3/20/2024 0 Comments Iupui airfoil database![]() Tumor location had a significant (P = 0.001) influence on overall survival animals with cutaneous tumors had the longest survival times, and those with oral tumors had the shortest survival times. The estimated overall survival rate was 47% at 2 years. Of all the factors examined, complete response at 2 months, reirradiation field size less than or equal to 10 cm2, and reirradiation dose greater than 40 gray emerged as predictors of local tumor control. The estimated local tumor control rate was 38% at 1 year after reirradiation. Tumor response was significantly (P = 0.041) affected when the interval between the 2 courses of irradiation was greater than 5 months. ![]() Eighty-six percent of the tumors had partial or complete response at 2 months after reirradiation. Reirradiation of tumors in cats and dogs.įifty-one cats and dogs with tumor recurrence after irradiation were treated with a second course of radiotherapy, using either teletherapy or brachytherapy. As techniques are refined in proton therapy, we may be able to improve the therapeutic ratio by maintaining the benefits of radiotherapy while better minimizing the risks. In these settings, proton therapy may decrease toxicity associated with breast radiotherapy. Proton therapy may offer advantages compared to other techniques in the setting of breast boosts, accelerated partial breast irradiation, and post-mastectomy radiotherapy. Breast cancer is another emerging area of proton therapy development and use. Proton therapy has begun to be used for consolidation after chemotherapy in patients with Hodgkin and non-Hodgkin lymphoma. ![]() Late toxicities from even relatively low radiation doses, including cardiac complications and second cancers, are of concern in lymphoma patients with high cure rates and long life expectancies. Lymphoma is another special case where proton therapy may be advantageous. Chordomas and soft tissue sarcomas require particularly high radiation doses, posing additional challenges for re-irradiation. Proton therapy has been used in a limited number of patients with rectal, pancreatic, esophageal, and lung cancers. Re-irradiation may theoretically be made safer with proton therapy due to lower cumulative lifetime doses to sensitive tissues, such as the spinal cord. There are special cases where proton therapy may offer a substantial potential benefit compared to photon treatments where toxicity concerns dominate. The dose distributions that can be achieved with protons are usually superior to those of conventional photon external-beam radiation. Plastaras, John P Berman, Abigail T Freedman, Gary M ![]() Special cases for proton beam radiotherapy: re-irradiation, lymphoma, and breast cancer. Given the high mortality rate of CB, discussion of the risk of CB is an important component of informed consent for salvage reirradiation.« less The rate of CB was lower among patients treated with conventional or hyperfractionated schedules compared with regimens of accelerated hyperfractionation, though heterogeneous patient populations and treatment parameters preclude definite conclusions. Conclusion: Carotid blowout is an infrequent but serious complication of salvage reirradiation for H and N cancer. There was no statistically significant difference in the rate of CB between patients treated with or without concurrent chemotherapy, or between patients treated with or without salvage surgery before reirradiation. In patients treated in a continuous course with 1.8-2-Gy daily fractions or 1.2-Gy twice-daily fractions, 36% of whom received concurrent chemotherapy, the rate of CB was 1.3%, compared with 4.5% in patients treated with 1.5 Gy twice daily in alternating weeks or with delayed accelerated hyperfractionation, all of whom received concurrent chemotherapy (p = 0.002). Results: Among 1554 patients receiving salvage H and N reirradiation, there were 41 reported CBs, for a rate of 2.6% 76% were fatal. The cumulative risk of CB wasmore » compared between groups using Fisher's exact test. Treatment parameters, including prior radiation dose, interval from prior radiation, dose and fractionation of reirradiation, use of salvage surgery, and chemotherapy, were abstracted and summarized. Methods and Materials: A literature search identified 27 published articles on H and N reirradiation involving 1554 patients, and a pooled analysis was performed to determine the rate of CB. We sought to determine the reported rate of CB in patients receiving salvage reirradiation for H and N cancer. Purpose: Carotid blowout (CB) is a rare but frequently fatal complication of head-and-neck (H and N) cancer or its treatment. McDonald, Mark W., E-mail: Indiana University Health Proton Therapy Center, Bloomington, IN Moore, Michael G. Risk of Carotid Blowout After Reirradiation of the Head and Neck: A Systematic ReviewĭOE Office of Scientific and Technical Information (OSTI.GOV)
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