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Idasiak A.,II Klinika Radioterapii | Galwas-Kliber K.,II Klinika Radioterapii | Grzadziel A.,Zaklad Planowania Radioterapii i Brachyterapii | Stapor-Fudzinska M.,Zaklad Planowania Radioterapii i Brachyterapii | And 2 more authors.
Nowotwory | Year: 2011

Stereotactic body radiotherapy (SBRT) for non-small-cell lung cancer in early stages inoperable due to comorbidities, for solitary lung metastases or in case of recurrences of lung cancer after fractionated radiotherapy has gained increased attention over the last years. The present report describes our attempts to implement SBRT with real-time tumor tracking (CyberKnife system) in Gliwice. We also present a brief review of recent literature on this subject. Real-time tumor tracking accounts for tumor motion during respiration by constantly repositioning the radiation beam towards the moving target. This improves the isodose coverage of the tumor and contributes towards normal tissue sparing. A review of the published studies suggests that the control rates in early-stage primary lung cancer treated with SBRT range from 85% to 100%, with acceptable normal tissue reactions.


Introduction. Pancreatic cancer is the sixth highest cause of mortality in patients with malignant neoplasms in Poland. The results of treatment are poor and prognosis unfavourable. The basic method of treatment is surgery with adjuvant chemo or radiochemotherapy. Aim. The aim of the study was to compare CFRT (2F, 3F, 4F) and IMRT in planning of adiuvant radiotherapy for fifteen patients with pancreatic cancer. Material and method. For each patient from this group four treatment plans were performed: three for CFRT and one for IMRT. The CFRT plans consisted of two opposite fields (2F), two opposite fields and one oblique fields (3F), two lateral and two oblique fields (4F) and the IMRT plan. The treatment plans were performed to achieve a minimum dose to the PTV which was no lower than 95% of the total prescribed dose. Treatment plans were compared using dose-volume histograms (DVH) and using V20 parameter for left (LK) and right kidney (RK), V30 for liver (L), maximal dose for spinal cord (SC), maximal dose for intestines (IN), mean dose for whole liver and each kidney. The PTC (Percent Target Coverage), CI (Conformity Index) and HI (Homogenity Index) parameters were evaluated for each plan. For the evaluation of statistical significance the nonparametric Wilcoxon's test was performed. Results. The minimum dose in the PTV (PTVmin) for 2F plan was: 42.8 Gy, 3F - 42.9 Gy, 4F - 43.2 Gy and in IMRT - 43.2 Gy (p = 0.006). The maximal dose for spinal cord was acceptable in all plans (3F - 44 Gy, 4F - 42 Gy, IMRT - 45 Gy) except in 2F - 47.7 Gy (2F vs IMRT p = 0.00065, 3F vs IMRT p = 0.95, 4F vs IMRT p = 0.005). The median volume for each kidney V20 was comparable for all conformal plans. For the left kidney 44.7%, 41%, 40% for 2F, 3F and 4F respectively and 11.3%, 10.7%, 9.2% for the right kidney. The V20 for the left kidney was 18% and 6% for the right kidney using the IMRT plans (p < 0.002). The V30 for the liver was comparable for each of the plans: 2F - 8,3%, 3F - 8%, 4F - 7% and IMRT - 7%. (2F vs IMRT p = 0.015, 3F vs IMRT p = 0.04, 4F vs IMRT p = 0.36). The maximal dose to the intestines was acceptable in all plans 2F - 48.5 Gy, 3F - 47.0 Gy, 4F - 46.7 Gy, IMRT - 48.0 Gy (p = 0.001). Conclusions. Using IMRT in the planning of adjuvant radiotherapy for patients after surgery for pancreatic cancer achieves a better dose distribution and protection of kidneys compared to standard conformal planning. All techniques achieved a similar dose distribution in the liver and intestines. © 2013, Polskie Towarzystwo Onkologiczne.


Szczepanik K.,Zaklad Radioterapii | Jochymek B.,Zaklad Radioterapii | Kleszyk l.,Zaklad Radioterapii | Stapor-Fudzinska M.,Zaklad Planowania Radioterapii i Brachyterapii | Urbanczyk H.,Zaklad Radioterapii
Onkologia i Radioterapia | Year: 2011

The cancer of the lung is usually recognized in the advanced of the stage. A percentage of treated surgically sick persons is a measure of the problem in early recognizing, constituting 16 %, in Poland about 10 %. Manifestations associated with illness are usually associated with the presence of mass of the bump in bronchi. Such manifestations as noncharacteristic as cough belong to them (about 80 % patients), converting inflammatory conditions (40 %), airlessness (15 %), pain within the chest. This last manifestation is connected with running leak of the pleura, mediastinums, walls of the chest, of nervous trunks. Curing the lung cancer is difficult on account of frequent transportation through the lymphatic system. 3 procedures which are being entertained exist depending on the kind of cancer, the degree of the progress, the general state of health and the age of the person. If not transportation took place the operating treatment and the radiotherapy can contribute for total healing illness. If cancer of the lung is advanced, a chemotherapy which often consists of two medicines is applied. At first curing the forefront is abiding (combinations of four medicines based on platinum), but if it reaches a relapse, curing the back row, in which other medicines are being used is abiding. Good results in curing cancer of the flat-epithelial lung are being get at simultaneous radio and chemotherapy. © Onkologia I Radioterapia.


Glowacki G.,Zaklad Radioterapii | Miszczyk L.,Zaklad Radioterapii | losarek K.,Zaklad Planowania Radioterapii i Brachyterapii | Jochymek B.,Zaklad Radioterapii | And 10 more authors.
Nowotwory | Year: 2014

Allogenic and autologous hematopoietic stem cell transplantation (HSCT) is widely used for the treatment of many myeloid and lymphoid malignancies. Conditioning precedes bone marrow transplantation. Chemotherapy alone or with radiotherapy (TBI - total bone marrow irradiation) are used to conditioning. The proven efficacy of TBI means that the use of this conditioning is essential even though it is limited by adverse effects: both acute and late toxicity. New methods of irradiation are desirable.In our Institution we have performed a phase II study (ClinicalTrials.gov NCT01665014) from 2012 for patients with multiple plasmocytoma. The TMI we use is a modified form of TBI. It seems to be especially appropriate for the treatment of neoplasms located mainly or only in bone marrow (multiple myeloma, acute leukemias).Limitation of irradiated volumes only to bones probably will reduce a toxicity of treatment.Currently there are no internationally agreed methodological guidelines for TMI. Also there are only few publications on TMI. The aim of this paper is to introduce the methodology of TMI used in our department. © Polskie Towarzystwo Onkologiczne.

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