere individually as with the group in cancer prevention and cancer detection.To decrease excessive anxiety in people cancer screening, countries must adapt their messages and work out a discourse that speaks to everybody. Furthermore, each gender, generation and personality has his specific prejudices. This reflexion introduces first attempts of setting limits to psychotraumatism in cancer disclosure. Many symptoms could be avoided with a right training of doctors and caregivers. To begin a specific way to announce cancer will be exposed with authentic and empathic progressive approach of truth.Methods: Qualitative methods are preferentially used to expose somebody to what the majority consider as a death threat. With the humanization of healthcare, doctors can not announce cancer anymore in a corridor nor by phone neither with an email. This first step of the « working alliance » between doctor and patient realizes the conditions of what Jimmie Holland calls the « patient total care » : a holistic approach of the patient in his environment. The second step is the restoration of the continuous identity of the patient despite the illness. The narration of his story is necessary to integrate the breach of the diagnosis. Listening to this story is often the task of the psychologist. Sometimes doctors or nurses try to consolidate the patient personality but it takes special skills and a lot of time. For example some specific questions like « What is difficult for you at this moment ? » or « what are your life priorities ? » can build a clinical approach, deeply in trapsychic more than humanistic. It’s an ethic matter. Some psychopathological symptoms may impair patients global state. The clinician may wonder about present symptoms as well as previous crisis disruptions. He will take into account the transference upon him, the caregivers and all the institution. Transferanceisa freudian concept thatincludesun conscious feelings usually reserved to parents but shifted on doctors or caregivers. The positive part of the transference will help patients to trust and accept to be cured by the oncology team.Results: Announcing cancer is the doctor’s work. In psychotraumatic conditions, a psychological accompanying is useful to help the patient to bind the traumatic disclosure to his emotional life. The psychodynamic therapy (PT) is a deep in trapsychic work while the cognitivo-behavioral therapy (CBT) is a way to adapt patient to illness and treatment. In PT patient is deeply committed to change his way of mentalizing (connecting affects to behaviors). Both are helpful without additional drugs.Conclusion: Psycho-oncological approach of cancer recognizes multi-factoriality of cancer aetiology and cure. Beyond simple understanding of psychological states it offers an integrative approach of the patient as a unique person in his culture and interpersonal environment.-----------------------------------------Cite this article as: Bacqué M. Decrease of anxio-depressive disorders in cancer with non drug psychotherapies. Int J Cancer Ther Oncol 2015; 3(4):3403.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.
The World Congress on Controversies in Breast Cancer (CoBRA) in Melbourne, Australia
No full textThe World Congress on Controversies in Breast Cancer (CoBRA) will take place October 22-24, 2015 in Melbourne, Australia.CoBRA is a concept congress dealing with controversial topics in breast cancer in the format of debates and discussions, allowing ample time for speaker-participant interaction.CLICK HERE for more informatio